Monday, September 17, 2018

2018 Proposition 8, California, on Dialysis Treatment

   The 2008 Proposition 8, was a California ballot proposition for a state constitutional amendment to oppose same-sex marriage. Proposition 8 was ultimately ruled unconstitutional in 2010.  After a lot of contention in and out of court, same-sex marriages in California resumed in 2013.  This shows Proposition 8’s effect on life as we know it.

   Today’s Proposition 8 is just as contentious.  The Proponents of California's Proposition 8 says, “Proposition 8 would improve the quality of care for the 66,000 Californians who are on dialysis, and that’s why the initiative is supported by the California Democratic Party; CalPERS, the nation’s largest public pension fund; firefighters; patients; healthcare advocates; dialysis workers; veterans; and 130 other community groups, labor unions and churches.”

   The flyer above says, “California Proposition 8 sets severely low limits on what insurance companies are required to pay for dialysis care… These limits do not cover the cost...forcing many dialysis clinics to cut back services or even close.”

   In terms of insurance payments, “a ‘yes’ vote requires dialysis clinics to issue refunds to patients or patients’ payers for revenue above 115% of the costs of direct patient care and healthcare improvements.”  That means the clinics are paid 100% + 15% profit, only the excess over the 15% will be refunded to the payer.

   “A ‘no’ vote opposes refunds to patients or patients’ payers, the dialysis clinics gets to keep the profits all and above 115% percent.

   A Mercury News Editorial says, “The complex initiative designed to regulate the dialysis industry is better suited for the Legislature, (not a ballot measure) where the wording of new laws can be thoroughly vetted and easily altered if problems arise.”

   The Legislature has already spoken on this issue way back in 1972.  Public Law 92-603, 92nd Congress, H.R. 1 qualified all dialysis patients for Medicare benefits.  Patients, their families, and physicians, as well as the National Kidney Foundation, lobbied to get the federal and state governments to provide financial coverage for treatment of kidney disease.  Congress passed it, and President Richard M. Nixon signed the Social Security Amendments of 1972 getting him overwhelmingly reelected.  This law is based on the United States Declaration of Independence guarantee of “life, liberty…” just as both pro and con of the current Proposition 8, both sides, agree that missing dialysis treatments will kill the patient.

   I am a Jehovah’s Witness.  We don’t vote.  I am also a dialysis patient who will be impacted by Proposition 8, one way or another.  I have laid out the arguments from both sides as neutral as I can.  It’s up to the rest of California dialysis patients to decide which way they want to go on this.
   Whatever happens, I trust Jehovah God will take care of me as he has done, through all these years of my living dangerously.


  1. How stupid are these regulators, simply provide a one time stipend of 25K to all people donating a kidney and the savings on dialysis patients moving directly to transplant would be enormous. They are keeping you on dialysis while torturing and killing many people all for the almighty dollar.

  2. Exactly...the Medicare $$$ for dialysis is motivation enough for Congress to push the FDA to quickly approve clinical trials for the bionic kidney; and also provide said stipend to those living donors, and/or to the immediate families of deceased donors. I know for a fact that WEEKLY charges for in-center and home treatments can run ~$24-28K.