Ballot propositions draw big money like shit draws flies. The scatological reference is deliberate on my part because today I’m going to look at some election news that just plain stinks.
I have to admit to missing the ominous backstory on 2018’s Proposition 8, the one about kidney dialysis companies. I bought into the narrative that this was a battle between corporate ‘care’ companies and organized labor. And while it is true workers for these companies are trying to organize despite fierce opposition, the battle over this measure is a metaphor for the much bigger struggle over the future of healthcare.
Michael Hiltznik of the Los Angeles Times has unearthed the truth behind the motivations of the corporations willing to spend $99 million to defeat this measure.
Entitled “How profiteering by the same dialysis firms trying to kill Proposition 8 almost destroyed Obamacare,” the story uncovers one of the primary reasons private health insurers in California were bailing out from participation in Obamacare.
Underlying much of the unexpected cost of covering patients in Obamacare was a single industry — private dialysis firms, which have been accused of gaming the system to fatten their own profits. They did so with an alleged scheme that came under attack by federal healthcare regulators under President Obama, but has been allowed to continue under Trump.
The two biggest firms in this business are Denver-based DaVita and German-owned Fresenius, which operate clinics where desperately ill patients go to have their blood artificially filtered because their kidneys no longer function adequately. The two firms’ 4,900 outpatient clinics account for roughly 70% of the market. They serve about 400,000 patients, who typically go several times a week.
You should get to know these names because they’re the targets of Proposition 8 on November’s California ballot. The measure would cap the firms’ profits and provide incentives for higher staff levels and pay at their hundreds of California clinics.
There’s more to the story, including a complicated method allegedly used by dialysis companies to encourage patients with poor English reading skills away from Medicare and into private insurance. The companies–of course–deny everything, but the evidence unearthed in a lawsuit brought by Aetna is damning, to say the least.
Rules drawn up in the last year of the Obama administration to address this monetary malpractice have gone by the wayside since the Trump administration began deregulating everything.
Here are some more facts:
- Medicare pays about $260 per dialysis treatment; at three treatments per week, that’s about $40,500 a year to dialysis firms.
- Private insurers, which pay the firms on an out-of-network basis, reimburse $2,000 to $4,500 per session.
- DaVita’s pretax operating profits were about $1.8 billion on $10.1 billion in dialysis revenue last year.
- DaVita is putting up about $61.5 million to defeat Prop 8
- Fresenius reported pretax operating profit of $2.3 billion on dialysis revenue of $11.7 billion in North America.
- Fresenius is putting up about $27.7 million to defeat Prop 8
- The Service Employees International Union (which is hoping to unionize dialysis workers) has spent about $20 million in support of Prop 8
Are we back to the old days at the Union-Tribune?
I was surprised to see the front page–above the fold–headline at the UT on Wednesday about the SurveyUSA polling on Proposition 6, aka ‘the Gas Tax.”
Support for this measure comes from the California Republican Party, which has brought in a who’s who of GOP stars from around the country, hoping to increase their side’s voter turnout. Rightwing radio host Carl DeMaio is leading the charge.
The opposition includes an unlikely coalition of chambers of commerce, contractors, labor unions, and city governments, along with environmental and transportation advocacy organizations.
Public opinion surveys are quirky, and I always try to read the fine print when I see one from SurveyUSA, simply because I remember some “interesting” (ok, skewed conservative) results from the past.
Up in Sacramento, Scott Lay, proprietor of The Nooner newsletter, also raised an eyebrow upon seeing the UT story and dug deeper before I could get back to the polling.
To make a long story short, SurveyUSA sorta kinda cheated on the Proposition 6 query, rephrasing the official title of the measure in what Lay correctly called “a HEAVILY skewed question.” (Emphasis in original)
Seriously, as the kids type on their phones “WTF” with this phrase “A NO vote on Prop 6 would keep the fuel taxes imposed in 2017 by the California legislature in place, and would allow the legislature to impose whatever fees and taxes it approved in the future provided 2/3 of the CA House and 2/3 of the CA Senate approved. On Proposition 6, how do you vote?”
It doesn’t say anything about what the taxes/fees are for and suggests all fees and taxes can be increased with a 2/3 law by the Legislature. Uh, the Legislature can’t touch property taxes without a vote of the people.
If you are in media or politics, regardless of where you stand on Prop. 6, you have to admit the question was crap as is putting it above the fold. As a subscriber to SDUT, I’m pissed at this and I neither drive nor am affiliated with Prop. 6. Bad polling, bad “journalism.”
Carl Demaio as the public face of this endeavor should tell you all you need to know.
One of the most competitive statewide contests is the Dem-on-(sort of)Dem race for Superintendent of Public Instruction.
School reformers of the charter school persuasion are backing Marshall Tuck, as they did four years ago when he lost to Tom Torlakson. Although Tuck says he’s a Democrat, the money backing him has a certain dark money/Republican aroma.
Funded by charter school groups, wealthy individuals and school reform organization EdVoice assorted committees have spent more than $12 million on Tuck’s behalf since the start of the month, with Bill Bloomfield adding in more than $700,000 worth of independent expenditures.
On the other side of this proxy battle is Assemblyman Tony Thurmond. He’s backed by labor groups, the Democratic Party, and social justice organizations.
A labor-funded committee reported spending some $4.5 million just this month including more than $3 million on a new round of TV ads this week. The State Democratic Party and committees representing firefighters and correctional officers have anted up an additional $1.5 million on Thurmond’s behalf.
Tuck’s dark money supporters have dipped into the GOP’s well of dirty tricks and misleading ads this week. California Democratic Party Women’s Caucus Chair Christine Pelosi and Southern Chair Carolyn Fowler, both #MeToo activists, are among those demanding that a pro-Tuck PAC’s TV ad be pulled, saying it ad exploited “victims and the #MeToo movement to lie about (Tuck’s) opponent.”
The cable TV spot suggests the Thurmond was “reprimanded by the Obama administration” for working in a school district that “did not respond promptly … to the sexual harassment of students.” Needless to say, it wouldn’t pass a fact check.
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