Proposition 46

Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits.

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Proposition 46 would increase the state's cap on medical negligence lawsuits from $250,000 to over $1 million. Under certain conditions doctors would receive drug and alcohol testing, with the results reported to the California Medical Board. The Medical Board would be required to suspend any doctors with positive results while investigating the results. Any doctors found to be impaired would be disciplined. Health care practitioners would be required to report doctors suspected of drug or alcohol use while on duty. Finally, health care practitioners would be required to consult a state prescription drug database before prescribing specific controlled substances. 

Proposition 46 is an initiative statute.

Official Results

Yes votes: 2,376,817 [33.2%]

No votes: 4,774,364 [66.8%]

Details

Pro/Con
Pro: 

Supports of Proposition 46 believe the measure will help stem the impact of medical negligence in the state by forcing doctors to be accountable for wrongdoing while practicing. They claim the measure will help combat prescription drug abuse by forcing doctors to consult a database for patient's addiction history. They say that measure will help stem the impact of drug use by doctors by instituting routine testing.

Supporters: 

Yes on 46

Con: 

Opponents claim Proposition 46 is deceptive because it's true intent is to increase the limit on malpractice award amounts resulting in higher rates for the public as well as the departure of many doctors to areas with lower malpractice limits. They say the prescription drug database created by the measure is an invasion of privacy. They believe the testing of doctors for drug and alcohol abuse is an attempt to distract from the measure's true focus. 

Opponents: 

No on Prop. 46  

No on Prop. 46 Coalition

In Depth

Proposition 46 relates to malpractice, prescription drug monitoring, and alcohol and drug testing for doctors. Currently, health care providers purchase malpractice insurance to pay the cost of malpractice claims. In some cases, the organization a provider works for will pay for the cost of malpractice claims. These organizations generally include hospitals and physician groups. 

Proposition 46 would raise the cap on medical malpractice damages beginning January 1, 2015. The current cap is $250,000 but Prop. 46 would adjust it to reflect inflation increases that have occured since the cap was created. 

The measure would also require physicians and pharmacists to check the Controlled Substance Utilization Review and Evaluation System (CURES) database prior to prescribing specific drugs to a patient for the first time. The drugs are categorized as addictive and include such substances as Vicodin, OxyContin, and Adderall. If the CURES system finds that a paitent has an existing prescription for one of these drugs, the provider must determine if there is an approiate need for an additional one. 

Proposition 46 would require hospitals to conduct alcohol and drug testing of physicians. When a doctor is made responsible for a patient's treatment prior to an adverse event, they would have to undergo a test. Adverse events include injuries associated with medication errors or errors made during surgery or events that end with the death or serious injury of a patient. Physicians would also have to undergo testing if they become the subject of a report of drug or alcohol use while treating patients. The hospital would be required to bill the physician for the cost of the test. 

When tests come up positive or if the physician refuses to take the test, the hospital would be required to make a report to the medical board. The board would be required to take disciplinary action including suspending of his or her license.

The measure is expected to increase health care spending in the state by increasing medical malpractice costs and changing the amount and types of health care services provided. The number of malpractice claims could increase or decrease if the measure passes. The cap could raise the amount that could to go to attorneys representing injured parties, which could increase the number claims bringing costs up. State and local governments could see spending on health care costs associated with providers passing along additional costs to clients, such as local governments.  Raising the cap on damages might encourage health care providers to alter how they practice medicine in order to avoid malpractice claims. This could increase health care costs. 

Polling

Field Poll #2490, October 31, 2014
On Prop. 46, 32% are intending to vote Yes, 49% are on the No side and 19% are undecided.

Field Poll #2478, August 20, 2014 - 2014 TCWF-Field Health Policy Poll - Part 2, Over One in Three Voters Under Age 65 Personally Visited the Covered California Website, Medi-Cal Viewed as Increasingly Important to Voters and Their Families, Support for Proposals Aimed at Improving State's Health Care System, Including Prop. 45 

 

Page 4: " Proposition 46, the "Drug and Alcohol Testing of Doctors; Medical Negligence Lawsuits" initiative, is currently supported by 58% and opposed by 30%, with 12% undecided."

USC Dornsife/Los Angeles Times, September 13, 2014

"Support for Prop. 46 Drops Steeply as Voters Hear Initiative Details"

 

Voter Resources

Official CA Documents

Official Voter Information Guide

Campaign Finance Information 
Cal-Access 
Check out how much money is being raised and spent to pass or defeat this measure, and where the money is coming from.

Cal-Access Ballot Measure Summary Data Search 
Select "General 04 November 2014" and "Proposition 046" from the drop-down menus. Cal-Access provides financial information supplied by state candidates, donors, lobbyists, and others.

Nonpartisan Analyses
Ballotpedia 
League of Women Voters: Pros and Cons
Project for an Informed Electorate - Fact Check:
No on Prop. 46 "Inside"
Yes on Prop. 46
 

Multimedia
Supporters
Carmen Pack - Sí a la Proposición 46
Carmen Pack - Sí a la Proposición 46
What is Proposition 46?
What is Proposition 46?
Prop 46 - Inebriated Dr Ad
Prop 46 - Inebriated Dr Ad
Proposition 46 & Hospital Killers
Proposition 46 & Hospital Killers
Proponents of Prop 46 in California - Troy and Alana Pack Act Initiative
Proponents of Prop 46 in California - Troy and Alana Pack Act Initiative
Debunk No on Prop 46 Commercial
Debunk No on Prop 46 Commercial
Prop 46—Every 30 seconds
Prop 46—Every 30 seconds
DR Loyd Press Conference
DR Loyd Press Conference
Barbara Boxer: Yes On California Prop 46
Barbara Boxer: Yes On California Prop 46
Yes On 46 - Sept 3 2014 Press Conference - Audio
Yes On 46 - Sept 3 2014 Press Conference - Audio
 Dr. Stephen Loyd: Yes on California Prop 46
Dr. Stephen Loyd: Yes on California Prop 46
Prop 46 Debate
Prop 46 Debate
LA Board of Supervisor's Meeting-Prop 46
LA Board of Supervisor's Meeting-Prop 46
Debunking No on Prop 46 Radio Commercial
Debunking No on Prop 46 Radio Commercial
Shoot Holes in the No On Prop 46 Propaganda—CURES
Shoot Holes in the No On Prop 46 Propaganda—CURES
Sacramento Press Conference — Prop 46 — Legislative Hearing
Sacramento Press Conference — Prop 46 — Legislative Hearing
Bob Pack: Yes on Prop 46
Bob Pack: Yes on Prop 46
MICRA reform 2014 Supported by Barbara Boxer | Prop 46 medical cap
MICRA reform 2014 Supported by Barbara Boxer | Prop 46 medical cap
CMA's Alicia Wagnon gives wrong info to Prop 46 Legislative Hearing
CMA's Alicia Wagnon gives wrong info to Prop 46 Legislative Hearing
 No on Prop 46 campaign lies
No on Prop 46 campaign lies
AdWatch: No on 46 ad nothing more than a scare tactic
AdWatch: No on 46 ad nothing more than a scare tactic
NBCLA Prop. 46 News Conference
NBCLA Prop. 46 News Conference
KNBC TV-4 Los Angeles: Prop 45 Supporters Dump BS at Blue Shield
KNBC TV-4 Los Angeles: Prop 45 Supporters Dump BS at Blue Shield
Non-Partisan
Proposition 46: Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits
Proposition 46: Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits
Prop 46 - Drugs and Malpractice Lawsuits
Prop 46 - Drugs and Malpractice Lawsuits
Prop 46 - Drogas y Demandas por Descuido
Prop 46 - Drogas y Demandas por Descuido
 November 2014 Proposition 46 Analysis
November 2014 Proposition 46 Analysis
Prop 46: Drug and Alcohol Testing of Doctors, Increased Negligence Awards
Prop 46: Drug and Alcohol Testing of Doctors, Increased Negligence Awards
CMA puts money up against Patient Safety & Prop 46
CMA puts money up against Patient Safety & Prop 46
KNSD TV-7 NBC - San Diego, CA: Prop 46 Will Save Lives
KNSD TV-7 NBC - San Diego, CA: Prop 46 Will Save Lives
 KTVU Oakland - Is your Doctor impared? A new way to report your Doctor in California.
KTVU Oakland - Is your Doctor impared? A new way to report your Doctor in California.
 Should Doctors Have To Take Random Drug Tests?
Should Doctors Have To Take Random Drug Tests?
KPIX CBS San Fransisco - A new billboard from Consumer watchdog aims to help patients.
KPIX CBS San Fransisco - A new billboard from Consumer watchdog aims to help patients.
 Proposition 46: MD Drug Testing (California 2014 Midterm Election)
Proposition 46: MD Drug Testing (California 2014 Midterm Election)
California’s Malpractice System: Fair or Failed
California’s Malpractice System: Fair or Failed
No On Prop 46 - Expert on Costs
No On Prop 46 - Expert on Costs
Battle Over Proposition 46 Focuses On Medical Malpractice Awards
Battle Over Proposition 46 Focuses On Medical Malpractice Awards
Opponents
The Truth About Proposition 46
The Truth About Proposition 46
Prop 46 Deception (California Nov. 2014 Ballot)
Prop 46 Deception (California Nov. 2014 Ballot)
NO ON 46 - Risk
NO ON 46 - Risk
 No On Prop 46 - Terrible Joke
No On Prop 46 - Terrible Joke
Prop 46 Deception (California Nov. 2014 Ballot)
Prop 46 Deception (California Nov. 2014 Ballot)
No On Prop 46 - Inside
No On Prop 46 - Inside
No On 46 - Cynical
No On 46 - Cynical
Proposition 46 Government project
Proposition 46 Government project
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