Prop 23 Fails While Needs of Dialysis Patients Persist

Proposition 23, a California ballot measure that would have increased regulations on outpatient dialysis centers that serve nearly 80,000 patients in California, was overwhelmingly defeated by 63 percent of the electorate who voted against it.

The initiative was proposed by Service Employees International Union – United Healthcare Workers West (SEI-UHW) who claimed that increasing regulations on outpatient dialysis centers would improve patient safety.

The successful No-Campaign, which raised nearly $100 million to fight the initiative, argued that the measure wouldn’t mprove patient safety and was being used as a political tactic by SEI-UHW.

For now, the battle between dialysis companies and the worker’s union is over, but the needs of the patients on dialysis remain, and nephrologists argue that going forward the focus should be on increasing prevention of chronic conditions and improving availability of organ donations.

“It is truly the best thing we can do for our patients to focus on treating them early, preventing disease, progression,” said Dr. Brian Brady, associate professor of Nephrology and Health Policy at Stanford. “If you were a patient or I were the patient, this the kind of care we would want.”

Along with prevention, Brady also said there are opportunities to improve outcomes for patients on dialysis by increasing availability of organ donations.

With over 100,000 patients on the transplant list nationwide and only 21,000 organ donations in 2019, there is a significant supply-demand mismatch that can be addressed by policy changes.


  • Christopher Rios

    Christopher Rios graduated from Harvard College in 2015 with a degree in Neurobiology and Spanish. He started at Stanford School of Medicine in 2017 and is currently an MS4. Christopher is originally from Kansas City, Kansas. He is Puerto Rican and interested in addressing health disparities for Latinx populations at the domestic and international level. After college, he spent a year in Nicaragua working with the Roberto Clemente Clinic to develop a clean water distribution service. After his first year of medical school, Christopher conducted a small research project looking the response of the Puerto Rican health system to Hurricane Maria. In the following September, he accompanied the Latino Medical Student Association to DC and lobbied for increased funding for Puerto Rico. During this same period, he worked with Dr. Michele Barry at Stanford to develop an experimental class with MUBS student in Beirut. As a part of this class, undergraduate and graduate students at Stanford collaborated with MUBS students to learn about a refugee community in Lebanon and develop interventions to address health and education needs. Over the last year, Christopher has been on clinical rotations at Stanford Hospital and Santa Clara Valley Medical Center. He is planning on applying into neurosurgery, emergency medicine, or critical care. Christopher’s primary interest is health disparities, primarily for Latinx populations. Through Stanford Journalism, Christopher hopes to learn how to use media and journalism to tell stories about patients and medicine in a way that is accessible and captivating, and ultimately facilitates empathy and understanding between people of different backgrounds.

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