Politics

Election 2014 FAQ: Prop 46 — doctor drug testing and medical negligence

Proposition 46, an initiative statute placed on the ballot by voter petition, would increase the cap on medical malpractice damages for things like pain and suffering, require doctors to check a prescription database before dispensing drugs to new patients, and make physicians subject to random drug and alcohol testing.
Proposition 46, an initiative statute placed on the ballot by voter petition, would increase the cap on medical malpractice damages for things like pain and suffering, require doctors to check a prescription database before dispensing drugs to new patients, and make physicians subject to random drug and alcohol testing.
File photo by Micah Taylor/flickr Creative Commons

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Proposition 46 is an initiative statute placed on the ballot by voter petition. It is also referred to as the Troy and Alana Pack Patient Safety Act of 2014.

Who's behind this ballot measure?

For proponent Robert Pack, Prop 46 represents the latest chapter in a story that began shortly after his two children were struck by a car and killed in October 2003.

A jury found the driver was drunk and high on prescription drugs and sentenced her to 30 years to life in prison. 

But for Pack a key problem that remained unresolved was doctor shopping — when a patient goes from clinic to clinic selling each physician on a different pain in order to collect prescription medications. 

Pack, a tech professional, responded by becoming a political activist, helping to push two California bills through the legislature with the help of state Sen. Tom Torlakson. One increased the penalties for drunk driving. Another created a statewide database to help monitor prescriptions, though there is currently no requirement that doctors check it before dispensing drugs.

Prop 46 expands on Pack's earlier efforts.

What would it do?

If approved, Prop 46 would:

How is this different from existing laws?

According to the Legislative Analyst's Office, currently:

How much will it cost taxpayers?

There is "substantial uncertainty" about many of the potential financial impacts to state and local governments, but the LAO estimates:

Raising the cap on noneconomic damages to $1.1 million could lead to ...

Requiring physicians to check the CURES database and undergo drug and alcohol testing could lead to ...

More: Read the full LAO analysis

How much money's being spent on the campaigns?

Who's supporting it and why?

By far the biggest financial backer of Prop 46 is the group Consumer Attorneys of California, a professional organization for consumer and personal injury lawyers. CAOC has given nearly $1.2 million to the campaign as of September 24.

The advocacy outfit Consumer Watchdog has also played a key role in organizing the campaign and was the second largest financial backer with $290,000 in contributions.

Supporters of Prop 46 say it will protect patient safety by:

Attorneys could also potentially benefit from a higher cap on noneconomic damages by charging more in fees. However, according to the LAO, attorneys are limited in the share of an award they can demand as payment. They cannot receive as a fee, for instance, more than 40 percent of the first $50,000 recovered or more than 15 percent of the amount recovered greater than $600,000. Prop 46 would retain that limit.

More: Yes on 46 campaign website

Who's opposing it and why?

Doctors, hospitals and insurance companies have mounted an expensive campaign against Prop 46.

The Cooperative of American Physicians, The Doctors Company and NORCAL Mutual Insurance Company — all medical malpractice insurers — have contributed about $10 million each to oppose the measure.

Kaiser Permanente, the California Medical Association, the California Hospital Association, the California Dental Association and others have also contributed millions to the No on 46 campaign.
Opponents argue that Prop 46 will:

More: No on 46 campaign website

… a YES vote means…

You accept the changes proposed: the cap on noneconomic damages for medical malpractice, including pain and suffering, will be increased to $1.1 million and adjusted annually for inflation; health care providers will be required to check a prescription database before dispensing certain drugs to new patients; and doctors will be subject to random drug and alcohol testing.

… a NO vote means…

You reject the changes will be made: the current $250,000 cap on noneconomic damages will remain; health care providers will not be required to check the prescription database; and doctors will not be subject to random drug and alcohol testing.

What else is being reported on this measure?

And there's this explainer put together by SeePolitical, a nonprofit organization that aims to help voters by decoding complicated political issues with accessible video content:

Video

Para ver en español, haz clic aquí.

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This story has been updated.