The November general election ballot includes two statewide propositions that address health issues. Proposition 14 asks voters to extend the life of the California Institute for Regenerative Medicine (CIRM) with the passage of a $5.5 billion bond and Proposition 23 is a second round in a protracted battle between organized labor and for-profit dialysis centers. For very different reasons, voters should reject both Propositions 14 and 23.

To understand Proposition 14, voters must look back to 2004, when they overwhelmingly passed Proposition 71, a $3 billion bond measure that established the California Institute for Regenerative Medicine (CIRM).

Led by Palo Alto real estate developer Robert KJein, whose son suffered from Type 1 diabetes, the campaign was in response to the George W. Bush administration’s refusal to fund research involving human embryonic stem cells.

Promising research breakthroughs that could cure diseases ranging from diabetes to Huntington’s disease, and bringing rehabilitation to those suffering from traumatic injuries, advocates marshaled wide support, including from California’s celebrity community.

In the years since the measure’s passages, CIRM doled out millions in grants and created an impressive infrastructure of research institutes. Stem cell research greatly advanced in California, but the promised spectacular breakthroughs have lagged – a result of the tedious and time-consuming nature of research.

The initial funding to create CIRM is now nearly exhausted. Stem cell advocates, including Klein, whose son succumbed to his disease, are now asking voters to approve a $5.5 billion bond to continue stem cell research.

Voters and earlier proposition advocates should be proud of the progress the initial $3 billion stem cell investment has accomplished. But times have changed and passage of another mega-bond now would be unwise.

As California continues to struggle under the catastrophic burden of the coronavirus pandemic, increasing state budget deficits loom, public service cuts are likely and economic recovery is likely to take more than a decade.

In 2009, President Barack Obama lifted most of the restrictions on federal funding for embryonic stem cell research and demand for the cells has been greatly reduced as other research and technologies have advanced.

Adding $5.5 billion to the state debt for just stem cell research would be unwise in these economically dire times. Vote NO on Proposition 14.

Proposition 23 is an odd topic for a ballot fight. On one side are union activists, who have been frustrated in their effort to organize the staffs of the state’s many dialysis centers. On the other side are center owners, medical associations and patients.

Proposition 23 basically is a replay of a 2018 ballot battle, with voters decisively siding with dialysis centers. Rather than accepting that vote, union activists are taking another bite on the apple with Proposition 23. What is it about NO that these folks don’t get?

In 2018, California voters overwhelmingly rejected a proposition backed by labor that would have capped for-profit clinics’ profits.

A $3 billion-a-year industry in California, with payments coming primarily from Medi-Cal, Medicare and group or personal insurance, kidney dialysis clinics are in increasing demand by patients dependent on regular treatments for survival. Chronic kidney disease is the ninth leading cause of death in the U.S.

This time around, Proposition 23 proponents cite data contending for-profit dialysis clinics have a high mortality rate that should be corrected with mandated staffing ratios. But proposition opponents contend dialysis clinics are strictly regulated and provide high quality care.

The clinics already have physicians on staff, nephrologists make daily rounds and patients typically have personal physicians, according to Kathy Fairbanks, a media strategist for No on 23. “RNs, techs, social workers, dieticians see the patients every time they come in for treatment – three times a week.”

The regulation of patient care at dialysis clinics should be a matter of legislation of industry regulation, not a union negotiating ploy decided by voters. Vote NO on Proposition 23.