08/26/2014

Nov. 4 vote will impact your practice


The campaign working to defeat Proposition 46 in November has ramped up its voter education activities by launching statewide television and radio ads to defeat the ballot initiative backed by trial lawyers. The No on 46 campaign is airing the ads in English and Spanish, highlighting the high cost of Proposition 46 — both in dollars and patient access to care — which would raise the cap on the state’s Medical Injury Compensation Reform Act (MICRA).  

In addition to the ads, statewide newspaper editorials, social media and online videos focus on the flawed proposition written and paid for almost exclusively by trial lawyers who stand to personally profit from quadrupling the limit on MICRA’s $250,000 cap on speculative noneconomic damages to $1.1 million.

The Legislative Analyst’s Office estimates that lifting the MICRA cap would cost local governments and the state hundreds of millions of dollars annually, which has prompted many local government organizations, including the League of California Cities, to oppose Proposition 46. A former California legislative analyst evaluated increased costs across all sectors of the health care industry and found Proposition 46 would increase health costs for consumers, taxpayers and the state by about $9.9 billion annually. For a family of four, the increase in health care costs would be more than $1,000 a year.

Opponents of Proposition 46 are working to educate voters that the ballot measure includes two other unrelated provisions designed to mask the change to MICRA. The initiative also threatens personal privacy by requiring a massive expansion of the use of a government-run prescription drug database without any additional security safeguards. The measure requires doctors and pharmacists to use the CURES database system prior to prescribing or dispensing Schedule II or III controlled substances. This requirement would force the CURES database to respond to 30-40 million “hits” a year, up from the current 1 million, which the database simply cannot do in its current form. In a 2012 review of CURES, the Department of Justice stated that the system is “slow and freezes” with its current usage and upgrades will not be completed until at least the summer of 2015. However, this provision of Proposition 46 would take effect the day after the election, which means providers could be faced with either breaking the law to provide medications to patients or deny patients needed prescriptions.


The third provision of Proposition 46 requires random drug testing of physicians and requires hospitals to administer the tests after an “adverse” event. Backers of Proposition 46 admit this provision was added to the ballot measure as the “ultimate sweetener” just because it polled well with voters.

In addition to CDA, the coalition working to defeat Proposition 46 is made up of more than 500 organizations, representing health care organizations, hospitals, clinics, law enforcement, educators, state and local governments, Planned Parenthood, the ACLU and many others. The campaign has more than $30 million in the bank to fight the initiative, with commitments of tens of millions more to defeat it.

Join CDA Past President Dan Davidson, DMD, at CDA Presents in San Francisco for a presentation that explains how MICRA protects patients and access to health care, and how passage of Proposition 46 could negatively impact patients and cost billions of dollars. The presentation is Saturday, Sept. 6, 1:30-2:30 p.m. at Moscone South, Room 274.

More information on Proposition 46 can be found on this website. The No on 46 campaign is providing free materials such as brochures, posters, buttons and information cards that can be shared with colleagues and patients. To place an order or to receive regular updates, sign up for the campaign email list at NoOn46.com. Also, follow the campaign on Twitter (@NoOn46) and Facebook.