Pubdate: Fri, 26 Sep 2014
Source: Sacramento Bee (CA)
Copyright: 2014 The Sacramento Bee
Contact: http://mapinc.org/url/0n4cG7L1
Website: http://www.sacbee.com/
Details: http://www.mapinc.org/media/376
Author: Paul R. Phinney
Note: Paul R. Phinney was chief of pediatrics at two Kaiser 
Permanente facilities in the Sacramento area over 14 years and is the 
immediate past president of the California Medical Association.
Bookmark: http://www.mapinc.org/testing.htm (Drug Testing)

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.
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MAP posted-by: Jay Bergstrom