Proposition 46: Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits
Should California require random drug testing of doctors, require doctors to check a statewide database before prescribing certain drugs, and raise the cap on noneconomic damages in medical negligence lawsuits?
California does not require drug testing of doctors. The state has a database to track prescriptions of certain controlled drugs, but does not require doctors to check the database before prescribing drugs.
There are two kinds of damages in medical negligence lawsuits: economic damages, which pay for the financial costs of an injury, such as medical bills or loss of income, and noneconomic damages, which pay for items such as pain and suffering and loss of quality of life. Attorneys in malpractice cases typically work on contingency; that is, they don’t charge for their time, but instead take a percentage of the damages awarded their clients.
In 1975, California enacted the Medical Injury Compensation Reform Act (MICRA), which placed a cap of $250,000 on noneconomic damages in medical negligence litigation, and limited the percentage of a damages award that an attorney can take. Neither cap has ever been raised. (There is no cap on economic damages.)
Prop. 46 would
- mandate random drug tests of doctors, in addition to tests after events of possible medical negligence or if the doctor is suspected of using drugs or alcohol;
- require doctors to check a statewide database before prescribing certain drugs to prevent patients from “doctor shopping” for multiple prescriptions;
- raise the cap for noneconomic damages in malpractice lawsuits to $1.1 million (reflecting inflation since 1975) and index it to inflation going forward. The cap on attorney’s fees would remain unchanged.
State and local governments fund significant health care services including Medi-Cal and health care to employees and retirees. The cap increase likely would increase costs of malpractice insurance and payments of malpractice claims. Conversely, the higher cap could encourage medical providers to practice medicine in a way that would decrease malpractice claims. There would likely be a very small percentage increase in health care costs in the economy overall as a result of raising the cap (less than 0.5% of the annual general fund budget), but that increase could have a significant effect on government health care spending, from tens of millions of dollars to several hundred million dollars annually.
Use of the drug database could reduce the amount of drugs prescribed, saving drug costs. Prescription drug abuse would be reduced, lowering governmental costs associated with drug abuse, including treatment, rehabilitation, law enforcement and incarceration.
Testing doctors could prevent some medical errors. Savings are uncertain, but potentially significant, and would offset to some extent the increased governmental costs from raising the cap on noneconomic damages.