Far and away the best prize that life offers is the chance to work hard at work worth doing.
– Theodore Roosevelt
Dear Patient and Friend,
Theodore Roosevelt’s quote happily describes my professional career. With that in mind, I feel duty-bound to share with you my professional and personal concerns about a November ballot measure, Proposition 46. We generally don’t discuss politics in our office but this is not a political issue, as in which candidate should be elected.
Rather, Proposition 46 is a medical care issue and it has ramifications for every Californian. I owe it to you to explain it and particularly to explain why it is an attempt to fool the voters.
Proposition 46 is deceptive and therefore sinister. It purports to be protecting the public from drug-impaired MDs. But that issue, which is not a major issue, believe me, is merely the attention-grabbing wrapping on the package to get you to say “Yes”. The real and buried content of this initiative is to reverse a 39-year successful program which has controlled medical liability insurance costs and therefore helped to control medical costs and keep MDs from abandoning California for less oppressive states. Adoption of Prop 46 will be a huge step backwards and will only worsen medical care for all of us.
Here is What Proposition 46 is Really About
In 1975, California’s legislature, under unprecedented public pressure, passed landmark legislation stopping runaway payouts in medical malpractice cases. Some might recall the bumper stickers: Sick? Call your lawyer! Certain lawyers were getting rich from unfortunate and not always preventable complaints and outcomes.
Before that 1975 act, known as MICRA (Medical Injury Compensation Reform Act), medical costs were soaring and MDs were quitting or fleeing the state.
Since then, for 39 years, multiple self-serving attorney-sponsored courtroom assaults on MICRA have been rebuffed by judges. Failing to convince their own judge-brethren, a small number of selfish lawyers now try to fool, and thus insult, the voters.
The maximum $250,000 “pain and suffering (hard to put a price tag on)” limit was inserted into MICRA to put a lid on emotionally charged but often irrational huge payouts. The law still protected the injured because it allowed unlimited compensation dollars for the actual costs of the medical care. So real costs are covered, but irrational dollars for “pain and suffering”, which cannot be measured, are tightened.
By the way, MICRA also imposes limits of how much of the insurance money goes to lawyers and how much is left for the injured party. MICRA mandated more settlement dollars for patients and less for attorneys. Anything wrong with that? Of course not. We MDs buy insurance to protect our patients; not to enrich certain lawyers.
The law made sense to other states, by the way. Been to Texas lately? It’s booming because it, too, put the brakes on runaway lawyer paydays for medical malpractice and other civil litigation.
Don’t Just Take My Word for It. Here is What your Voter Information Guide Says:
The non-partisan California General Election Official Voter Information Guide, which you have already received, on page 29, says exactly why everyone should be concerned:
Raising the cap on non-economic damages would likely increase overall health care spending in California (both governmental and non-governmental) by:
1) increasing direct medical malpractice costs and
2) changing the amount and type of health care services provided.
The Guide also cites, on page 26, the Legislative Analyst’s Estimate of Net State and Local Government Fiscal Impact:
“Increased state and local government health care costs from raising the cap on medical malpractice damages, likely ranging from the tens of millions to dollars to several hundred million dollars annually”
That is not good news. But what the Legislative Analyst cannot tell you is that this will be the breaking point for many California MDs. With continued financial pressure on MDs by insurers who continue to pay less for services, this will cause younger MDs to pick up and move to more enlightened states, such as Texas. The more senior MDs — like myself, frankly — the ones I want for my patients, and my family, for their long experience and capabilities will look towards an earlier retirement. That’s not good news for any us, because we all need medical care.
My purpose is not to bash the lawyer-sponsors of this referendum. Rather to help you look behind the curtain. Objective and sophisticated observers of the election scene have quickly come out against Prop 46, and their words should be heeded:
Monday, September 15, 2014
SF CHRONICLE OPPOSES PROP 46 AS “FLAWED,” “MISDIRECTED” AND “DECIDEDLY CYNICAL”
“Chronicle joins major newspapers across CA criticizing Prop 46 proponents for including “sweeteners” by ‘political consultants trying to spritz populist perfume on a controversial measure'”In opposing Prop 46, the Chronicle joins every other major daily newspaper in California to take a position on Proposition 46 to date — Contra Costa Times, Oakland Tribune, Sacramento Bee and San Jose Mercury News.
Headlined “Poorly-crafted State Proposition 46 Puts Doctors on Defense,” the editorial states that proponents “who put together and funded Proposition 46 might have been too clever for their own good” and “this measure overreached in a decidedly cynical way.”
On August 3, 2014, The New York Times commented on the deceptive nature of the ballot measure.
There you have it.
MD drug testing is the proposition’s smokescreen title. A referendum packaging MD drug testing and overturning a popular and cost-saving insurance reform makes as much sense as a ballot measure combining a limit on water consumption and gun control.
To even better understand this deceptive and thus dishonest ballot measure, visit: www.NoOn46.com. Watch the short video. I believe you will agree with me.
Best wishes.
Robert Kotler, MD, FACS
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