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Letter: Prop. 46 deserves a ‘no’ vote


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To the community,

California Proposition 46 is costly and deceiving to voters. It would increase costs for patients, deter doctors from practicing in California, and threaten patient privacy. The consequences are also higher for rural communities like South Lake Tahoe. I have been a physician in South Lake Tahoe for over 34 years and I’m asking our voters and patients to take a closer look; Prop. 46 just doesn’t add up.

Prop. 46 will escalate insurance rates and, ultimately, increase healthcare costs for patients. The non-partisan California Legislative Analyst’s Office estimates that Prop. 46 would cost patients an additional $9.9 billion annually, that’s $1,000 a year for a family of four.

The second part of Prop. 46, also considered the “sweetener” to woo voters, would require random drug testing on physicians. While this may seem like a valuable safety measure, data shows that a minuscule percentage of harm is done by impaired physicians and Prop. 46 would exclude testing physicians who practice in private offices. Medical facilities, including Barton Memorial Hospital, already have proven and effective safety measures in place to protect patients from harm.

Lastly, Prop. 46 would require doctors use a state-controlled database before prescribing certain controlled substances and to discourage patients who “doctor hop” for pain medication. But the Prop. 46 solution to this real problem is inadequate: the database is unreliable, understaffed, and lacks security measures. This will only burden medical providers to operate an additional program that is not ready or secure for statewide use.

I encourage voters to take a closer look at this proposition. Please join Barton Health and over 500 other organizations across party lines and vote “no” on Prop. 46 in the upcoming election.

Paul Rork, physician and board of director Barton Health

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Comments (3)
  1. Joe says - Posted: October 25, 2014

    This letter is full of scare tactics that big profit medical insurance companies want you to believe. Prop 46 is about patient and public safety and justice.

    The effects of the 1975 MICRA law 250K cap have now reduced the value of many of your family members to essentially zero as you can not obtain a lawyer in any wrongful death malpractice case for them.

    Hundreds of thousands of Americans die yearly as the result of preventable medical negligence. Common hospital malpractice errors include: incorrect medication/dosage, surgical mistakes, preventable infections, diagnosis failures, birth delivery mistakes, anesthesia errors and under/over treatment.

    All Californian families are now denied any justice and accountability when a family member without job income(children, retirees, ect) dies as a result of medical errors due to the 1975 MICRA law which malpractice insurance companies backed and that capped the non-economic “pain and suffering” award to 250K with no adjustment for inflation. Except in rare punitive damage cases this is the only award available.

    Malpractice lawyers will not take these wrongful death cases because the MICRA law also limits the attorney award to about 30%(BPC 6146) or about $75K of any maximum $250K award and attorney and medical expert costs in a case quickly exceeds $75K, search on “caps harm California” and “protectconsumerjustice org how micra came to be”.

    Governor Brown who signed MICRA into law said 17 years later that MICRA did not lower health care costs and only enriched insurers and placed negligent or incompetent physicians outside the reach of judicial accountability. Ralph Nader has reminded Governor Brown’s of this earlier statement and has asked him to support Prop 46.

    The MICRA cap and low non-economic damage caps in many other states have enabled malpractice insurance companies to earn billions in profits by essentially eliminating their monetary liability in these cases. It’s no wonder malpractice insurance companies have spent tens of millions to defeat Prop 46 which doesn’t even eliminate the cap, only adjusts it for inflation.

    California malpractice insurance companies profit an incredible 70 cents for every dollar collected in malpractice premiums which leaves plenty of room for an increase in malpractice payouts without a rate increase to doctors.

    22 other states do not have a non-economic damage cap and medical insurance rates are not any higher in those states nor are there shortages of physicians.

    Since 1988 Prop 103 has regulated doctors malpractice insurance premiums and can not be increased unless justified with the Insurance Commissioner.

    California drivers do not have a law that eliminates their liability if they kill a person in a car accident and neither should negligent medical professionals and their insurance companies. When there isn’t accountability there isn’t a deterrent to avoid repeating negligence.

    Prop 46 also includes testing doctors for drug and alcohol which is done in other occupations such as in the transportation industry. Certainly it is in the public’s interest for doctors to be thinking clearly when they have our lives in their hands.

    Overprescribing of prescription narcotics is now a national epidemic. The Centers for Disease Control cited 475,000 emergency room visits and 36,000 deaths from prescription narcotic overdoses in a recent year, at a price tag of $72 billion in avoidable health care expenditures.

    Prop 46 will also require physicians to check the state’s existing and secure DOJ CURES prescription drug database before prescribing narcotics and other addictive drugs to curb doctor-shopping drug abusers, to prevent over-dose deaths and to reduce harmful behavior and health care costs.

    PLEASE VOTE YES ON PROPOSITION 46 for Public Safety and Patient Justice.

  2. Michael B. Clark says - Posted: October 26, 2014

    Thank you for the opposition view, Joe. Is there some reason why you choose to remain anonymous? It seems that you have a great deal of expertise in the subject area. In my view, anonymity reduces the credibility of your argument while revealing your identity would increase that credibility. Making an idle opinion may certainly be anonymous, however, providing expert opinion should have an identity so that one might be able to judge the veracity of the argument, in my humble opinion.

    Would you mind responding to the issue of database access, security and maintenance. In other words, who can access this database, how will it be maintained and how will data remain secure in today’s complex data environment? I am concerned that the patient database may be abused through inadequate procedures and controls.

  3. Eileen Tichane says - Posted: October 28, 2014

    I agree with Joe – he is amazingly knowledgeable about the subject. Currently I am in a lawsuit which we are having to do “Pro Per” (without a lawyer) because over 20 lawyers in Silicon Valley said we had an excellent case but they could NOT afford to take it on. It costs over $100,000 to take a case to trial and the Medical Insurance companies force this upon both the defendant (doctor, hospital, medical clinic, etc.) and the plaintiff. This leaves about $150,000 for the lawyer and his clients to split. On average it takes two years to go to court. And as a small business owner I was also told that since my future income can’t be proven like an employee I get hit twice (I had been in business for a very long time but that doesn’t count). This Proposition is really about SAFETY. If we can’t get the system to change when mistakes are made, we are no better than a 3rd world country. I’m not against doctors, hospitals or the medical system but I am certain that there needs to be excellent checks and balances – this is about people’s LIVES.

    So I’ve lost my business, have late stage breast cancer and have fought for two years plus just to ‘maybe’ get my day in court. It has cost the hospital and the doctors in my case a lot of money I’m sure of it. So it costs them money, me money- Who WINS – the MEDICAL MALPRACTICE INSURANCE COMPANIES…..no question. This is about our “CIVIL RIGHTS” are being taken away – not by doctors, not by lawyers (neither of which are greedy by any stretch) but by Medical “MALPRACTICE” Insurance companies – AND THEY ARE GREEDY. Eileen