CALIFORNIA FOCUS
FOR RELEASE: FRIDAY, DECEMBER 14, 2018 OR THEREAFTER
BY THOMAS D. ELIAS
FOR RELEASE: FRIDAY, DECEMBER 14, 2018 OR THEREAFTER
BY THOMAS D. ELIAS
“KIDNEY PATIENTS BREATHE EASIER, BUT WARINESS ADVISED”
For
quite awhile this year, it seemed like open season on kidney dialysis patients,
the more than 66,000 Californians who depend for life after kidney failure on
getting their blood cleansed during sessions of three or more hours three times
a week.
The
most serious threat came from Proposition 8, which lost at the polls by a 62–38
percent margin, but not before it became the year’s most expensive
issue-oriented campaign in America, more than $120 million being spent on both
sides.
There
was also a threat this year from the Legislature, whose strong Democratic
majorities are so much under the sway of labor unions which provide much of
their campaign funding that they easily passed a measure threatening to throw dialysis patients off
their health insurance plans if they accept third-party aid in paying their
premiums.
Bear in
mind, many dialysis patients are so exhausted and weakened by the constant
blood exchanges they undergo that they cannot work, living on fixed disability
payments and other forms of welfare. For many, premium assistance is the key to
staying alive.
Fortunately
for them, outgoing Gov. Jerry Brown vetoed this ill-advised measure sponsored
by Democratic state Sen. Connie Leyva, whose Inland Empire district spans many
miles between Pomona and San Bernardino.
“This
bill goes too far as it would permit health plans and insurers to refuse
premium assistance payments and to choose which patients they will cover,”
Brown’s veto message said.
Spreading
the alarm as the measure sped through committee after committee was the
American Kidney Fund (AKF), largely funded by big dialysis companies which
stood to lose under the measure. The AKF uses donations to give premium help
for 74,000 dialysis patients in all 50 states, including almost 4,000 Californians.
Noting
that the bill was largely backed by health insurance companies, a statement
from the AKF called the Leyva bill “a thinly veiled attempt by insurers to
prevent kidney patients from being able to choose their own insurance plan if
they accept charitable premium assistance.”
The
fund claimed the bill’s aim was to let insurance companies rid themselves of
“sicker and more costly patients.” And make no mistake, dialysis is costly,
often running more than $6,000 per month and sometimes more than $50,000.
That
high cost was also the ostensible motivating factor behind Proposition 8,
primarily sponsored by the Service Employees International Union, which would
dearly like to recruit thousands of technicians and nurses working in
California’s 550 dialysis clinics.
The
measure claimed it would hold costs down by forbidding clinics from charging
insurance companies for the work of physician medical directors vital to
maintaining quality care. It also would not have allowed clinics to charge for
the work of facility administrators, security personnel and professional
services like accounting, payroll and legal expenses, all normally considered
ordinary costs of doing business.
Cut
those costs, the sponsors argued, and everyone’s health insurance premiums
would drop. But the two largest owners of dialysis clinics in California, the
German-based Fresenius Medical Care and Denver-based DaVita Corp. responded by
saying the cuts would force them to close many clinics.
No one
knows how many they would really have shuttered, but if they closed any
significant number, the long rides many dialysis patients now endure several
times a week before and after treatment would grow even longer and tax their
depleted strength much more.
Fresenius
and DaVita put their money where their mouths were by becoming the prime
funders of the seemingly ubiquitous campaign against Proposition 8.
Had
either of these proposals become state law, the lives of thousands of patients
figured to become even more difficult.
So
there was relief in the clinics when both measures ultimately failed. But there
is no guarantee either won’t be back, especially with a new governor taking
office Jan. 3 and nobody quite sure how he might deal with similar measures if
the Legislature puts them on his desk.
This
means dialysis patients who are fit enough to track these developments – and
many are not – cannot afford to relax completely even though the two immediate
threats were not realized. They must remain wary and ready to respond again if
and when similar dangers arise.
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Email Thomas Elias
at tdelias@aol.com. His book, "The Burzynski Breakthrough: The Most
Promising Cancer Treatment and the Government’s Campaign to Squelch It,"
is now available in a soft cover fourth edition. For more Elias columns, visit www.californiafocus.net