I’ll have to tackle my comments on the initiatives one at a time, because this would be way too long, and I’m unsure how many I’ll try to cover. I’ll start with the likely but unfortunately doomed Prop 23, regarding dialysis clinics.
First, for all of my comments, keep in mind that with nearly 40 million people in California now, nothing gets on the state initiative ballot without some big money behind it. If you can’t afford a regiment of paid signature gatherers across the state, you’re not getting anything on the ballot. Then if you can’t afford an advertising blitz once your initiative is on the ballot, you’re going to lose. So the first thing I do on all of these is follow the money to see where the money is coming from and what goals the funding groups have.
This became a little easier in 2014 when the Califorrnia Fair Political Practices Commission (FPPC) started posting lists of the top 10 contributors for and against ballot initiatives (and candidates, but that’s a different issue). Here’s the link to the FPPC Top-10 Contributors site. The FPPC’s list only includes, “the top 10 contributors to committees primarily formed to support or oppose state ballot measures and independent expenditure committees supporting or opposing state candidates that raised at least a million dollars.” So the list doesn’t include contributions from general committees (like a political party) or contributions under $1 million. When it comes to ballot initiatives, money from those sources is relatively so low they are irrelevant, so we’re not missing much of the big picture by excluding them.
My wife’s last job (before her health forced her to quit was working permanently) was with a non-profit that supervised & evaluated all of the dialysis centers in a big chunk of the LA area (there’s a bunch of these groups, hers covered basically the north & west side of Los Angeles, including the the San Fernando Valley, and to the northeast the San Gabriel Valley). Without fail, every quarter, every year, the dialysis centers with the worst patient outcomes (quality of life and additional lifespan), most infections, most complaints, least staffing, and highest death rates were the for-profit ones who are now against Prop 23. They used the same scare tactics to annihilate Proposition 8 in the November 2018 election. Prop 8 would have limited dialysis centers to a 15% profit, on the idea that the dialysis companies would then have to spend the extra money on more staff, maintenance, sanitation, equipment, etc. The money supporting Prop 8 came mostly from the healthcare worker unions because they were hoping it will create more jobs. With all of my wife’s health issues, we have come to know more than the average number of nurses and healthcare workers, so I like to think there’s some concern about patient welfare driving the unions as well (I could write an essay about the differences between what a union does & wants versus what its members do and want, but I’ll save that for another time).
So Prop 23 is the same song, second verse. If you look up Prop 23 on the FPPC site, you’ll see only a single entry in support of Prop 23, the “SEIU United Healthcare Workers West Political Action Committee.” They have contributed a total of $5,560,000. Sounds like a lot, until you look at the opposition side.
The donor list against Prop 23 has five entries, and includes the same giant for-profit dialysis companies that continually received poor or failing ratings from my wife’s former employer (which no longer exists, after being swallowed by a large for-profit version). Here’s the five listed “No on 23” donors and the amounts donated as of the time I write this post:
| 1 |
DaVita, Inc. |
DC |
+ |
$66,766,553 |
| 2 |
Fresenius Medical Care |
KS |
+ |
$28,780,597 |
| 3 |
US Renal Care, Inc. |
TX |
- |
$6,858,924 |
| 4 |
Dialysis Clinic, Inc. |
TN |
- |
$600,000 |
| 5 |
Satellite Heatlhcare, Inc. |
CA |
- |
$400,000 |
|
Total from top contributors |
$103,406,074 |
|
|
(Side note: Wow, the forum software did a excellent job of copy-pasting that table!)
Having a plus symbol means that donor has continued to make donations. A minus symbol means that donor has not donated any more, just the initial amount shown. So DaVita & FMC clearly continue shoveling money into the No on 23 campaign, and at the time I write this are outspending the healthcare unions 20:1. I asked my wife her opinion about the quality of care delivered by these large donors, and she politely described DaVita and FMC as “horrible,” and went on in some detail about their numerous, continued inspection failures and poor patient outcomes. She didn’t recognize the others, and thought the bottom two maybe were home dialysis providers, but I haven’t looked into them beyond that. (BTW, she also said that if you unfortunately require dialysis, the best results were always home dialysis. It is expensive, but the infection rates, length & qualify of life, etc. were always significantly better than any clinic. But because of the expense, it is hard to get covered by insurance.)
One thing that caught my eye is that Prop 23 would prohibit dialysis clinics from closing or significantly reducing their size without approval from the California Department of Public Health (because finding another dialysis location near a patient and with available capacity can sometimes take a while, and dialysis patients don’t have that time). In other words, despite the three or four patients that “No on 23” has managed to find who say that Prop 23 will kill them, right now there’s nothing stopping DaVita or FMC from simply closing or shrinking a less profitable location without notice. So if anyone is going to be killing patients by closing dialysis clinics, it is DaVita and FMC, and Prop 23 actually creates protections against that. Their ads are completely vague about why clinics might close after Prop 23, because they don’t want to say the actual reason: it would be DaVita or FMC deciding a clinic wasn’t profitable enough with the new staff & reporting requirements. But they would need the CDPH approval to do that if Prop 23 passes, so nobody is going to suddenly lose their access to dialysis and die. The dialysis giants will continue making high profits, and neither company has run for Bankruptcy Court after putting $105 million into their campaign against Prop 23 (so far), only two years after spending over $111 million to shoot down Proposition 8 and its 15% profit limit. The “No on 23” ads are incredibly misleading, and the truth is not the scary picture that flood of advertising is painting.
So, my recommendation is vote Yes on 23. My wife further recommends everyone pay attention to their renal health, because being on dialysis sucks.
