In November, California voters will be asked to go to the ballot on Proposition 46, a law that seeks to quadruple the current state limit on medical malpractice claims and would require doctors to undergo mandatory drug testing.

Behind Proposition 46

California currently caps non-economic damages in medical malpractice lawsuits at $250,000. Non-economic damages refers to things such as pain and suffering that some lawsuits seek compensation for. Proposition 46 seeks to relate the cap for medical malpractice lawsuits to inflation rates, which means that it would be raised to $1.1 million immediately. Economic damages, such as future medical care or lost work opportunities, do not have a cap in malpractice lawsuits.

Aside from increasing the cap, the law will:

• Require that doctors be drug and alcohol tested and report those results to the California Medical Board
• Suspend doctors with positive tests and take appropriate disciplinary action if the doctor was proven to be impaired while on duty
• Require that health care practitioners report suspicions of drug or alcohol impairment and medical malpractice
• Require that health care practitioners consult the state prescription drug history database before prescribing some substances.

Proposition 46 would be the first law in the United States that requires physicians to undergo random drug testing.

Support & Opposition for Proposition 46

As with any ballot measure, there is support and opposition to the proposition. It is believed that if this proposition passes, many other states will follow suit and raise or eliminate caps on medical malpractice claims.

Supporters feel that too many doctors are medically negligent and non-economic damages are too low. The California Medical Board puts one in five doctors as suffering from drug or alcohol abuse at some time during their career. Supporters note that over 300,000 injuries occur each year from doctors making medical mistakes, and by raising the amount that they could be sued for will force doctors and other health care providers to be more careful about potential mistakes. They also believe that raising the medical malpractice cap will still allow insurance agencies to make a profit from those they insure while not forcing health care costs to rise.

Opposition states that only lawyers will benefit from the increase in trial payouts. They claim that those that will have to pay for the increase in medical malpractice costs will be the consumers of medicine, citing a study that increases consumer cost by $9.9 billion. The database that doctors will have to implement prescription medications into is controlled by the federal government, which will have unrestricted access to this information. Finally, with medical liability costs rising, doctors may need to go to other states to make the profit they seek. This means community clinics may have to eliminate specific services and other benefits.

No matter what the outcome in November, the battle over Proposition 46 by supporters and opponents will be one to watch. With potential effects to be felt all over the United States, California voters will be setting a precedent that will be likely be echoed in other states.