If you’re not from California, this post maybe won’t necessarily impact you directly, but it is something important enough and close enough to my heart that I’m going to post it here regardless. I will preface this with the fact that my husband is a physician in California. We’re not hiding that fact, but even if he wasn’t, we would still vote the same way.
There is a proposition on the ballot this November called Prop 46. At first glance, it has a lot of really appealing ideas. It requires mandatory drug testing of physicians and punishes those who test positive. It requires physicians to consult with a national database before prescribing controlled substances, as a way to reduce prescription drug abuse and doctor shopping. Oh and it raises medical malpractice payouts to 1.1 million (from $250,000).
Once you get past that first glance, there are huge, serious issues here.
I’m not going to argue against drug testing for physicians. That was something that was added to the front of this proposition to try to hide what this is really about. If someone wants to draw up a clean proposition for vote that isn’t written by trial lawyers trying to make a buck, I will happily support drug testing physicians. I have been drug tested as a teacher and as a physical therapist, I have absolutely zero issue with drug testing and appropriately punishing/reporting physicians. So let’s just set that aside because it’s a trojan horse.
A little history: The current malpractice cap was created by an act known as the Medical Injury Compensation Reform Act. The idea was to put a limit on the “pain and suffering” payouts that result from medical malpractice, as a way to help prevent malpractice insurance costs from being prohibitive to practicing medicine. It doesn’t cap payouts for medical care, it simply says that beyond the amount that will be paid to cover medical costs and medical care following an event of malpractice, you can only get an additional $250,000 for the suffering the patient/family experienced.
Proposition 46 quadruples that amount to over $1 million dollars for pain and suffering alone. Proponents of prop 46 will say that this is to correct for inflation and that the cost of increased insurance for physicians won’t be passed along to consumers, but they also don’t explain how that’s possible. Probably because it’s not.
If physicians now need to carry FOUR times their current malpractice insurance, how will they pay for that insurance increase? I know popular belief is that physicians sleep on their piles of money, but I can say with great confidence that it couldn’t be farther from the truth. To answer my own question, physicians will respond to their increased insurance in 1 of 2 ways: 1. They will stop practicing (either all together or at least in California) or 2. They will be forced to charge patients more- likely by way of yearly feeds to be a patient, charging for after hours services, or refusing to see low paying insurances.
So basically you will end up paying more out of your pocket or you will need to find a new doctor (who will charge you more). But, on the off chance that you’re one of a very tiny number of people who experience medical malpractice, you can now sue the pants off your doctor. And if you’re one of the lawyers who created this proposition, you can get 4 times as rich!
The other major, major issue with this proposition is the forced use of the drug history database. The Controlled Substance Utilization Review and Evaluation System (CURES) is a database that is used to track prescription use. Basically pharmacists enter schedule II-IV drugs into the system with the idea being to catch patients who doctor shop for medications and to track doctors who are “overprescribing” medications. Currently only a fraction of physicians and pharmacists use this database and it is poorly funded and doesn’t work well as a result. Prop 46 would require physicians to consult CURES before prescribing any schedule II or III medications.
I’m not going to lie, I think having physicians use the CURES database is awesome. There is strong support for this and I understand why. We DO have a problem with prescription drug abuse. We do have an issue with doctor shopping. And to a lesser extent and issue with overprescription. We need to address this, but the CURES database, in it’s current form, won’t do that.
The database isn’t ready for mandatory use. In California, once a proposition passes, it has to be enacted immediately. There is absolutely no way that the day after the election every physician or pharmacist could use CURES. It would crash within the first hour. This means doctors wouldn’t be able to prescribe, pharmacists wouldn’t be able to dispense medications. The database will take months and millions of dollars to be ready for mandatory use. Where exactly is that money coming from? And in it’s current form, the CURES database isn’t protected adequately, which means your sensitive personal medical information is at risk.
It’s really unfortunate that we’ve allowed 2 very important issues- drug abuse by physicians and prescription drug abuse by patients, get thrown together with a relatively obvious ploy for more money by trial lawyers. This proposition isn’t really about patients or protecting people, it’s about money. It’s about trial lawyers getting more money from malpractice at great cost to consumers, both financially and personally. It’s going to increase healthcare costs across the state, it’s going to cause physicians to move or retire and it’s going to put sensitive medical information at risk.
It’s just not worth it. We can do better. Voting no on this proposition doesn’t mean giving up on prescription drug abuse, it means seeing this for what it is: a wolf in sheep’s clothing. Vote no on proposition 46 and tell trial lawyers that they can’t trick voters into higher medical costs that harm patients and physicians and benefit a small group lawyers.
For more information, this is the most recent Legislative Analyst’s office report. It will better explain a lot of the costs.
Also, there’s a full list of donors who gave over $50,000 towards this proposition on this website. Interestingly, all but 2 of the donors are groups of lawyers.
(Just as an FYI, I am moderating comments on this post- but not original comments. You are free to share your opinion as to why you agree or disagree with this post and I encourage you to do so. I wrote this and am prepared to handle the disagreement, however, you are not free to harass other commenters because they disagree with you.)