Finally, a proposition that doesn’t have much at all to do with California’s sovereignty or our relationship with the United States!

Prop 23 creates new regulations for dialysis clinics in California. Prop 23 would require dialysis clinics to:

• always have a physician on staff (unless the state declares a physician shortage)
• report dialysis-related infections to the state health department
• obtain permission from the state health department to close a dialysis clinic
• not discriminate against patients based on the insurance they carry

This is your chance, as a California voter, to play the role of a legislator. On the one hand, these regulations seem pretty straightforward, but what impact will they have on markets—will the increased cost of keeping a physician on staff make some clinics unaffordable, or so unprofitable they have to close?

At ICI, we believe that it’s a good thing California voters so regularly have to make tough calls like these; while Americans can believe that politics is all about voting for the right party; Californians know better. Governance is tough, and messy, and sometimes there are no right answers. Like we said, democracy in California is as real as it gets.

One thing we do like about this initiative: by default, any law passed by California voters can only be changed by going back to the voters. But Prop 23 allows the legislature to update the law within the initiative’s original intent, through the regular process (some initiatives sort of keep the legislature in the game require the legislature to muster a 2/3 vote in both houses, or *cough cough Prop 22* an 7/8 vote). So if Prop 23, and turns out to be less than perfect, chances are we won’t all have to become dialysis clinic policy experts again at some later election.

NEXT: Prop 24: no recommendation on changing California’s privacy laws