Election day is right around the corner!
It is just one week away….
California residents are most likely already aware of Prop 46, which is the most hotly debated and contested ballot initiative this year.
For those outside of California, it is still an interesting debate to follow.
So what is Proposition 46?
It is a ballot initiative in California that addresses several health care reforms.
There are actually three different initiatives all rolled into one.
1) Increase the limit on damages for pain and suffering.
▪ The projected raise on medical malpractice suits would go from $250,000 to $1.1 million. This is the cap on the amount of damages for pain and suffering that can be awarded in a medical malpractice lawsuit. The cap would be indexed to inflation in subsequent years.
According to the Legislative Analyst’s Office, raising the malpractice cap would likely increase total health care spending by 0.1 percent to 0.5 percent. For state and local government, it said the increase could amount to “several hundred million dollars annually.”
Why do we oppose Prop 46?
Prop 46 is essentially well-intentioned. The source of Prop. 46 came from a tragic event – the death of two young children because of a driver high on prescription drugs. And the father’s efforts to bring this reform bill through the political process is certainly noble.
However, the costs are too onerous on doctors and health systems with the medical malpractice suits.
As for the random drug testing for physicians, it is certainly a good idea, but the design of the execution here is flawed. They would be required to submit to drug testing 12 hours after a medical error or risk suspension. But complications from malpractice can take weeks, even years, to appear. It will create another layer of bureaucratic red tape, and will be difficult from an administrative standpoint.
The biggest issue here comes from the mandatory consulting of the PDMP. The database in California is CURES, or the Controlled Substance Utilization Review and Evaluation System. It has existed in California for over 40 years.
Despite that, currently 5% of all 100,000 California physicians currently use CURES on a regular basis. It has been the victim of budget cuts almost every year. There is now one employee to manage the CURES database, for the entire state of California. It has proven to be consistently inaccurate. The data cannot be verified. The data is not in real-time. It can take up to 4-6 weeks for a prescription to be entered into the system. So a doctor shopper could realistically continue to procure drugs without anybody knowing. CURES is not really a tool for prevention at all.
As always, the issue is that a government built and run system is not going to be an effective system over the long term. It will always be the subject of political debates, budget cuts, and mismanagement.
We need better technology to tackle this highly important issue in the state. A private solution is the only way to really communicate between physicians and pharmacists, to track transactions at the point of prescribing, and to monitor the system effectively.
Check out ScriptGuard at www.scriptguard.com for more information.