Vote against threat to malpractice protection

Dear Colleague,

California voters will soon cast ballots in the November 4 general election and, as your association president, it's important to let you know that rarely does the dental profession face a ballot measure with the potential for such a direct, negative impact on health care as Proposition 46. We need your help to make sure this ballot measure does not pass.

The primary goal of Proposition 46, sponsored by trial lawyers, is to make malpractice lawsuits against dentists and other health care providers more lucrative, which will significantly increase liability insurance costs, the volume of litigation and patients' health care costs.

Specifically, the main provision of Proposition 46 will quadruple the noneconomic damages cap under California's landmark Medical Injury Compensation Reform Act (MICRA), the law that governs compensation for patients injured in a medical procedure, raising it from $250,000 to $1.1 million, plus annual inflation adjustments. Under MICRA, Californians already have the right to unlimited economic damages, which include past and future medical expenses and past and future lost wages. In addition, Californians have the right to unlimited punitive damages.

The California State Legislature enacted MICRA in response to a liability insurance crisis in the 1970s, during a time when premiums skyrocketed as much as 400 percent annually and drove health care providers out of practice or out of state. It was also in response to this crisis that CDA created The Dentists Insurance Company (TDIC) to help dentists stabilize the cost of their premiums.

For decades, CDA has worked with a large coalition to successfully block attempts by trial lawyers to overturn MICRA in the Legislature and courts. Proposition 46 is the first attempt to change the law through a ballot measure and, in an effort to distract voters from the quadrupling of the MICRA cap, proponents included two other unrelated provisions.

CDA and more than 600 organizations are working to defeat this measure, but we can't do it alone. Here's what you can do:

  • We urge you to vote NO on Proposition 46. If you have not yet registered to vote, please do before October 20 at registertovote.ca.gov.
  • Get the word out to patients, colleagues and friends. Visit NoOn46.com and order free campaign materials to display in your offices. Local dental societies also have materials available.

Thank you for being a member of CDA. Your membership allows us to aggressively fight harmful proposals like Proposition 46, for the benefit of you and your patients.

James D. Stephens, DDS

Key Facts About Proposition 46

Quadrupling MICRA's Noneconomic Damages Cap

  • Analyses indicate that quadrupling MICRA's cap on noneconomic damages could increase health care costs by $1,000 per family of four annually and that state and local government health care costs could increase by several hundred million dollars annually.
  • Proposition 46 would triple the legal fees trial lawyers can receive from a maximum noneconomic damages award.
  • Prior to MICRA's passage, dentists and other health care providers were seeing annual liability premium increases of up to 400 percent due to excessive lawsuits and payouts. MICRA ensures that patients can receive fair compensation (unlimited health care costs, lost wages, future earnings, punitive damages, etc.) while stabilizing health care costs so providers can stay in practice, treating patients.
  • Community clinics warn that if Proposition 46 passes, increased costs will give them no choice but to reduce or eliminate vital services, particularly in underserved areas.

Mandatory Use of the State's CURES Prescription Drug Database

  • Proposition 46 would require all prescribing providers to check a patient's prescription history through the state's prescription drug database (known as CURES) prior to issuing a Schedule II or III drug.
  • The state Department of Justice, which oversees CURES, has stated that the system is "slow and freezes" and that it is "not sufficient enough" to carry on its mission.
  • The Proposition 46 mandate would take effect Nov. 5 and upgrades to the CURES system are not expected until the summer of 2015 at the earliest.
  • Proposition 46 provides no increased security standards to protect patients' personal prescription information from hacking and theft, putting the privacy of this information at risk.

Drug and Alcohol Testing of Physicians

  • Proposition 46 requires hospitals to conduct drug and alcohol testing of physicians. The measure's backers admitted to the Los Angeles Times that this provision was included only because it tested well in focus groups, calling it the "ultimate sweetener" for voters. This was a political ploy to appeal to voters, not a well-reasoned policy proposal.