To:
• U.S. Congress & State Legislatures
• Secretary of Health & Human Services & Centers for Medicare & Medicaid Services
• Private Health-Insurance CEOs (UnitedHealth, Cigna, Aetna, Blue Cross, Humana)
• CEOs of DaVita, Fresenius, and all dialysis providers
• Joint Commission & State Medical Boards
• National Association of Insurance Commissioners

OUR STORY: WHY WE CALL IT “VIA VERA”
Vera Jackson was a grandmother, gospel-choir alto, and retired school secretary whose home dialysis machine became the hallway to every birthday, graduation, and Sunday dinner she refused to miss. Vera believed “the true path” to a good life runs straight through dignity—no shortcuts, no excuses.

Yet shortcuts and excuses were all the system offered.

Her treatments were cut short so the clinic could squeeze in “extras.”

Transportation vouchers disappeared when her ZIP code shifted after a city-ward redraw.

Billing codes multiplied like weeds, drowning her daughter in envelopes no social worker could explain.

When Vera died in 2018 from a completely preventable infection—two weeks after the clinic’s staff whistle-blower was fired—her friends decided the only tribute worthy of her name was to bulldoze the inequities that killed her. Via Vera Dialysis Reform Collaborative was born, led by patients, nurses, technicians, ethicists, and lawyers united around one conviction:

Dialysis care must be the same high standard—safe, transparent, equitable—whether the payer is Medicare, Medicaid, private insurance, or your own credit card.

THE SYSTEMIC FAILURES WE’RE FACING
Private insurers reimburse dialysis chains up to 10× more than Medicare, creating a perverse incentive to push patients off public plans.

Black and Indigenous patients are 2–3 × more likely to develop kidney failure yet have fewer nearby facilities, longer travel times, and higher infection rates.

Two multinational corporations (DaVita & Fresenius) control ~80 % of U.S. clinics, setting policy from the boardroom rather than the bedside.

Proprietary billing codes and gag clauses block families from understanding or contesting charges.

State oversight is fractured: some boards regulate dialysis as “out-patient,” others as “durable medical equipment,” leaving safety gaps big enough to bury data—and people.

This isn’t a single-payer problem or a private-payer problem; it’s a human-rights failure baked into every layer of payor, provider, and regulator.

OUR ROADMAP: THE VIA VERA CODE OF CONDUCT
Universal Equity Metrics
• All dialysis providers—public or private—must publish race-, income-, disability-, and geography-stratified outcomes quarterly.
• Reimbursements and executive bonuses tied to closing those gaps.

Transparent, Uniform Billing
• One standardized, patient-readable bill nationwide.
• Ban on hidden “out-of-network facility” up-charges and predatory collection contracts.

Minimum Staffing & Session Length
• RN-to-patient ratio of 1:6 or better; minimum 4-hour treatment unless clinically contraindicated.
• Protection from schedule-shortening for profit or throughput.

Guaranteed Transportation & Tele-support
• Federally funded ride and tele-interpretation programs available to every patient, regardless of insurance.

Patient Governance & Whistle-blower Shield
• At least two current patients on every facility’s quality board.
• Federal retaliation penalties for firing or intimidating staff who report safety breaches.

Central Safety Dashboard
• Real-time public map of infection outbreaks, machine recalls, staffing violations, and inspection citations—just like restaurant-grade cards.

WHAT CHANGE WILL MEAN
Fewer avoidable deaths—projected 13,000 lives saved in five years.

$4.6 billion in system-wide savings from reduced ER visits and hospital readmissions.

True freedom of choice for patients: clinics compete on care quality, not insurance mix.

Restored trust in a sector that literally holds life in the balance every 48–72 hours.

WHAT WE’RE ASKING YOU TO DO
Congress & State Legislatures: Pass enabling legislation that ties all dialysis reimbursement—public and private—to the Via Vera Code of Conduct.

HHS/CMS: Open an immediate rule-making docket to incorporate equity metrics into every star rating and payment schedule.

Insurance CEOs: Adopt uniform billing and fund the transportation guarantee now—don’t wait for a mandate.

Dialysis Chains: Seat patients on your boards, protect whistle-blowers, publish your infection data in real time.

Medical Boards & Accrediting Bodies: Make compliance with the Code of Conduct a condition of licensure and accreditation.

ADD YOUR NAME
When we reach 100,000 signatures, Via Vera patients and allies will deliver this petition—printed names, personal stories, and a draft federal bill—to Congress and each target listed above. We’ll livestream every hand-off, just as transparent as dialysis care should be.

Vera taught us the path to dignity is straight. Let’s walk it together—sign, share, and demand a dialysis system that treats every life like it matters. 💚

After signing, please leave a comment about why you stand with dialysis patients. Each story fuels the push for laws strong enough to save lives.