ARGUMENT IN FAVOR OF PROPOSITION 8

VOTE YES ON PROPOSITION 8—THE FAIR PRICING FOR DIALYSIS ACT

Dialysis is a life-saving treatment for patients with kidney failure in which their blood is taken out, cleaned, and then put back in their body. Dialysis patients should have a clean, sterile environment during their treatments, but big, corporate dialysis providers, which make billions by charging these critically ill patients as much as $150,000 a year, won't invest enough in basic sanitation. Bloodstains, cockroaches, and dirty bathrooms have all been reported at dialysis clinics, and patients' lives have been put at risk from exposure to dangerous infections and diseases. These high prices drive up healthcare costs for all Californians. PROP. 8 will require the corporations to refund excessive profits that aren't spent on improving dialysis patient care.

STOP OVERCHARGING PATIENTS

California's largest dialysis company marks up its charges for some patients as much as 350% above the actual costs of providing care, or as much as $150,000 per year. PROP. 8 will provide strong incentives for dialysis companies to lower costs and improve their quality of care, making patients the priority everywhere, which is especially important in low income and minority communities.

LOWER HEALTHCARE COSTS FOR EVERYONE

Because dialysis patients are often charged such huge sums of money for their life-saving treatment, insurance companies are forced to pass those costs on to policyholders, driving up healthcare costs for all Californians. One insurance provider, Blue Shield of California, reported that it takes 3,800 other policyholders to offset the cost of one dialysis patient. PROP. 8 will help lower the cost of healthcare for all Californians.

SUPPORTED BY A BROAD COALITION

Dialysis Advocates, LLC • Californians for Disability Rights • CalPERS • Congress of California Seniors • Service Employees International Union California • Minority Veterans Coalition of California • and many more . . . MAKE PATIENTS THE HIGHEST PRIORITY We should vote “YES” on Prop. 8 and tell dialysis companies to prioritize lifesaving treatment for patients over corporate profits.

VOTE YES ON PROPOSITION 8

Learn more about how PROP. 8 will help improve healthcare for Californians at www.YESonProp8.com

TANGI FOSTER, Dialysis Patient

GARY PASSMORE, President

Congress of California Seniors

NANCY BRASMER, President

California Alliance for Retired Americans

REBUTTAL TO ARGUMENT IN FAVOR OF PROPOSITION 8

Proponents are trying to mislead voters. Their measure is flawed and dangerous. Here are the facts.

Proposition 8 is opposed by thousands of health care professionals and dialysis patients across California including the American Nurses Association\California, California Medical Association, and the American College of Emergency Physicians, California Chapter because it jeopardizes access to care for 66,000 patients who need dialysis to stay alive.

"Missing even one appointment can be fatal for dialysis patients. By limiting access to dialysis care, Proposition 8 jeopardizes patient lives."—Theodore M. Mazer, M.D., President, California Medical Association, representing 43,000 doctors

CALIFORNIA DIALYSIS CLINICS RANK AMONG THE HIGHEST IN THE NATION FOR QUALITY CARE

California dialysis clinics are highly regulated at both the state and federal level. According to federal regulators, California clinics outperform other states in clinical quality and patient satisfaction.

PROP. 8 WOULD FORCE COMMUNITY DIALYSIS CLINICS TO CUT SERVICES AND CLOSE—ENDANGERING PATIENTS

An independent analysis by California's former Legislative Analyst found that under Prop. 8, 83% of dialysis clinics would operate at a loss. That reality would force hundreds of clinics to reduce operations or close.

PROPOSITION 8 WOULD COST CONSUMERS AND TAXPAYERS HUNDREDS OF MILLIONS ANNUALLY

Prop. 8 limits what insurance companies pay for dialysis care. But NOTHING in Prop. 8 requires insurance companies to pass ANY savings to consumers. In fact, Prop. 8 would INCREASE COSTS for taxpayers by hundreds of millions annually by forcing dialysis patients into more costly hospitals and emergency rooms, further straining already overcrowded ERs.

Please join doctors, nurses and patients.

VOTE NO ON PROPOSITION 8. IT'S DANGEROUS.

www.NoProp8.com

PHILLIP BAUTISTA, RN, President

American Nurses Association\California

TERRY RICO, Dialysis Patient

THEODORE M. MAZER, MD, President

California Medical Association

ARGUMENT AGAINST PROPOSITION 8

PROP. 8 PUTS VULNERABLE DIALYSIS PATIENT LIVES AT RISK

The American Nurses Association\California, California Medical Association, American College of Emergency Physicians, California Chapter and patient advocates all OPPOSE Prop. 8 because it jeopardizes access to care for 66,000 patients in California who need frequent dialysis treatments to stay alive.

"Patients on dialysis have kidney failure and are very sick. They require dialysis three days a week, four hours at a time to do the job of their kidneys to remove toxins from the body. These patients cannot survive without regular treatments. Prop. 8 dangerously reduces access to care and places vulnerable patients at serious risk."—Phillip Bautista, BSN, RN, PHN, President, American Nurses Association\California

PROP. 8 WILL FORCE COMMUNITY DIALYSIS CLINICS TO CUT SERVICES AND CLOSE

Proposition 8 severely limits what insurance companies are required to pay for dialysis care. These arbitrary limits will not cover the actual cost of providing care. In fact, an independent analysis conducted by California's former Legislative Analyst concluded Prop. 8 will result in 83% of dialysis clinics operating at a loss. That will force hundreds of clinics to reduce operations or close, endangering patients.

Without access to community clinics, patients will have to travel long distances, miss treatments or end up in the emergency room.

DOCTORS, NURSES, AND PATIENT ADVOCATES ALL OPPOSE PROP. 8

"Missing even one appointment can be fatal for dialysis patients. By limiting access to dialysis care, this proposition jeopardizes patient lives."—Dr. Theodore M. Mazer, President, California Medical Association, representing 43,000 doctors

"As emergency physicians, we regularly treat dialysis patients who end up in the ER due to missed appointments or complications from kidney failure. This proposition will increase the risk of life-threatening complications for these very vulnerable patients."— Dr. Aimee Moulin, President, American College of Emergency Physicians, California Chapter

PROP. 8 DISPROPORTIONATELY HURTS DISADVANTAGED COMMUNITIES

Prop. 8 is opposed by California NAACP and National Hispanic Medical Association because it will disproportionately impact patients in disadvantaged communities with higher risk of kidney failure.

PROP. 8 INCREASES COSTS FOR ALL CALIFORNIANS BY HUNDREDS OF MILLIONS ANNUALLY

When clinics close, dialysis patients end up in the ER where care is more expensive. According to the former Legislative Analyst, this measure will increase taxpayer costs by nearly $300 million annually.

CALIFORNIA DIALYSIS QUALITY RANKS AMONG THE HIGHEST IN THE NATION

California dialysis clinics are highly regulated by federal and state regulators that provide quality reports on every facility. According to the federal Centers for Medicare & Medicaid Services, California clinics outperform other states in clinical quality and patient satisfaction. This measure makes no sense when California dialysis care is highly regulated and saving lives.

PROP. 8 COMES BETWEEN DOCTORS AND PATIENTS

Vote NO on Prop. 8 and leave complicated medical decisions about dialysis in the hands of doctors and patients.

PROP. 8 IS DANGEROUS. VOTE NO.

Please join doctors, nurses and patient advocates and reject this dangerous proposition that puts vulnerable dialysis patients at risk. www.NoProp8.com

PHILLIP BAUTISTA, RN, President

American Nurses Association\California

THEODORE M. MAZER, MD, President

California Medical Association

AIMEE MOULIN, MD, President

American College of Emergency Physicians, California Chapter

REBUTTAL TO ARGUMENT AGAINST
PROPOSITION 8

VOTE YES ON PROPOSITION 8 TO IMPROVE HEALTH CARE IN CALIFORNIA.

DIALYSIS CORPORATIONS CUT CORNERS AND ENDANGER PATIENTS

Patients with kidney failure generally undergo dialysis three times a week, where their blood is removed, cleaned and put back in their bodies. Patients and caregivers report unsafe conditions at dialysis clinics, including short-staffing and poor sanitation and hygiene, which puts them at risk of life-threatening infections.

"When I started dialysis, I didn't expect I'd have to worry about the clinic that's supposed to keep me healthy. I've seen bugs crawling in between the plastic that covers the light fixtures in the ceiling. I've had to call the health department many times to report roaches, bloodstains, and lack of adequate cleaning."—Tangi Foster, Dialysis Patient

Visit www.YesOn8.com to read firsthand accounts from Dialysis patients.

DIALYSIS CORPORATIONS MAKE HUGE PROFITS AT PATIENTS’ EXPENSE

For-profit dialysis corporations make billions in profits while clinics in vulnerable communities are run-down, with no doctor on site at times.

PROP. 8 pushes dialysis corporations to invest some of those profits to improve patient care, which is especially needed in low-income communities.

OVERCHARGING DRIVES UP THE COST FOR ALL OF US

Dialysis corporations mark up the cost of care for some patients by 350%, an expense absorbed by insurance companies and passed on to policyholders throughout California.

Their high prices make healthcare more expensive for all of us.

The California Democratic Party, veterans, healthcare advocates and religious leaders all support YES ON PROP. 8.

It's time Dialysis corporations prioritize patient care, not their profits.

GUADALUPE TELLEZ, Dialysis Registered Nurse

PASTOR WILLIAM D. SMART, JR.

Southern Christian Leadership Conference of Southern California

TANGI FOSTER, Dialysis Patient