Prop 46, attempt to raise medical malpractice cap, defeated

LOS ANGELES -- Voters on Tuesday soundly defeated a proposal to lift a decades-old cap on courtroom damages for medical negligence, after a multimillion-dollar political duel pitting trial lawyers against doctors and insurers.

The defeat of Proposition 46 came after a cascade of negative advertising financed by insurance and physician groups. They warned the change would send medical costs soaring and drive doctors from the state.

"In this health care environment, undermining California's long-standing malpractice cap is a political poison pill," Dustin Corcoran, chief executive of the California Medical Association and chairman of the No on 46 campaign, said in a statement. "Increasing payouts in medical lawsuits would have increased health care costs."

The fight over the proposal created the most expensive campaign in the state this year. The initiative attracted national attention, in part because it called for making California the first state to impose random drug and alcohol tests on doctors.

But the reason the contest lured more than $60 million in donations was its proposal to lift the cap on damages for pain and suffering caused by doctor negligence to $1.1 million, up from $250,000.

Consumer advocates and lawyers who backed the proposal said it was about safety and point to cases in which drug- or alcohol-addicted doctors have harmed patients. In one ad, Democratic Sen. Barbara Boxer says, "Make sure impaired doctors don't treat someone you love."

But insurance companies, hospitals and physician groups depicted the proposal as a sugar-coated pill that's really about fattening attorneys' wallets.

A third provision of the initiative called for requiring doctors to check a statewide database before prescribing painkillers and other powerful drugs in an attempt to curb pill-shopping and other abuses.

The nonpartisan Legislative Analyst's Office concluded that raising the cap on medical malpractice damages will increase government health care costs "from the tens of millions of dollars to several hundred million dollars annually." The higher costs could be offset to some extent by uncertain, but potentially significant, savings from prescription drug monitoring and doctor testing, the analyst found.

Research has indicated the rates of drug and alcohol abuse for health care professionals are similar to those in the general public, if not higher because of access to prescription narcotics.

According to the proposal, doctors with hospital privileges would be tested randomly or when a physician is suspected of abusing alcohol or drugs or when a mistake occurs in treatment, such as surgery.