A dialysis patient. File photo.

In summary

California healthcare workers union leader Dave Regan has used initiatives and threats of initiatives in the past in negotiations on behalf of his 100,000-member union. That Proposition 8 opponents are spending $105 million-plus to defeat the initiative is sure to send a message to Regan’s future foes that ballot measure fights come at a steep cost.

Win or lose, Dave Regan, the healthcare worker union leader who is pushing an initiative to regulate dialysis clinic profits, is getting some satisfaction at the huge sums being spent by the dialysis industry, $105 million and counting.

“In a weird kind of way, we must be doing something right,” Regan said, referring to the spending.

Proposition 8 would limit California’s 555 dialysis clinics to 15 percent profit, and provide incentives for the operators to increase staffing.

Regan’s Service Employees International Union-United Healthcare Workers West would dearly love to organize the 9,000 workers at the main private clinics, DaVita Kidney Care and Fresenius Medical Care.

“It’s unconscionable that UHW is willing to continuously put patient lives at risk to pursue its union organizing agenda,” said Kathy Fairbanks, spokeswoman for the industry opposed to the initiative.

Regan has used initiatives and threats of initiatives in the past in negotiations on behalf of his 100,000-member union. That Proposition 8 opponents are spending $105 million-plus to defeat the initiative is sure to send a message to Regan’s future foes that ballot measures come at a steep cost.

Not that he’s conceding his Proposition 8 will fail, but Regan said in an interview that he plans to press for new legislation in 2019 aimed at the dialysis industry, may return to the ballot in 2020 with a new initiative, and hopes to work with labor leaders in other states who might want to copy what he is doing.

“Honestly we did not just do this as a one-off. We are committed to patients and the workers over the long-term,” Regan said.

So far, the Colorado-based DaVita has led the opposition by spending $67 million to defeat the initiative and Fresenius Medical Care of Kansas has spent $29.3 million. Fairbanks declined to say what the ultimate budget is.

But Regan predicted the dialysis companies would spend $150 million to defeat Proposition 8.

A $150 million campaign seems unlikely; there are only two weeks until the Nov. 6 election day. But there’s little doubt that dialysis companies are willing to spend whatever it will take to defeat Proposition 8.

The $105 million-plus no-on-8 campaign would not be a California record but probably will be the single costliest state race in the nation this year.

“It is an incredibly lucrative line of business and they’re determined to defend the business model,” Regan said, calling dialysis “the payday lending part of the healthcare industry.”

Unlike other labor-backed campaigns, in which unions join together, Regan’s 100,000-member union is all but alone and has no coalition.

His Service Employees International Union-United Healthcare Workers West spent $17.6 million on the campaign. Others gave a relative pittance:

  • $1 million from the California State Council of Service Employees International, the union’s umbrella.
  • $2,500 from an electrical workers’ local.
  • $53,000 from the California Democratic Party

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Dan Morain joined CalMatters in March 2018. He is the former editorial page editor of The Sacramento Bee. Morain also spent 27 years at The Los Angeles Times, and has covered the Capitol since 1992.