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"title": "Transcript: Prop. 29 Would Change How Dialysis Is Regulated in California",
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"content": "\u003cp>\u003cem>This is a transcript of the Prop Fest episode explaining Proposition 29 on the 2022 California ballot. Check out \u003ca href=\"https://www.kqed.org/voterguide/\">KQED’s Voter Guide\u003c/a> for more information on local and state races.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:00:00] Hello. Hello. I’m \u003ca href=\"https://www.kqed.org/author/ohubertallen\">Olivia Allen Price\u003c/a>. And this is KQED’s Prop Fest, a podcast series brought to you by \u003ca href=\"https://www.kqed.org/podcasts/baycurious\">Bay Curious\u003c/a> and our friends at \u003ca href=\"https://www.kqed.org/podcasts/thebay\">The Bay\u003c/a>. Today, we’re taking a closer look at Proposition 29, the dialysis prop on your ballot. It reads like this. Prop 29 requires an onsite licensed medical professional at kidney dialysis clinics and establishes other state requirements. This proposition may have you feeling deja vu because this is our third time seeing a dialysis proposition on the ballot since 2018, and they all look kind of similar. We’ll get into why this keeps coming back and unpack what Proposition 29 would do. Just ahead. Stick around.\u003c/p>\n\u003cp>KQED science editor \u003ca href=\"https://www.kqed.org/author/kevinstark\">Kevin Stark\u003c/a> is here to help us dig in on what is going on with Proposition 29. Kevin, thanks for stopping by.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:00:57] Absolutely. Thanks for having me.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:00:59] Let’s take a closer read on this one. What exactly would Proposition 29 do?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:01:04] So Prop 29 is aimed at improving care at the dialysis clinics in California. There’s roughly 650 of them. And this would impose new regulations and rules. The biggest significant change here is that it would require that there be some kind of care provider onsite with patients as they’re receiving treatment. That’s a change from how it works. Now there are technicians onsite at all times and there’s doctors that supervise, but they only come in occasionally and there isn’t one always in the building.\u003c/p>\n\u003cp>[baycuriouspodcastinfo]\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:01:34] If you’re not familiar. Dialysis is for people with kidney failure. Our kidneys clean toxins from our blood. So when they’re not working, people need dialysis treatment to stay alive. Patients usually go three times a week and the procedure last three or 4 hours. So being on dialysis is really disruptive to someone’s life, even more so if they’re having to travel to a clinic far away. Kidney failure is caused by a number of health conditions, but most often diabetes or high blood pressure, because people of color are more likely to experience those conditions. They’re more likely to be on dialysis. Proposition 29 is going to feel super familiar to people who have voted in previous elections here in California, because this is the third time that voters are being asked to weigh in on how dialysis clinics should run. Kevin, why do we keep seeing dialysis on the ballot?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:02:27] You’re absolutely right. Californians voted on this twice recently, Proposition eight in 2018 and Proposition 23 in 2020. Behind the scenes, here is a labor dispute. SEIU UHW, West is one of the largest health care unions in the state, and they have been trying for nearly a decade now to organize workers at dialysis clinics. The major companies that own these clinics, DaVita, Fresenius, have pushed back on this effort. And in fact, they’ve dumped tens of millions of dollars into fighting all of the propositions. If you talk to the companies, they will tell you that this is the unions really kind of putting the screw on them. They’re trying to bleed them of money. This is all about that fight for unionization. And if they were to come to an agreement on that, that maybe you wouldn’t be seeing the propositions. So basically, in a nutshell, they’re arguing that the unions are taking advantage of California’s proposition system. The unions have a completely different view of this. Obviously, they say this is about improving the care for patients. You know, they say that they after the last propositions failed, they went back. They listen to the criticism. They actually talked with researchers to figure out ways to improve the policy. And this is the result, Proposition 29. I asked SEIU’s David Miller to respond exactly to the criticism that this is not about the clinics, but it’s about a larger fight over unionization.\u003c/p>\n\u003cp>\u003cstrong>David Miller\u003c/strong> [00:03:54] Where movement of workers and also of patients. And we seek to improve care across the spectrum. We are seeking to do stuff in the broad interests so that this is not about some narrow play to sort of get dialysis. We see this is actually part of our mandate that we want to improve staffing in these clinics.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:04:12] So is Prop 29 the same thing we voted on in 2020?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:04:17] The No on Prop 29 campaign would argue that this is a carbon copy of that policy, and they say that voters have already rejected it. Not entirely true. There is a core idea here that is really the same and that’s, you know, having a physician or a care provider onsite at all times when patients are receiving care, there’s not a lot of difference there. There’s a lot of smaller nuances and changes in the edges of this policy. The union expanded the definition of care providers here. It used to be that it was exclusively doctors. Now it’s nurse practitioners as well as physician assistants, also capitalizing on the pandemic and this expansion of telehealth. There’s also a stipulation in here that if there was no one available to be onsite, they could have someone that, you know, a doctor or a nurse that’s available over telehealth.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:05:07] A key question here is does having a physician or nurse practitioner onsite at a dialysis clinic make patients safer? KQED health reporter April Dembosky had something interesting to say about this in our Prop Fest episode from 2020, which is the last time we voted on a similar measure.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky\u003c/strong> [00:05:26] So health care is complicated, and it’s hard to know if this would really help patients or if it might have unintended consequences. So patients already have their own doctors. They come see them in the clinics once a month or once a week to check on their dialysis prescription and medications to monitor their labs. And researchers have studied whether the frequency of doctor’s visits makes a difference in patient’s health. Back in 2004, Medicare, the government health program that pays for most dialysis treatment created a new incentive to encourage doctors to visit their dialysis patients more often. So instead of one or two times a month, it pushed them to visit four or more times per month. Well, after more than ten years of doing this, it turns out seeing your doctor more often has no impact on health outcomes. In fact, patients who were seen less often by their doctor actually had better survival rates. So the government was paying doctors more money for more services with no conclusive benefits to show for it.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:06:34] Kevin What would happen in the event of an emergency? You know, imagine having a physician or a nurse practitioner, there would be a good thing.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:06:41] That is exactly the argument that the unions make, you know, in an emergency. Let’s say a patient faints, their heart stops. If that happens while in the clinic, someone has to perform CPR, call 911 to have paramedics take them to the hospital. Advocates say having a doctor, a nurse practitioner or physician on site would absolutely help here.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:06:59] But it’s worth noting that this proposition moves in the opposite direction of a lot of other health policy changes that have happened recently. You know, generally California and the rest of the nation have been changing laws so that physicians aren’t having to do everything. There’s sort of been this wider recognition that a lot of health care duties don’t require the expertize of a doctor or a nurse practitioner.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:07:22] Yeah, I think that’s a really good point. And I think if you talk to the companies that manage all these clinics, they would say, you know, you don’t need a doctor in the clinic to perform CPR and to call 911. This is something that a technician can do. And then I think the addition of the telehealth argument into this proposition might be a way for the union to try and get around this idea itself. Like, you know, I think they’re saying basically, okay, maybe you don’t need someone on site, but you need someone that’s there that’s supervising. And then I think I would also note that the clinics do have doctors that work for them. They just don’t happen to always be on site.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:07:54] Now, there are a few other regulations in this prop that aren’t getting as much attention. Tell me about those.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:08:00] So the unions added that clinics would need to report any infection that happens during treatment to the state. You know, the companies say they already are required to do this. Individuals without insurance would not be able to be denied care. Again, you know, the companies say that it’s not something that happens. Clinics would have to report additional information to state regulators and they would also actually have to get the consent of state health officials before they would close a clinic.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:08:32] One thing the No on 29 campaign has been saying in campaign ads is that these new regulations could cause clinics to close. Is that a real threat?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:08:41] Well, I think that’s the argument that the companies that run these clinics are making. State analysts projected it would cost them hundreds of millions of dollars to comply with these regulations if they were to pass. Here’s Bryan Wong, who’s a medical director for DaVita in Oakland. He says clinics there might actually need to close.\u003c/p>\n\u003cp>\u003cstrong>Bryan Wong\u003c/strong> [00:08:57] Those that are in the rural area, probably even worse because those in a rural area. They probably have a huge amount of medical only patients, and those are the patients that are at most risk of getting harm. Why? Because the density of dialysis clinics in rural areas is much, much less than in urban areas.\u003c/p>\n\u003cp>[emailsignup newslettername=\"baycurious\" align=\"right\"]\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:09:20] So I would just temper that and just keep this in mind about any talk about clinics closing is that the companies that run these dialysis clinics are, by and large hugely profitable businesses. And if their costs do increase, they likely would pass them on to insurance companies or find other ways to make it up.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:09:36] I’m curious, how do dialysis patients feel about this proposition?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:09:40] There’s a key argument against Prop 29, which is basically that health care is just incredibly complicated, that the regulations should be crafted by lawmakers in a very nuanced way. And, you know, putting that responsibility onto voters with a really blunt instrument like a proposition is just not the way to do it. April, when she was reporting on this, you know, she talked to one patient, DeWayne Cox, and he made this point explicitly.\u003c/p>\n\u003cp>\u003cstrong>DeWayne Cox\u003c/strong> [00:10:06] When I see these propositions that are put before the voters, who have no idea what we go through and what’s necessary to keep us alive. It makes me angry because they’re playing politics for whatever their reasons are, but they’re putting patients like me in the middle of it.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:10:37] I want to transition us now to talk about campaign spending. What do things look like for Prop 39 right now?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:10:43] Wow. Expensive and completely lopsided. In the first week of September when we’re recording this divide, it just dropped to 8 million into the No on 29 campaign. The companies had already spent, you know, tens of millions of dollars on this. SEIU is putting up some money on this as well, but it’s really just a fraction of what DaVita and Fresenius have spent.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:11:02] So it’s interesting that the union is pushing on this, keeps pushing on this topic, but then gets outgunned every time on the funding.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:11:10] You know, if you’re looking at it from the sort of course political lens like this is where the leverage on the union fight is. Like this is now the third time they’ve done this. Each time the companies are dumping in tens of millions of dollars to fight it, and that’s a check that they are going to have to keep writing until they sort this out.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:11:31] All right, KQED science editor Kevin Stark. Thanks.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark:\u003c/strong> [00:11:35] Thanks for having me.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:11:39] In a nutshell, a vote yes on Prop 29 says you want dialysis clinics to follow these new requirements, including having a physician or nurse practitioner on site while patients are being treated. A vote no would keep things the way they are right now.\u003c/p>\n\u003cp>That’s it for today’s episode of Prop Fest. If you’re just tuning in, be sure to check out all our other episodes in our podcast feed. You can find transcripts of those episodes at \u003ca href=\"https://www.kqed.org/propfesthttps://www.kqed.org/propfest\">Bay Curious.org/Propfest\u003c/a>. If you’re new to the \u003ca href=\"https://www.kqed.org/podcasts/baycurious\">Bay Curious podcast\u003c/a>, welcome. Every Thursday we drop episodes that explore listener questions about the San Francisco Bay Area. It’s a lot of fun and we always learn so much. So if you’re diggin’ Prop Fest, I think you’ll enjoy our other work too. Be sure to subscribe so you don’t miss out.\u003c/p>\n\u003cp>Prop Fest is produced by Katrina Schwartz. Amanda Font, Darren Tu, Brendan Willard and me Olivia Allen-Price in partnership with the team behind the Bay, Allan Montecillo, Ericka Cruz Guevarra and Maria Esquinca. Our show is made in San Francisco at member supported KQED. We’ll be back tomorrow with Kevin talking about Proposition 30, which would tax the richest Californians and use the money for green transportation initiatives. You don’t want to miss it. I’ll see you then.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[baycuriousquestion]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This is a transcript of the Prop Fest episode explaining Proposition 29 on the 2022 California ballot. Check out \u003ca href=\"https://www.kqed.org/voterguide/\">KQED’s Voter Guide\u003c/a> for more information on local and state races.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:00:00] Hello. Hello. I’m \u003ca href=\"https://www.kqed.org/author/ohubertallen\">Olivia Allen Price\u003c/a>. And this is KQED’s Prop Fest, a podcast series brought to you by \u003ca href=\"https://www.kqed.org/podcasts/baycurious\">Bay Curious\u003c/a> and our friends at \u003ca href=\"https://www.kqed.org/podcasts/thebay\">The Bay\u003c/a>. Today, we’re taking a closer look at Proposition 29, the dialysis prop on your ballot. It reads like this. Prop 29 requires an onsite licensed medical professional at kidney dialysis clinics and establishes other state requirements. This proposition may have you feeling deja vu because this is our third time seeing a dialysis proposition on the ballot since 2018, and they all look kind of similar. We’ll get into why this keeps coming back and unpack what Proposition 29 would do. Just ahead. Stick around.\u003c/p>\n\u003cp>KQED science editor \u003ca href=\"https://www.kqed.org/author/kevinstark\">Kevin Stark\u003c/a> is here to help us dig in on what is going on with Proposition 29. Kevin, thanks for stopping by.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:00:57] Absolutely. Thanks for having me.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:00:59] Let’s take a closer read on this one. What exactly would Proposition 29 do?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:01:04] So Prop 29 is aimed at improving care at the dialysis clinics in California. There’s roughly 650 of them. And this would impose new regulations and rules. The biggest significant change here is that it would require that there be some kind of care provider onsite with patients as they’re receiving treatment. That’s a change from how it works. Now there are technicians onsite at all times and there’s doctors that supervise, but they only come in occasionally and there isn’t one always in the building.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003caside class=\"alignleft utils-parseShortcode-shortcodes-__bayCuriousPodcastShortcode__bayCurious\">\u003cimg src=https://cdn.kqed.org/wp-content/uploads/2023/02/bayCuriousLogo.png alt=\"Bay Curious Podcast\" loading=\"lazy\" />\n \u003ca href=\"/news/series/baycurious\">Bay Curious\u003c/a> is a podcast that answers your questions about the Bay Area.\n Subscribe on \u003ca href=\"https://itunes.apple.com/us/podcast/bay-curious/id1172473406\" target=\"_blank\" rel=\"noopener noreferrer\">Apple Podcasts\u003c/a>,\n \u003ca href=\"http://www.npr.org/podcasts/500557090/bay-curious\" target=\"_blank\" rel=\"noopener noreferrer\">NPR One\u003c/a> or your favorite podcast platform.\u003c/aside>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:01:34] If you’re not familiar. Dialysis is for people with kidney failure. Our kidneys clean toxins from our blood. So when they’re not working, people need dialysis treatment to stay alive. Patients usually go three times a week and the procedure last three or 4 hours. So being on dialysis is really disruptive to someone’s life, even more so if they’re having to travel to a clinic far away. Kidney failure is caused by a number of health conditions, but most often diabetes or high blood pressure, because people of color are more likely to experience those conditions. They’re more likely to be on dialysis. Proposition 29 is going to feel super familiar to people who have voted in previous elections here in California, because this is the third time that voters are being asked to weigh in on how dialysis clinics should run. Kevin, why do we keep seeing dialysis on the ballot?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:02:27] You’re absolutely right. Californians voted on this twice recently, Proposition eight in 2018 and Proposition 23 in 2020. Behind the scenes, here is a labor dispute. SEIU UHW, West is one of the largest health care unions in the state, and they have been trying for nearly a decade now to organize workers at dialysis clinics. The major companies that own these clinics, DaVita, Fresenius, have pushed back on this effort. And in fact, they’ve dumped tens of millions of dollars into fighting all of the propositions. If you talk to the companies, they will tell you that this is the unions really kind of putting the screw on them. They’re trying to bleed them of money. This is all about that fight for unionization. And if they were to come to an agreement on that, that maybe you wouldn’t be seeing the propositions. So basically, in a nutshell, they’re arguing that the unions are taking advantage of California’s proposition system. The unions have a completely different view of this. Obviously, they say this is about improving the care for patients. You know, they say that they after the last propositions failed, they went back. They listen to the criticism. They actually talked with researchers to figure out ways to improve the policy. And this is the result, Proposition 29. I asked SEIU’s David Miller to respond exactly to the criticism that this is not about the clinics, but it’s about a larger fight over unionization.\u003c/p>\n\u003cp>\u003cstrong>David Miller\u003c/strong> [00:03:54] Where movement of workers and also of patients. And we seek to improve care across the spectrum. We are seeking to do stuff in the broad interests so that this is not about some narrow play to sort of get dialysis. We see this is actually part of our mandate that we want to improve staffing in these clinics.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:04:12] So is Prop 29 the same thing we voted on in 2020?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:04:17] The No on Prop 29 campaign would argue that this is a carbon copy of that policy, and they say that voters have already rejected it. Not entirely true. There is a core idea here that is really the same and that’s, you know, having a physician or a care provider onsite at all times when patients are receiving care, there’s not a lot of difference there. There’s a lot of smaller nuances and changes in the edges of this policy. The union expanded the definition of care providers here. It used to be that it was exclusively doctors. Now it’s nurse practitioners as well as physician assistants, also capitalizing on the pandemic and this expansion of telehealth. There’s also a stipulation in here that if there was no one available to be onsite, they could have someone that, you know, a doctor or a nurse that’s available over telehealth.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:05:07] A key question here is does having a physician or nurse practitioner onsite at a dialysis clinic make patients safer? KQED health reporter April Dembosky had something interesting to say about this in our Prop Fest episode from 2020, which is the last time we voted on a similar measure.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky\u003c/strong> [00:05:26] So health care is complicated, and it’s hard to know if this would really help patients or if it might have unintended consequences. So patients already have their own doctors. They come see them in the clinics once a month or once a week to check on their dialysis prescription and medications to monitor their labs. And researchers have studied whether the frequency of doctor’s visits makes a difference in patient’s health. Back in 2004, Medicare, the government health program that pays for most dialysis treatment created a new incentive to encourage doctors to visit their dialysis patients more often. So instead of one or two times a month, it pushed them to visit four or more times per month. Well, after more than ten years of doing this, it turns out seeing your doctor more often has no impact on health outcomes. In fact, patients who were seen less often by their doctor actually had better survival rates. So the government was paying doctors more money for more services with no conclusive benefits to show for it.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:06:34] Kevin What would happen in the event of an emergency? You know, imagine having a physician or a nurse practitioner, there would be a good thing.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:06:41] That is exactly the argument that the unions make, you know, in an emergency. Let’s say a patient faints, their heart stops. If that happens while in the clinic, someone has to perform CPR, call 911 to have paramedics take them to the hospital. Advocates say having a doctor, a nurse practitioner or physician on site would absolutely help here.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:06:59] But it’s worth noting that this proposition moves in the opposite direction of a lot of other health policy changes that have happened recently. You know, generally California and the rest of the nation have been changing laws so that physicians aren’t having to do everything. There’s sort of been this wider recognition that a lot of health care duties don’t require the expertize of a doctor or a nurse practitioner.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:07:22] Yeah, I think that’s a really good point. And I think if you talk to the companies that manage all these clinics, they would say, you know, you don’t need a doctor in the clinic to perform CPR and to call 911. This is something that a technician can do. And then I think the addition of the telehealth argument into this proposition might be a way for the union to try and get around this idea itself. Like, you know, I think they’re saying basically, okay, maybe you don’t need someone on site, but you need someone that’s there that’s supervising. And then I think I would also note that the clinics do have doctors that work for them. They just don’t happen to always be on site.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:07:54] Now, there are a few other regulations in this prop that aren’t getting as much attention. Tell me about those.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:08:00] So the unions added that clinics would need to report any infection that happens during treatment to the state. You know, the companies say they already are required to do this. Individuals without insurance would not be able to be denied care. Again, you know, the companies say that it’s not something that happens. Clinics would have to report additional information to state regulators and they would also actually have to get the consent of state health officials before they would close a clinic.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:08:32] One thing the No on 29 campaign has been saying in campaign ads is that these new regulations could cause clinics to close. Is that a real threat?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:08:41] Well, I think that’s the argument that the companies that run these clinics are making. State analysts projected it would cost them hundreds of millions of dollars to comply with these regulations if they were to pass. Here’s Bryan Wong, who’s a medical director for DaVita in Oakland. He says clinics there might actually need to close.\u003c/p>\n\u003cp>\u003cstrong>Bryan Wong\u003c/strong> [00:08:57] Those that are in the rural area, probably even worse because those in a rural area. They probably have a huge amount of medical only patients, and those are the patients that are at most risk of getting harm. Why? Because the density of dialysis clinics in rural areas is much, much less than in urban areas.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:09:20] So I would just temper that and just keep this in mind about any talk about clinics closing is that the companies that run these dialysis clinics are, by and large hugely profitable businesses. And if their costs do increase, they likely would pass them on to insurance companies or find other ways to make it up.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:09:36] I’m curious, how do dialysis patients feel about this proposition?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:09:40] There’s a key argument against Prop 29, which is basically that health care is just incredibly complicated, that the regulations should be crafted by lawmakers in a very nuanced way. And, you know, putting that responsibility onto voters with a really blunt instrument like a proposition is just not the way to do it. April, when she was reporting on this, you know, she talked to one patient, DeWayne Cox, and he made this point explicitly.\u003c/p>\n\u003cp>\u003cstrong>DeWayne Cox\u003c/strong> [00:10:06] When I see these propositions that are put before the voters, who have no idea what we go through and what’s necessary to keep us alive. It makes me angry because they’re playing politics for whatever their reasons are, but they’re putting patients like me in the middle of it.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:10:37] I want to transition us now to talk about campaign spending. What do things look like for Prop 39 right now?\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:10:43] Wow. Expensive and completely lopsided. In the first week of September when we’re recording this divide, it just dropped to 8 million into the No on 29 campaign. The companies had already spent, you know, tens of millions of dollars on this. SEIU is putting up some money on this as well, but it’s really just a fraction of what DaVita and Fresenius have spent.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:11:02] So it’s interesting that the union is pushing on this, keeps pushing on this topic, but then gets outgunned every time on the funding.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark\u003c/strong> [00:11:10] You know, if you’re looking at it from the sort of course political lens like this is where the leverage on the union fight is. Like this is now the third time they’ve done this. Each time the companies are dumping in tens of millions of dollars to fight it, and that’s a check that they are going to have to keep writing until they sort this out.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:11:31] All right, KQED science editor Kevin Stark. Thanks.\u003c/p>\n\u003cp>\u003cstrong>Kevin Stark:\u003c/strong> [00:11:35] Thanks for having me.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price\u003c/strong> [00:11:39] In a nutshell, a vote yes on Prop 29 says you want dialysis clinics to follow these new requirements, including having a physician or nurse practitioner on site while patients are being treated. A vote no would keep things the way they are right now.\u003c/p>\n\u003cp>That’s it for today’s episode of Prop Fest. If you’re just tuning in, be sure to check out all our other episodes in our podcast feed. You can find transcripts of those episodes at \u003ca href=\"https://www.kqed.org/propfesthttps://www.kqed.org/propfest\">Bay Curious.org/Propfest\u003c/a>. If you’re new to the \u003ca href=\"https://www.kqed.org/podcasts/baycurious\">Bay Curious podcast\u003c/a>, welcome. Every Thursday we drop episodes that explore listener questions about the San Francisco Bay Area. It’s a lot of fun and we always learn so much. So if you’re diggin’ Prop Fest, I think you’ll enjoy our other work too. Be sure to subscribe so you don’t miss out.\u003c/p>\n\u003cp>Prop Fest is produced by Katrina Schwartz. Amanda Font, Darren Tu, Brendan Willard and me Olivia Allen-Price in partnership with the team behind the Bay, Allan Montecillo, Ericka Cruz Guevarra and Maria Esquinca. Our show is made in San Francisco at member supported KQED. We’ll be back tomorrow with Kevin talking about Proposition 30, which would tax the richest Californians and use the money for green transportation initiatives. You don’t want to miss it. I’ll see you then.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"airtime": "SUN 7:30pm-8pm",
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"hyphenacion": {
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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"title": "Latino USA",
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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},
"marketplace": {
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"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"rss": "https://rss.art19.com/masters-of-scale"
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},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"meta": {
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/onourwatch",
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"order": 11
},
"link": "/podcasts/onourwatch",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
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"link": "/radio/program/on-the-media",
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"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
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"pbs-newshour": {
"id": "pbs-newshour",
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"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
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},
"link": "/radio/program/pbs-newshour",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
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},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
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"info": "KQED's series of daily listener commentaries since 1991.",
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"officialWebsiteLink": "/perspectives/",
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"order": 14
},
"link": "/perspectives",
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"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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"rss": "https://feeds.npr.org/510289/podcast.xml"
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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