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Oct. 29–SACRAMENTO — A war amidst a healthcare abutment and the dialysis industry it wants to adapt has morphed into one of the best big-ticket election admeasurement campaigns in California history.

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Proposition 8, sponsored by the Service Advisers International Union-United Healthcare Workers, would compress the profits of hundreds of dialysis clinics beyond California. If allowable by voters, the admeasurement would crave clinics to accommodate rebates to insurers and pay a amends to the accompaniment on business revenues that exhausted 115% of assertive costs to bear care.

A affiliation led by DaVita and Fresenius Medical Care, the two companies that ascendancy a accumulated 72% of the dialysis bazaar in California, has accustomed $110 actor to a attack to exhausted the admeasurement — accidental to the best money aloft for such a attack in accompaniment history.

Opponents appearance Proposition 8 as an existential blackmail to the dialysis industry and its patients, and say the 95,000-member SEIU-UHW is application the election meausre to bear an claiming to its foes: Acquiesce to the union’s demands or pay for an big-ticket campaign.

“Proposition 8 puts California patients at accident in an accomplishment to force unionization of employees,” DaVita Arch Controlling Kent Thiry said in a statement. “There is an accustomed and accustomed action for advisers to vote a abutment up or down. Instead of afterward that process, SEIU-UHW is advancing a alarming action that puts patients at grave risk.”

Thiry’s accumulation warns that dialysis clinics may accessible for beneath hours, or would bang altogether if the admeasurement becomes law.

Dave Regan, arch of SEIU-UHW, says his abutment wants to rein in a dialysis industry he says is “predatory.” The abutment has aloft $18.8 actor for the Proposition 8 campaign.

DaVita and Fresenius arise billions in operating assets aftermost year and accept been accused by critics of assorted approach to access profitability, such as council patients to clandestine allowance or not giving advisers abundant time to abundantly apple-pie stations.

DaVita has been ordered to pay amercement and acclimatized lawsuits for added than $1 billion in the aftermost bristles years, including $253.5 actor in amercement awarded in June to the families of two patients who died of cardiac arrest afterwards accepting affliction at its California clinics. The aggregation has said it would address that decision.

“The acumen Prop. 8 is on the election is because they accept a abhorrent business archetypal and they’re gouging patients and insurers,” Regan said.

After years of big-ticket squabbles in the Capitol, Regan catholic to Denver, home to DaVita headquarters, to accommodated with Thiry for the aboriginal time on the eve of the June borderline to abjure election initiatives this year.

Assemblyman Adam Gray (D-Merced), the baton of a abstinent affiliation of Democrats in the Legislature, acted as intermediary. Gray said he spent weeks aggravating to accompany the two abandon calm in hopes of breaking a stalemate and award accepted ground.

But the eleventh-hour chat over banquet came too backward to accommodate a accord and alarm off the proposal.

Regan initially declared the appointment as a “social meeting” he abounding at Gray’s request. He afterwards said the timing was casual and he never advised to bang a accord with Thiry to cull Proposition 8 from the ballot.

“Nothing consequential alike came up,” Regan said. “Nothing was proposed. There was no affectionate of an acceding of any array and it was a amusing discussion.”

Thiry said it “was absolutely not a amusing meeting,” but beneath to elaborate.

Now voters are larboard to adjudge the fate of the 80,000 patients who accept dialysis assay at about 600 accountant clinics anniversary ages in California, according to abstracts from the Aldermanic Analyst’s Office.

SEIU-UHW argues its admeasurement will accommodate an allurement to dialysis companies so they advance added money into accommodating care. Under the measure, clinics could accumulate added of their profits if they access costs for care.

Kathy Fairbanks, a backer for the action campaign, said the industry believes that aborigine approval of Proposition 8 would force best clinics in California to accomplish in the red.

“You can’t accumulate accomplishing that anniversary afterwards week, ages afterwards month, year afterwards year,” she said. “This is action to demolish the clinics in California and, by extension, all the patients.”

An assay by the Aldermanic Analyst’s Office, the Legislature’s detached budgetary advisor, said abbreviation revenues would accomplish for-profit clinics “less assisting or could alike be unprofitable.”

Proposition 8 excludes the salaries of authoritative agents and some aerial accuse from the bulk adding for accommodating care, which would added abate profits.

“This to me is archetypal action aggravating to, not aloof adapt a business, but affect how they operate,” said Rob Stutzman, a Republican political adviser who is not complex in the Proposition 8 campaign.

Scrutiny of dialysis clinics sparked a aldermanic angle to authorize staff-to-patient ratios in the industry for the aboriginal time. The bill, sponsored by SEIU-UHW, adjourned in the accompaniment Legislature aftermost year.

Gov. Jerry Brown banned addition bill this year aimed to arrest an declared dialysis industry convenance of auspicious patients to assurance up for clandestine allowance and funneling money to nonprofits to advice patients pay off premiums. Dialysis corporations accomplish best of their profits off accumulation or alone allowance plans, which are billed abundant added than Medi-Cal or Medicare for the aforementioned services.

“Right now they accept every banking allurement to accumulate staffing and added absolute accommodating casework at a bald minimum because again they acquire every dollar in accumulation margin,” Regan said.

SEIU-UHW has a history of axis to the election amidst action disputes.

Regan alleged off a brace of election initiatives in 2012 to absolute accuse for affliction at clandestine hospitals and crave nonprofits to absorb at atomic 5% of revenues on alms affliction afterwards the California Hospital Assn. agreed to a affiliation that could advice the union’s acclimation efforts.

The affiliation soured and the abutment filed two measures the aing year to absolute prices for affliction at clandestine hospitals and controlling salaries at nonprofit hospitals.

The abutment pulled the initiatives aback in 2014 as allotment of a new acceding with the hospitals to attack calm to accession Medi-Cal acceding ante in barter for an easier aisle to acclimation bags of abeyant abutment members, amid added provisions.

A Sacramento adjudicator attempt bottomward addition SEIU-UHW election action to cap hospital controlling pay in 2016. That aforementioned year, the abutment pushed a election action to access pay for workers, which helped atom a aldermanic accord to accession California’s minimum wage.

This year alone, the abutment filed 11 election initiatives in California — seven at the bounded akin and four statewide initiatives. Best of the initiatives bootless to authorize or the abutment alone its effort.

One of the bounded measures would accept placed acquirement caps on the Watsonville Association Hospital. The abutment withdrew the action afterwards it accomplished a aggregate acceding acceding with the hospital, said Duane Dauner, the above arch controlling of the California Hospital Assn. and a baton of the campaigns adjoin the bounded initiatives. The hospital additionally agreed to anatomy a board to adviser and ascendancy pricing, said Sean Wherley, a agent for SEIU-UHW.

SEIU-UHW additionally sponsored bristles bounded initiatives in cities with Stanford Health Affliction association clinics. Admeasurement F in Palo Alto and Admeasurement U in Livermore, the alone two to arise on the Nov. 6 ballot, would absolute the bulk of money hospitals can allegation for accommodating care. Stanford claims the abutment pushed the measures to burden its hospitals to accomplish it easier to unionize.

Wherley said the abutment is not acclimation at Stanford’s healthcare facilities.

“He thinks initiatives are the solutions to bypass accustomed action relations action and tries to actually force the hospitals, doctors, dentists and others into unionization or he will proceed,” Dauner said of Regan.

Gray, the accompaniment legislator, acicular to several accompaniment action battles this year, including a ban on soda taxes and a accord on customer aloofness protections, as examples of added appropriate interests application the election as leverage.

“I abutment absolute democracy, but I absolutely anticipate the action process, by everybody, has been acclimated in means that absolutely weren’t intended,” Gray said.

Regan said SEIU-UHW didn’t authorize Proposition 8 to burden the dialysis industry to bang a deal. He said the abutment wants to advance healthcare, and election initiatives are an able way to accomplish important action changes.

He acicular to 17 minimum allowance and Medicaid amplification initiatives the abutment accurate in added states back 2016 that he said were not affiliated to acclimation efforts.

“Most of the being that we do is in following of the accepted good, whether it’s the minimum allowance or Medicaid expansion,” Regan said. “The dialysis industry should be appropriate to do added than criticize the abutment because they don’t appetite to allocution about their business models or profits.”

___

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