Proposition 29 on the Nov. 8 ballot would make California dialysis clinics have certain reporting requirements, ownership disclosures and at least one physician, nurse practitioner or physician assistant on-site while patients are being treated. Here, two essays argue for and against the ballot measure, which is the third such try for dialysis regulation since 2018.

Cartagena is a dialysis patient who lives in Concord.

My kidneys failed 11 years ago, and I have been a dialysis patient ever since. During that time, I’ve seen firsthand how care for dialysis patients like me suffers in the name of profit. Dialysis care is in crisis and our lives as patients are being put at risk. We urgently need the changes under Proposition 29 to protect dialysis patients and improve the care we receive.

That’s why Proposition 29 is opposed by health care and patient advocacy organizations.

Between now and early October when voting gets underway, The San Diego Union-Tribune Editorial Board is planning to publish dozens of candidate Q&As and nearly two dozen commentaries connected to a handful of San Diego city ballot measures and seven state propositions on the Nov. 8 election. Keep checking back as we fill in this voter guide.

Dialysis keeps patients alive when our kidneys fail by taking out our blood, cleaning it and putting it back in our bodies. Most dialysis treatments take place at specialized dialysis clinics, three times a week, for three to five hours per session. Patients like me need regular treatments or our health will degrade quickly.

Dialysis is difficult and puts my body under a lot of stress. I’ve passed out during treatments and it’s terrifying. I’ve seen other patients faint, suffer strokes or have heart attacks. I’ve even seen other patients pass away, and it is heartbreaking.

When serious problems happen, most dialysis clinics just call 911. But the ambulance might not arrive in time to get us to a hospital. We need a doctor on-site who can handle life-or-death situations in an emergency.

One week, I felt very dizzy and wobbly after my dialysis treatments but was sent home anyways. I eventually ended up in the emergency room due to a bad sinus infection and sepsis. After that happened, I couldn’t help but wonder if maybe a doctor or advanced practitioner had been there to check up on me, it wouldn’t have gotten to that point.

While dialysis patient care technicians or nurses in the clinics do their best to help, they are frequently overworked and overwhelmed with many patients at once. Clinics are often short-staffed, which makes me concerned for my safety.

Sometimes we bleed after treatment while applying pressure to stop the bleeding. Patients have bled on the treatment floor, in treatment chairs, by the weigh station, in the lobby, and even outside. Blood is left unattended because staff members are busy with patients as they are short-staffed.

I am often anxious when I’m sent home after treatment because I’m afraid that I’m going to bleed out more. A doctor on-site would be better able to evaluate my situation before I leave the clinic.

I have brought up my concerns for years, but I feel like I am constantly ignored. I don’t have many options to go elsewhere for treatment. There are two corporations that dominate the industry, DaVita and Fresenius, and together they own approximately 80 percent of dialysis clinics in California. These two massively profitable corporations have done everything possible to stop patients and workers from improving the quality of care at dialysis clinics.

While the quality of care for dialysis patients suffers, dialysis corporations are making billions across the United States. Instead of investing in better care for patients, they want to keep the huge profits flowing, often right into their own pockets. As of June 2021, DaVita’s CEO compensation was listed at $73.4 million.

Proposition 29 would protect patients by improving clinical staffing in dialysis clinics, prohibiting discrimination against patients based on the type of insurance they have and requiring approval before clinics close or reduce services.

Another benefit of Proposition 29 is that it would help dialysis patients make better decisions for their care by improving transparency and reporting of health care-associated infections and physician ownership of dialysis clinics.

Most importantly, Proposition 29 would maintain doctors or other advanced practitioners on-site, which would improve the quality of care. Studies have linked frequency of physician contact with better quality of care and lower mortality rates for dialysis patients.

Tens of thousands of Californians receive dialysis in clinics each month, and we deserve better quality care. Anyone could end up needing treatment for a variety of reasons. I had to start dialysis in my 40s. I’ve even seen patients as young as 19 who need dialysis treatment.

Imagine if it was you, your loved one or your child in this situation. Wouldn’t you want the best treatment available?

The dialysis industry makes billions of dollars by taking advantage of patients like me who need this lifesaving treatment. Help us improve the quality of care and protect the lives of dialysis patients — vote yes on Proposition 29.

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Financial relief that could save people hundreds of dollars is welcome.

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Public education is better than Proposition 31.

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Get Weekend Opinion on Sunday mornings

Editorials, Commentary, Reader Reaction and a touch of Steve Breen delivered every Sunday.

You may occasionally receive promotional content from the San Diego Union-Tribune.

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