Testimony Against The HHC Proposal To Privatize Dialysis Services

Arthur CheliotesReprinted by LaborPress Monday July 30, 2012

The Following is Testimony of CWA Local 1182 President Arthur Cheliotes, at a New York City Health and Hospitals Corporation Hearing Held Thursday July 26, 2012, Regarding the  Privatization of Nine Kidney Dialysis Units.

Good Afternoon, My name is Arthur Cheliotes, President of Local 1180 of the Communications workers Of America representing over 2,000 administrative and supervisory worker in HHC and nearly 9,000 NYC workers.  Local 1180 has grave concerns about the HHC proposal to privatize the inpatient and outpatient dialysis services at nine of the hospitals.

We are opposed to this plan, and request that you find other ways to reduce costs, as we believe that patients will ultimately receive poorer services.  Our concerns are based on sound research published in the Journal of the American Medical Association which concluded that private-for profit dialysis centers have shorter durations of treatment and that shorter durations of treatment are associated with higher mortality rates. In fact, in 2002 a meta-analysis found that in investor-owned renal dialysis centers, there was a 9 percent higher mortality rate than nonprofit centers.

The reasons are obvious:

  • There is a focus on producing profits. When this happens, patient safety and quality of care is decreased.
  • Fewer staff often leads to more errors and increased infections.
  • Private for-profit companies hire fewer, non-unionized nurses and technicians at lower wages than what they are currently paid.
  • Lower transplant rates; patients who receive transplants have a much higher life expectancy.

We have always supported HHC when it sought funding in Albany and Washington and are sympathetic and understanding of the HHC financial difficulties, we believe that there are better ways for HHC to provide care for New Yorkers without having to suffer major financial losses. HHC should begin a consultation process with patients, advocacy organizations, and unions to come up with alternatives that will keep dialysis clinics, and other direct patient care services, public and maintain high quality care for all of New York.

Privatized dialysis centers are for profit organization they are expected to give a 10-15% return to their investors and therefore are more focused on producing profits than patient safety. Therefore, they must maximize revenue and minimize costs to suck a profit out of both the HHC and the patients. This means reduced treatments both weekly and hourly to cut costs.  This means understaffing to maximize profits. Including not having board-certified physicians and one full-time registered nurse present. It has  been reported in ProPublica, Nov. 9, 2010, by Robin Fields that this  federal requirement is often ignored.
Therefore the risk for errors is greatly increased and quality of care is decreased. Often times, private vendors will increase the number of chairs available making it seem as if they are providing more to the community. What the companies don’t announce is that most of those additional chairs are for patients with private health insurance which will help maintain their profits. Therefore the number of chairs available for patients who are underinsured, uninsured or on Medicare/Medicaid will likely remain the same or even less.
Finally, For-profit dialysis centers are often detrimental to patient safety and care considering the statistics show a 9% increase in mortality of for-profit patients compared to its public counterpart. There are better ways for HHC to provide care for New Yorkers without having to suffer major financial losses. HHC should not be looking to privatize 9 dialysis centers but rather should be focused on treating the public with public funds and maintaining excellent medical care for all New Yorkers.


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