Soapbox

Union’s hardball tactics put dialysis patients in the crossfire

A health care union and kidney doctors are tussling over a possible ballot measure on the November ballot that would affect California dialysis clinics.
A health care union and kidney doctors are tussling over a possible ballot measure on the November ballot that would affect California dialysis clinics. Idaho Statesman

I'm a kidney doctor responsible for the care of more than 750 patients in the Bay Area with kidney failure. Many of my patients depend on dialysis treatments three times a week to stay alive. Missing even a single appointment can result in a trip to the emergency room or even death.

That's why I'm troubled that the United Healthcare Workers West union is trying to qualify a ballot measure for November that could significantly reduce patient access to dialysis treatment.

Bryan Wong.jpg
Bryan Wong

I am not an expert in politics, but even a lay person can recognize the sole reason UHW is pushing this measure is to organize workers in dialysis clinics. The union wants to use the threat of a ballot initiative to scare dialysis providers into complying with their demands. It is irresponsible and dangerous for UHW to use patients as pawns.

The proposed measure would impose unprecedented limits on what health insurance companies are required to pay community dialysis clinics. The reimbursements would not cover the cost of providing high-quality care. For example, the initiative specifically prohibits clinics from billing for necessary work by clinic physician medical directors, clinic coordinators and other critical staff positions.

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If reimbursements don't cover their operating costs, clinics will have to cut services or possibly close their doors. That would significantly reduce access to care, particularly in poor and rural communities where dialysis clinics already struggle.

Demand for dialysis in California is increasing at nearly five percent a year. Dialysis patients already have difficulty getting convenient appointments. If this initiative qualifies for the ballot and passes, patients would have to travel further or seek treatment in a hospital, increasing the likelihood they will miss a treatment and end up in the ER or worse.

UHW's misguided strong-arm tactics need to stop. A report this month disclosed that since 2012, UHW has spent nearly $22 million in California on ballot measures that would have jeopardized patient care. This election cycle, the union is pursuing two statewide ballot measures and seven local ballot measures to seek an advantage in negotiations.

I understand that politics can be a rough business. But it is unacceptable that a union that claims to represent the interests of health care workers and patients is putting them at risk.

Bryan Wong is a partner in East Bay Nephrology Group in Berkeley and a member of Patients and Caregivers to Protect Dialysis Patients, a coalition opposing the ballot measure. He can be contacted at bwong@ebnmg.org.

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