The National Kidney Foundation has a long history of opposing all cuts to patient care, particularly relating to dialysis.  Proposition 8, a ballot initiative put forth in California by the Service Employees International Union—United Healthcare Workers West (SEIU-UHW), is unfair to dialysis patients, fails to demonstrate how cuts in funding will improve patient care, and could result in cuts in services for dialysis patients in California.

Defending Kidney Patients’ Access To Care


Derek Forfang, Kidney Patient in San Pablo, CA

“Proposition 8 is not what it appears. Taking money from dialysis companies and giving it back to big insurance companies will help patients?  I don’t think so!  This proposition doesn’t guarantee any improvement in kidney patient care. It does put our most vulnerable patient communities at risk.  We don’t need an initiative to push the union’s agenda, a big insurance agenda or a dialysis company agenda, we need an initiative that puts patients first.  As a Californian with ESRD, I say Proposition 8 is not fair to patients.”

Jeffery Rhodes, Kidney Patient in San Francisco, CA

“After reading the proposition, I am proud to say I stand with the NKF in their stance against it. I have deep concerns about the impact and effects on kidney patients. I worry that this could lead to possible closure of clinics and patient services. Progress and goals toward a cure will be hindered and this could cause setbacks for kidney patients. I worry about the many doctors, nurses, techs and other staff who will be greatly affected. Most of all, it’s the kidney patients and their families who will bear the brunt of this initiative. Let’s put them first and make them the highest priority.”

Leslie Mather, Kidney Patient in Agoura Hills, CA

“I’m a songwriter, mother, and former dialysis patient.  Proposition 8 is a ballot initiative in California that claims it’s fighting for kidney patients, but don’t let it fool you. If Prop 8 passes, a dialysis patient’s access to care in a dialysis center will likely be in jeopardy as facilities close, and I’m very concerned about what it might do to the quality of care fellow patients receive. The number of patients trying to receive dialysis is increasing and we need more, not fewer, dialysis facilities.”

Joseph Marek, Family of a Kidney Patient in Santa Monica, CA

“Having dealt with the awful reality of dialysis through watching John and the other brave patients in the clinic every week enduring those treatments, I know full well the need for good and reliable treatment centers. But Prop 8 doesn’t require those changes. What it will do is hurt patients. Patients go through enough every day just to stay alive.”

Facts about Proposition 8

A bad policy for patients

Proposition 8 will only serve to place dialysis patients in the middle of a battle that will not benefit them.


Capping reimbursement will translate into cuts in care for dialysis patients in California. If clinics close, dialysis patients will be forced to travel farther to find another open clinic or not be able to get treatment, and facility staff will end up juggling even more patients at a time because fewer clinics now have too many patients to serve and not enough capacity to serve them.  Being on dialysis is hard enough without these added burdens.

A poorly conceived policy

While there may be room for improvement in the care and services provided by dialysis organizations, this cap won’t achieve that goal and could harm patients. The ballot initiative also does not clearly define how a cap in reimbursement for care will be reinvested to benefit patients or dialysis facility employees, and does not outline any oversight necessary to ensure excess funds are redirected towards benefitting patients.


Who would be responsible for making this happen?  Over what timeframe?  Who would benefit? All unanswered questions that the ballot initiative does not address.

Where would the impact of dialysis facility closures be felt the most?

The National Kidney Foundation believes that if this ballot initiative passes, dialysis providers will very likely close clinics that are not profitable, many of which are in lower-income neighborhoods and rural areas.

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