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Viewpoints: Prop. 46 will raise health costs

I have been a pediatrician in Sacramento for more than 30 years. I chose this line of work because I believe few things are more important than keeping children healthy and keeping health care accessible and affordable for every family.

That’s why I oppose Proposition 46, a deceptive measure that would have real costs for all Californians.

Proposition 46 was drafted by trial lawyers seeking more profit from lawsuits against doctors and hospitals. Its main provision would quadruple the limit on non-economic damages contained in California’s successful Medical Injury Compensation Reform Act, which governs lawsuits if someone is injured as a result of medical treatment. Because lawyers are compensated based on a percentage of payouts from medical lawsuits, they stand to gain if those payouts increase.

The independent Legislative Analyst’s Office cautions that Proposition 46 could increase state and local government costs by up to “several hundred million dollars annually.” Another estimate says the overall burden on California’s still-fragile economy would be even higher – roughly $1,000 annually for a family of four. Taxpayers would be stuck footing the bill.

If Proposition 46 were to pass, many doctors – particularly those in high-risk specialties such as obstetrics and gynecology – might be forced to reduce or eliminate vital services, especially for patients in underserved areas. That would mean less access to health care – at a time when we need more doctors to serve millions of newly insured Californians.

But Proposition 46 goes even further. It’s really three initiatives in one. Trying to gain favor with voters, its backers added two unrelated provisions to the initiative. They deal with drug and alcohol testing for physicians and a prescription drug database. Let’s examine both.

While well-intentioned, the provision that would require doctors and pharmacists to consult a statewide database before prescribing certain medications is unworkable. The database in question – the Controlled Substance Utilization Review and Evaluation System, or CURES – is problem-plagued and slow. Even the state staffer who oversees it has testified that the system currently “is not sufficient enough to carry out the mission that we need.”

Proposition 46 would mandate that all physicians use this database – before it is even ready or fully functional. For months, if not years, doctors will be forced to choose between withholding necessary treatment (thereby breaking their professional oath) or breaking this unwieldy new law.

What’s worse, Proposition 46 includes no additional safety precautions to protect the privacy of patient’s sensitive prescription drug information. That’s an unacceptable risk in this era of hacking and data breaches.

The drug testing provision is poll-driven politics at its worst. It is far from a thoughtful policy proposal. The trial lawyers behind Proposition 46 have never sought legislation to create a workable drug- and alcohol-testing program for doctors. This year, they worked to defeat a bill, AB 2346, that would have created a physician wellness program to help doctors with substance-abuse problems.

So why did they include it? Because it polls well. In fact, a main proponent of Proposition 46 has admitted to the media that drug and alcohol testing of doctors was the “ultimate sweetener” for voters. It is a deliberate effort to distract voters from the real facts.

Here are those facts: Proposition 46 would increase costs and limit Californians’ access to the doctors they know and trust. It is opposed by a broad coalition of doctors, community health centers, hospitals, local governments, public safety, business and labor unions, education groups, Planned Parenthood and the ACLU. I urge voters to reject Proposition 46 on Nov. 4.