July 2, 2014

No on Prop 46

California has benefited from a cap on pain and suffering in law suits since the mid 1970s, when MICRA was implemented. MICRA put in place a $250,000 cap on pain and suffering. One thing that many people do not realize is that it does not limit the amount of payments necessary to provide medical care. If a baby is injured and requires $25,000,000 to cover the cost of care for the rest of its life, then that is what gets paid.
Over the last 25 years, the amount paid for malpractice claims have been increasing. Despite this, the trial attorney’s want to change the cap on pain and suffering. If this cap were to increase, then the cost of malpractice insurance would increase. If the cost of malpractice insurance goes up, then the people who will suffer will be the most vulnerable, the poor and disabled, because providers, whether physicians or community clinics or whatever will have a hard time staying open with the increased costs.
Proposition 46 is deceivingly packaged. It starts out with mandating urine drug testing for physicians when there is an adverse event. This would mean that if I saw you, then you got injured in a car accident on the way home and then the ER doctor made an error in treating you, then I would be presumed to be acting below the standard of care, even if I did not know that you had the drug accident. The same would apply if I were out of town. It makes no sense.
The proposition also mandates the use of CURES, the State of California’s prescription monitoring program, every time I write a triplicate. Many of you may have seen me be unable to log on to CURES. Does that mean that I cannot write your script? Should I let you go into withdrawal because there is a problem with a database in Sacramento. Clearly, this is a very poorly though through proposition.
A related issue is that if I, or any provider, including paramedics, think a doctor is doing something wrong, then we are obligated to report that provider. There is no clear definition as to when we are supposed to make this report. In my over 30 years of practice, I have never seen anyone do anything that I believe is reportable. Under this proposition, if I do not report something, then I become liable. This is a requirement that we are not meant to be able to meet!
A coalition has been formed to stop Prop 46. The teachers oppose it because it will hurt kids. The doctors and hospitals and community clinics oppose it because it will harm the vulnerable. The SEIU and many other unions oppose it. The Chamber of Commerce opposes it.