Prop 46 Cheat Sheet: Drug and Alcohol Testing of Doctors, Increased Negligence Awards

Vicodin, shown here, is among the prescription drugs that would be under tighter control if Prop 46 passes.
Vicodin, shown here, is among the prescription drugs that would be under tighter control if Prop 46 passes. | Photo: Hiii Fiii/Flickr/Creative Commons License

This cheat sheet was published in tandem with a Prop 46 segment on KCET's "SoCal Connected." Watch it here or watch the full election special here.

Proposition 46 will appear on California's Nov. 4, 2014, ballot.

A shocking number of Americans die because of medical errors -- some estimates place them as the third leading cause of death after heart disease and cancer. Simultaneously, prescription drug abuse is at epidemic proportions, and doctors themselves are among the abusers.

This measure aims to remedy both problems, and to make medical negligence lawsuits more expensive for defendants as a means of preventing errors in operating rooms and other medical settings.

Prop 46 would create the nation's first random drug-testing rules for doctors. Additionally, it would mandate that doctors found to have worked while drunk or high are disciplined. Doctors would also be required to report other doctors they suspect of being under the influence on the job.

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As the measure's supporters point out, pilots, bus and truck drivers, and other professionals who hold people's lives in their hands are often given mandatory, random drug tests.

Under the proposition, doctors would also be required to check a national patient history database before prescribing commonly abused drugs such as OxyContin, Vicodin, and Adderall. That way, proponents argue, they could eliminate "doctor-shopping" and prescription drug abuse. The database already exists, but doctors are not under obligation to check it before dispensing drugs.

There's one more part to this measure. Prop 46 would quadruple the cap on pain and suffering awards in medical malpractice lawsuits. The cap, set at $250,000, dates back to a 1975 initiative which did not tie award amounts to inflation. Raising it to $1 million today would bring it in line with inflation; going forward, the cap would be tied to inflation.

If Prop 46 passes, it's predicted that medical providers would have to pay much more in malpractice insurance and negligence awards. Because state and local governments operate numerous medical facilities and programs, that could translate to a rise in government health care costs to the tune of tens to hundreds of millions of dollars a year, according to official legislative analysis. That is a significant amount given the tens of billions the state and local governments spend annually on health services.

Key Points:
Requires random drug and alcohol testing of doctors, and mandates discipline for doctors who practice medicine drunk or high

Requires doctors to report other doctors they suspect of practicing under the influence

Requires doctors to check a national database of patient history before prescribing drugs like OxyContin, Vicodin, Adderall to cut down on abuse

Raises the cap on pain and suffering damages in medical negligence lawsuits from $250,000 to $1 million, and ties the cap to inflation thereafter

What Your Vote Means:

A YES vote means doctors will be randomly drug tested and disciplined for practicing while high

A YES vote means government health care costs could rise from tens to hundreds of millions of dollars a year due to increased costs in malpractice insurance and negligence awards

A YES vote means doctors must consult a national patient database before prescribing controlled substances to prevent "doctor shopping"

A NO vote means the $250,000 cap on pain and suffering awards in medical negligence lawsuits remains in place

A NO vote means doctors will not be randomly drug tested

Principal Supporters:
Consumer Attorneys of California
Kabateck, Brown, Kellner; law firm
Robinson Calcagnie Robinson Davis; law firm
Cotchett, Pitre & McCarthy; law firm
Bisnar/Chase Personal Injury Attorneys; law firm
Panish, Shea & Boyle; law firm
Consumer Watchdog

Principal Opponents:
Cooperative of American Physicians IE Committee
The Doctors Company
Norcal Mutual Insurance Company
California Medical Association Physicians' Issues Committee
California Hospital Association
California Dental Association
California Medical Association
American College of Emergency Physicians, California Chapter

Click here to read full text of Prop 46.

NOTE: The author of this post -- not the proponents of each measure -- selected the aforementioned key points for each ballot measure. They do not represent all of the provisions detailed in Proposition 46, rather they are intended to offer the salient details.

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