For the third election in a row, California voters this November will weigh a ballot initiative to put expensive new mandates on dialysis clinics. Is this some kind of odd obsession by grassroots activists? No, it’s a campaign by Big Labor to bleed dialysis providers and bully the industry into unionizing.
Prop. 29 would require dialysis clinics to have a physician, nurse practitioner or physician assistant “on-site during all patient treatment hours.” The measure is backed by the Service Employees International Union-United Healthcare Workers West, which has tried unsuccessfully to unionize the industry. The same union pushed dialysis initiatives that failed in 2018 and 2020.
the union’s press secretary, says in an email that two companies,
and Fresenius, “dominate the industry,” and “dialysis patients are suffering in the name of profit and don’t have many options to shop around for treatment.” She claims that Prop. 29 is needed “to protect dialysis patients and improve the care they receive.” Yet patients will likely enjoy far fewer treatment choices if the initiative passes.
The No on Prop. 29 committee, funded by dialysis providers, says the unnecessary new rules could cost each clinic between $376,000 and $731,000 a year, which would drive many into the red. That story is backed up by the state’s Legislative Analyst’s Office, which pegs the figure for each clinic at “several hundred thousand dollars annually.” Providers might “try to negotiate higher rates from payers,” it adds.
Some clinics could be forced to close entirely, disrupting treatment for thousands of Californians who need it to stay alive. The closure of some clinics and higher prices at those that remain could cost state and local governments “tens of millions of dollars annually,” the Legislative Analyst’s Office says.
Anticipating this criticism, the language of Prop. 29 says it would prohibit “clinics from closing or substantially reducing services without state approval.” That assumes California has the legal authority to force an unprofitable private business to stay open.
If Prop. 29 passes, dialysis clinics would have to spend even more to challenge that in court. Then again, imposing costs on the industry seems to be the point of the initiative.
of the L.A. Times reports that the union will spend about $10 million on Prop. 29, most of that on gathering signatures to get it on the ballot. The dialysis industry, which can’t afford to risk the initiative’s passage, will devote more like $86 million to fight it.
The SEIU-UHW’s “tacit message” to dialysis providers is to “allow unionizing or we’ll keep forcing you to spend big money opposing our initiatives,” Mr. Skelton concluded. “Political extortion was not what reformers intended when they created California’s system of direct democracy 111 years ago.”
Yet that’s how it’s being used. SEIU-UHW President
once described ballot measures “as a tool to exert union strength in bargaining,” according to the minutes of a 2017 executive board meeting. The union claims it’s standing up for dialysis patients, even as it’s exploiting them for its own purposes.
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Appeared in the October 18, 2022, print edition as ‘Union Coercion on the California Ballot.’
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