By Doug Porter
The following analyses of Propositions 45 & 46 represent my opinions. The SD Free Press editorial board may or may not agree with me. For all our articles on the upcoming election, check out our 2014 Progressive Voter’s Guide.
There are no special interests more special than insurance companies, doctors and lawyers. Here we have two propositions involving all three groups. And there is more subterfuge going on than anybody can keep track of.
Monies from the committees supporting and opposing the different measures overlap. There is a joint campaign committee in support of both 45 and 46. “No on 45” funds have been transferred into the State GOP coffers and mysteriously reappeared three days later with interest.
Generally speaking Prop 45 is supported by consumer groups, Democrats and lawyers along with medical and professional unions. Prop 45 is opposed by the insurance industry, chambers of commerce, the GOP and blue collar trade unions.
Proposition 46 is generally supported by lawyers, consumer groups, and the California Nurses Association PAC. It is opposed by virtually the entire medical profession (it’s a phone book full of groups), organized labor, (trigger alert) the GOP, chambers of commerce and the ACLU.
(Endorsements are coming,soon. We just don’t meet that often)
The People Who Opposed Obamacare Have a Proposition for You
Proposition 45 – Healthcare Insurance. Rate Changes. Initiative Statute.
Supporters: Consumer Watchdog, yeson45.org
Opponents: Californians Against Higher Health Care Costs, stophighercosts.org
Ballotpedia Guide: The details, in plain English
You Might Not Know: California is the only state where auto insurance rates actually went down over the last 25 years. That’s because of Proposition 103, passed in 1989. Proposition 45 is the same kind of legislation, only for the Health Insurance industry.
My Analysis: Talk about your basic David vs. Goliath scenario. The health insurance industry has over $37 million banked to defeat Prop. 45 vs the less than $5 million raised by its proponents.
Just about every Chamber of Commerce in the state, the Republican Party, the California Medical Association and a host of trade unions all think Prop 45 is a bad idea.
The real money for the opposition, however, is coming from the Health Insurance industry. These are the same people who, while mouthing support for the Affordable Care Act, secretly pumped over $86 million into the US Chamber of Commerce campaign to defeat the bill
The gist of industry opposition to Prop 45 is that “special interests” (what the hell are the medical and insurance lobbies- non-special interests?) are out to give ONE POLITICIAN (their capitalization) new power over health care. They’re also pumping the airwaves full of vague predictions about the quality of health care services declining. (Does anybody remember the Obamacare Death Panels?)
That politician is the State Commissioner of Insurance, whose office has saved Californians an average annual savings of $345 per household, or $8,625 per family over the past 25 years on auto insurance.
Prop 45 requires companies to be transparent and truthful when applying for rate increases for health insurance. While the Affordable Healthcare Act made insurance available to millions of people, it does nothing about what they get charged for that coverage. Given that rates have gone up 185% over the past decade, maybe it’s time that California joined the 35 other states requiring insurers to justify rates for health coverage.
Please ignore the ads against Prop 45. Don’t be a sucker. Your wallet will thank you. Vote for 45.
Bringing the Drug War to Your Doctor’s Office
Proposition 46 – Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits. Initiative Statute.
Supporters: Yes on 46, Consumer Watchdog
Opponents: No on 46
Ballotpedia Guide: The details, in plain English
You Might Not Know: Supporters of Yes on 46 include Candace Lightner, Founder of Mothers Against Drunk Driving (MADD), Consumer Advocate Erin Brokovich, Actor Dennis Quaid, and California State Insurance Commissioner Dave Jones (the ONE POLITICIAN cast as a bad guy by the No on 45 crowd)
My Analysis: We’ve got a real problem with medical competence in this country. By some estimates, as many as 440,000 people die each year from preventable medical negligence.
A premise underlying Prop 46 is that raising the $250,000 cap on pain and suffering damages, which has never been adjusted for inflation, will address this issue.
If only they’d come up with some evidence that states with higher awards for pain and suffering have better medical care, I’d be all for this. I would most likely support this part in any case; $250,000 doesn’t go very far these days.
So when the trial lawyers (that’s who’s funding Prop 46) got around to marketing the idea of an initiative for bigger payouts, they found polling (and very passionate patient advocates) indicating that incompetent doctors were a concern for many voters. Who better to sell this measure than aggrieved loves ones?
This measure would also require doctors to crosscheck a database with prescribing controlled substances as a means of combating the process of “doctor-shopping” common to abusers of prescription drugs. This process has worked in other states. Somehow, opponents claim, it will never work in California: Hogwash.
Supporters of this initiative have painted the medical world as riddled with substance abuse problems, citing California Medical Board estimates pointing to almost one-in-five doctors (18%) who’ve suffered from drug and/or alcohol abuse at some point during their careers.
Given that 10% of all Americans consider themselves to be in recovery from drug or alcohol abuse problems and another 6.8% were dependent on alcohol or had problems related to their use of alcohol in 2012 AND 9.2 % of the population—had used an illicit drug or abused a psychotherapeutic medication in the past month, I’d say this 18% “scare stat” doesn’t really tell us much more than doctors are human.
What I take issue with about Proposition 46 –which I believe is well-meaning– is the drug testing requirement. That smacks of the “war on drugs” mentality to me. I don’t care if my caregiver smoked a joint before the Paul McCartney concert.
Furthermore, drug testing doesn’t work. Fact: educated users have been beating drug tests for years.
I think people should be able to sue for more money for pain and suffering. Doctors should have to cross check prescriptions for controlled substances. The medical profession needs a lot of policing, including a stringent (non-peer) review process. (not covered in this measure)
I just don’t think peeing in a cup solves this problem. Or any problem for that matter. I won’t vote for this.
And, yes, I realize I’m voting the way the GOP wants me to.
Doug Porter
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Yes on 45!!! It’s a tough call on 46. I think, as you stated, that the tipping point is that the GOP is against it so it must gore their ox and I am all for that. California has to take the lead in so many areas to keep hope alive in our mostly misguided nation (the entire middle of the map plus some, to say the least) that I am going to vote for this measure, encourage others to do the same, and hope for the best. We may cancel each other out in the tally but even the ads on TV make me ill at heart and that is reason enough to get the nod.
You missed the boat completely on Prop 46. It’s not about creating better healthcare, it’s about holding someone accountable when healthcare fails. I never thought I’d be one of the people harmed by doctors, but it’s happened twice in my family now. My mother died from hospital acquired sepsis in the same hospital where actor John Ritter died and his family sued/settled for millions. About 8 years ago, actress Alicia Cole went there for routine surgery and got the “flesh eating disease,” lost almost her entire abdomen and almost died https://www.youtube.com/watch?v=67vDXQMxUz4. Then in March 2012, my disabled sister went there with a stomach ache and was dead from medical negligence 2 days later. https://www.youtube.com/watch?v=vSgO6S7WgEU
I don’t believe anyone from the YES campaign “have painted the medical world as riddled with substance abuse problems.” We’ve been very clear that it was the California Medical Board itself that came out with the statistic that 1 in 5 doctors will have a drug or alcohol problem during their career. Common sense tells you that if you put stressed out and overworked doctors in the vicinity of an endless amount of drugs, there’s going to be problems. The fact that doctors are human is irrelevant. They are also to be held to a higher standard than most humans because they hold our lives in their hands. They take an oath to “do no harm.” But they do, and then they lie about it and try to keep the truth from you.
You may not care if your MD smoked a joint, but what if they were doing harder drugs or alcohol like this doctor?
Or this one?
Check out my blog for more doctors who have harmed at http://www.dastadlydoctors.tumblr.com
Sure, drug testing isn’t perfect, but you’re not considering the preventative effect that keeps a lot of doctors off of drugs and alcohol. Drug testing as much as speeding tickets is meant to keep people from breaking the law as well as finding them once they’ve done something wrong. Think of all the people that don’t speed on the freeway because they don’t want to get a ticket, then think of all the doctors that want to do right by their patients and don’t do drugs because they don’t want to get caught with a drug test. Even if a drug test finds a false positive, it can be devastating to a doctor. Many find it better just to avoid doing drugs and alcohol all together.
So you’re going to risk being harmed by a doctor and not being able to get to court and hold them responsible just because you think drug testing doesn’t work??? LOL…that’s an awfully big gamble.
1000 patients are dying DAILY from medical errors…not mistakes. That’s the same as if two jumbo jets crashed every single day killing everyone on board.
To me, it’s worth drug testing possibly not working to keep patients safe. If drug testing is good enough for every single soldier in our military, it’s good enough for doctors.
Like I said, there are very passionate patient care advocates out there who are supportive of 46. It’s too bad you have to stoop to getting personal with me to make your point. As somebody who spent a year of his life in and out of hospitals, I really do understand why people support 46. I just don’t think it’s the solution you think it is.
I’m not “stooping” to anything, I’m living this hell every day. My mother and sister are dead from medical negligence, I’m facing a court case that I could lose and the doctors that killed my sister could get away with it ready to go on to harm other patients. Every day I get up and face people like you posting erroneous information trying to sway voters to think like them. I’m tired, I’m not “stooping.”
I know it’s the solution I think because I’ve lived this campaign every day, 24/7, for almost 3 years now. I know Prop 46 inside and out. If I didn’t think it was the right solution, I wouldn’t be working so hard in my sister’s name to make it happen.
She was mentally retarded with the learning ability of a 4 year old. The world failed her, she had a hard life and then died at the hands of a negligent hospital and 7 doctors. At some point I’d like her name associated with something good and I’d like to think that Prop 46 is that thing…and that it will go on to make patients safer in her name.
You are misguided. Most medical errors are due to system errors and fatigue, not substance abuse.Your sister’s case has blinded you to the facts: Prop 46 will not make any patient safer.
No I’m not. I don’t care HOW preventable errors occur, if they’re preventable they should not be occurring. NO ONE said that most were due to substance abuse!
I’m not blinded by anything and you do not have the ability to make such an assumption.
Prop 46 WILL make patients safer just as traffic laws help keep drivers safe.
Plenty of people might have personal stories like Eric’s, but they all form a small fraction of those treated in Cali hospitals. Loss of life cannot be compared to numbers, it’s true, but when an entire profession can be disrupted by blinking lights on test machines those of us who haven’t lost a well-loved and loving relative have to be more mindful of the numbers.
Until you become one of the 1o00 killed by medical negligence daily or the 2 million harmed. It’s far too easy to think it’ll never happen to you…I know…I used to think that.
Eric, Prop. 46 is bad law. If it passes, the only people who’ll be drug tested are doctors. Health Insurance CEOs won’t have to be drug tested, nor will hospital administrators. Not even hospital workers are to be tested by this law. I’ve had a lot of hospitalizations for surgery in my life and I have to say I have a lot more faith in doctors than I do in your average insurance executive, or politician, or stockbroker, or cop.
This bill does not put a limit on claims of lost income due to the death of a spouse or family member. Lawsuits to collect for those damages are not limited in amounts for compensation. You should know that the present $250,000 limit is for pain and suffering, only. People in your position can only collect a quarter of a million dollars for the loss of a loved one. It sounds cold, but nothing can bring back a life.
It’s not bad law. Right now, that’s what we’re shooting for is doctors IN hospitals being tested. If we had tried to get all medical personnel tested at once it would have been a huge upheaval of the system. California will be the first state with random drug testing of doctors so we need to take this slowly and carefully.
Health insurance CEO’s and hospital administrators don’t as readily hold our lives in their hands like doctors do. I agree with you, though, in that I don’t trust any of those people you listed. Most doctors are good people…it’s only 5% of all doctors who commit 95% of the negligence. Regardless, we have to try and make people safe whenever and wherever we can.
Not passing drug testing just because not enough people are tested is just silly. That’s like saying, let’s not have check points on New Year’s eve unless we test every single driver on the road.
I DO know that the MICRA cap limits non-economic or “pain and suffering damages.” But not all people qualify to sue for economic damages. My disabled sister’s case does not qualify for much in the way of economic damages, because she was unmarried, disabled, did not work and had no children. If you have no income, and the government paid your medical bills, there’s not a lot you can sue for except pain and suffering.
It’s not about bringing someone back to life, I never can understand why people say that! It’s about holding someone accountable for harming or killing that life.
If that same doctor had killed my sister in the crosswalk in front of the hospital with his car, we could sue and GET millions of dollars in damages. But because he did it inside the hospital while he was working we can’t. Where is the sense or fairness in that?
No one is showing data that chemically loaded MDs are killing people. ERs are where septicemia occurs, as well as in operating theaters, as well as the hospital rooms that haven’t been tested and aired out. And the hospital administrators and the HMOs and insurance companies ought to be seeing to it that those facilities are being cleaned, not the surgeons and MDs.
Proposition 46 is focused on doctors because they are perceived wrongly as where the real money is made. The foundations, and mega hospitals and the insurers have the deepest pockets.
You can’t call them up when you need a doctor.
It’s perhaps worth noting that, last I heard, the unions opposing Prop 45 are doing so because they feel it doesn’t go far enough, which is different than the other opponents (as far as I know).
I suspect that one day very soon we will see the proposition process used simply to promote and advertise products: “Vote Pepsi as the Official State Soda ” and I’ll bet one of the bottlers have the money to make it happen. Propositions are a joke – they simply allow those with money to legislate when they could just as easily give all that money to the election of state Senate and Assembly candidates, which is where corruption truly belongs, at least according to the majority of the Supreme Court.
The way I read it Brian, the boards that currently look at and control our health insurance rates, don’t actually have the power to reject them, they can only give their opinion that they are unacceptable. Prop 45 will give the Insurance Commissioner the power to regulate health insurance rates and reject them if they’re too high, just like he can currently do with our auto insurance rates. The office of the insurance commissioner has saved us a ton of money on our auto insurance rates since Prop 103 was passed in 1988. I’m all for him doing the same thing with our health insurance.
I’ve actually met Dave Jones a few times now working on Prop 46 and he’s a really great guy. The opponents want voters to think he’s just another “politician,” and I just don’t agree with that. I think he’s someone who’s really working for us and wants to do a good job.
“I’ve actually met Dave Jones a few times now working on Prop 46 and he’s a really great guy”
I don’t know a thing about him. I’ve met Ted Gaines and I can tell you that he’s a really nice guy too. I”ll stipulate that they’re both nice guys, solid public servants, and probably want to do what’s right (in their respective minds) for the people of California.
I think I’d be terrified of vesting that much power in Ted Gaines or Dave Jones…or me for that matter.
“the boards that currently look at and control our health insurance rates, don’t actually have the power to reject them”
Wouldn’t it serve the State better to vest that power in the current boards?
Maybe, but that’s not what’s on the table. Should we forego better health insurance rates in the meantime until someone stands up and makes the boards better? That might never happen.
“The People Who Opposed Obamacare Have a Proposition for You” – this heading confused me. Isn’t it the people who opposed Obamacare who oppose Prop 45?
The insurance companies who fought Obamacare are funding No on 45. I am suggesting that we not take them up on any more of their ideas about what is good for us.
“Bud Light” is NOT a beer.
Elitist Liberal ! :)
Nah, just a beer snob ;-)
I agree with you Eric, this is about medical malpractice, patient safety and consumer justice. A quick read of Public Citizen’s Medical Malpractice Briefing Book debunks all the arguments against Prop. 46, and shows that damage caps are unjust, hurting the severely handicapped and women most. The Argument Against Proposition 46 states “..the real intent–to increase the limit on the amount of medical malpractice awards”.
Doug you agree with two provisions of the proposal, including this major one stated, yet will vote NO just to protect the civil rights of the doctors, to not take a drug test, one that you say doesn’t work anyway!? I don’t care what doctors consume as long as they are sober at work. That is not too much to ask.
Bob Dorn you please understand when these malpractice suits occur, the HMOs, the insurance companies, the administrators and the doctors are all on the same side, they are the defendants. The plaintiffs are the patients, the consumers, us.
Tim Medved, you’re pretending to have read what I said. Your prop 46 names only doctors who’ll be drug tested, your “HMOs, the insurance companies, the administrators” are not included in the proposition’s language. It’s good of you to require doctors “are sober at work,” but the proposal’s language ought to include the many others in the health care industry in its policing provisions; there are far more of them than there are doctors.
What hasn’t been mentioned is that the present $250,000 cap on malpractice awards helps stabilize health costs. Every time large money in court cases is awarded insurance premiums rise and so do costs of doing business. Large money awards will produce, also, a tort mania. We sue each other more than any other country in the world, despite the now-dead “tort reform” movement launched by Republicans many years ago. Those same conservatives are now pursuing greater medical malpractice awards today.
I think medical malpractice is being twisted into an argument against “doctors who kill patients.” Bacteria and viruses kill patients, and the doctors should not be forced to see that swab horizontal surfaces with sano-wash.
Bob, you’re misinformed.
Yes, it currently only names doctors as trying to drug test everyone in the medical industry on November 5th would have been a horrific mess. Doctors, out of all of the medical personnel are more apt to be harming patients than all of the others, so we’re starting with them. That in no way means that we won’t get around to the rest of the staff.
You don’t negate making good strides in patient safety just because you think it should be written differently. Prop 46 has an amendment section built right into it if it “furthers [the] purpose of improving patient safety.
The $250,000 cap has NOT stabilized health costs! Where’s your proof of that? We still have and always have had, high health costs here. It never stabilized doctor’s liability insurance costs either! It wasn’t until the passage of Prop 103 in 1988 that their insurance rates fell—that’s 13 years after MICRA passed.
Insurance rates are regulated in California so they can’t just willy nilly go up when doctors are negligent and insurance companies have to pay out to victims. You should be going after the negligent doctors and hospitals and the BILLION DOLLAR insurance industry if you want to cut costs!
Bacteria and viruses are totally preventable in hospital situations. No patient should get a hospital acquired infection like Alicia Cole did, in the very same hospital where my sister was killed due to medical negligence. https://www.youtube.com/watch?v=67vDXQMxUz4
Thanks Eric. The document “Medical Malpractice Briefing Book” at citizen.org is easy to find and read for those who like facts and researched information. It substantiates all you said.
Unfortunately Tort Reform continues to be successful, with liberals and Democrats buying into the myths, including No on Prop 46. Here’s a link to those myths: http://www.citizen.org/congress/article_redirect.cfm?ID=5671
I’ve been trying to make the point that the doctors are being targeted exclusively, and that’s just bad law. Now, Eric writes, “You should be going after the negligent doctors and hospitals and the BILLION DOLLAR insurance industry if you want to cut costs!”
But, Eric, Tim, your proposition 46 does not do that.
Infection is the leading cause of hospital-originated death, and it won’t be solved by drug testing doctors any more than having a monitor observe them carefully washing and gloving before surgeries. You have to get to the rest of the industry to eliminate septicemia. The hospitals are not run by doctors, they’re run by corporations.
But see, Bob, that’s where you’re just closing your eyes to the issues. Prop 46 does not TARGET doctors, it just happens to be about doctors. That’s like a proposition about banning smoking in public places, targets smokers. Well, duh.
So it’s not “bad law,” it’s the start of making good laws to protect patients. As I mentioned and you ignored, Prop 46 has an amendment section built into it. Don’t think for a moment that once we prove that testing doctors is successful and useful, we’ll stop there. We realize other medical staff have the same problems. It’s just not “good law” to do too much at once. It would be burdensome to the medical system to start testing every single medical person all at once, both physically and financially.
Prop 46 DOES go after the BILLION DOLLAR insurance industry! How can you not see that? Right now they’re rolling in the profits on the backs of medical negligent victims knowing full well they can’t get to court because of MICRA. 1000 people are dying daily from preventable medical errors, and only 1% of them are filing lawsuits.
You’re right, infection is on a rampage in hospitals. Drug testing isn’t SUPPOSED to stop infections! Why are you conflating the two topics? The MICRA portion of Prop 46 is meant to be a deterrent to get hospitals and doctors to be more careful. If they know there are stiffer penalties when they harm patients, we hope that will make them want to be more careful, not unlike stiff penalties for other crimes.
I’m not sure where you’re heading with the “run by corporations” part.
The unspoken debate is really about single-payer. Does California want even more government in healthcare (a single payer system) or should we let California continue implementing the Affordable Care Act?
The rest is noise. Without a political rant, I will offer this commentary:
Prop 45 is bad for California but the debate has reignited a conversation about the real cost drivers behind insurance premiums. Rate regulation offers a simple fix for a very complex issue and attempts to reduce premiums through caps on insurance rates. This is analogous to telling gas stations how much they can charge for gas. It seems logical unless you understand the component parts of our healthcare system and how we actually finance our healthcare.
Instead, I prefer (and believe most Californians would also) a plan to reduce health CARE cost in a meaningful way and not just trim and nibble at the edges of insurance. First, we should transform how we compensate providers; create a system based on quality outcomes, not fee-for-service. Second, we need legislation to help safely introduce new drugs to market; faster and shorter brand-exclusivity periods. We pay 4-6 times more than other countries for the same drugs (search: Lipitor, Plavix, Nexium). It is also estimated we can reduce as much as 30% of our healthcare spend by addressing fraud, waste and abuse… the unnecessary costs which do nothing to improve our health. A still relevant PBS documentary called Money & Medicine does a good job of explaining this and worth a watch. http://video.pbs.org/video/2283573727/
California voters are in the middle of a political crossfire. Everyone wants lower rates. Insurance companies make easy villains. Like every insurance commissioner before him, our insurance commissioner likely plans to run for Governor. Trying to help fix health insurance is a great political platform from which to launch a campaign. The real solution is complex but a simple fix like Prop 45 promises to make it all go away. Unfortunately, Prop 45 cannot deliver on this promise. If it were that simple, we’d have done this decades ago. I think California voters deserve better but it requires a little bit of homework and research before the Nov election. (See this brief Steven Brill video: The famous $77 box of gauze pads in TIME Magazine – The Bitter Pill ) http://content.time.com/time/video/player/0,32068,2178453595001_2136781,00.html
Reducing an insurance rate increase from 5% to 3% seems nice but I’d rather tackle the real issues and achieve a more meaningful savings. NoOn45.org
With regard to the “cap,” please take note that… even if one believes that the cap is an effective means to keep scumbag lawyers on a leash while still fully compensating victims of hack doctors, the amount which our legislature thought to be the perfect amount was $250,000… in 1975… it is now 2014… inflation has reached us in every area… there should be no reasonable argument against the notion that a dollar is 1975 bought more than it does in 2014. An adjustment for inflation to 2014 values should be acceptable… even for those promoting the cap.
Another point to make is that MICRA is absolutely discriminatory in its effect… the limit on pain and suffering of $250,000 is very often the limit of the entire case when it comes to the elderly and more often than it should be when it comes to women and minorities… Punitive damages? There are no punitive damages in medical malpractice cases… Lost wages? People over 65 are retired and women and minorities earn less than white males. Medical Costs? People over 65 have MediCare so there is none, and people on MediCal have none either. People, think before you vote. This law hurts the elderly and women and minorities and the poor… the very people who seem to NOT get the best medical care in the first place.
As a medical malpractice attorney AND physician, I found it difficult to read most of the Internet posts on this topic due to the misinformation, the hatred toward lawyers, the dramatic boo hoo me posts from physicians, and such. It’s really a very simple issue when boiled down. There are of course many great opinions posted, too bad they are often obscured by many over the top replies.
When I look into talking on a medical malpractice case, I know that physicians are not held to a standard of perfection or even to the standard of being the best or even almost the best in their field… They are held to the standard of care for their community and peers. The California legislature has made the legal procedures and rules for medical malpractice cases different from other areas, and done so with a purpose – that purpose being protection of doctors… and while there are many who see protecting doctors as a bad thing, it is not in and of itself really so… some doctors should be protected while others should not get the extra-legal shield afforded by the law. Physicians provide an extremely valuable services to the public and one that requires an enormous amount of skill and brain power to provide correctly – all in a field which is not black and white science but science and art combined – lives are at stake, opinions vary, advancements in science abound, no two patients are alike, etc. In addition, medical malpractice cases are extremely expensive and difficult to bring (properly, that is… anyone can slam together an unintelligible complaint and pay the filing fee). To make a suit “worth it,” there needs to be significant damages – and damages that would not have occurred otherwise. As a generalized example, a one month delay in treatment, that is just as effective one month later as it would have been earlier is not going to provide significant damages.
The current law makes bringing frivolous or even low dollar suits economically destructive for an attorney… as it stands now, those of us who know what we are doing will only take the high dollar cases… the hard costs of suit are enormous (as medical experts now regularly charge upwards of $800 an hour for testimony).
Please educate oneself about what is really going on before voting.
– Paul
Paul J. Molinaro, M.D., J.D.
Attorney at Law, Physician
http://www.888MDJDLAW.com