Proposition 46 is a November 4 ballot measure that would raise the cap on medical malpractice awards that result from lawsuits filed against doctors, nurses, hospitals and community health clinics. Trial attorneys get two-thirds of most medical malpractice judgments, while patients or their family members typically get a third of the money.
What patients and consumers pay each month for health coverage could rise sharply if Proposition 46 passes. That is why health organizations, medical groups, nurses, hospital officials, teachers' unions, homecare workers and women's groups have joined with business organizations such as the California Chamber of Commerce, California Small Business Association, Los Angeles Area Chamber of Commerce, and California Black Chamber of Commerce -- and notably, both the California Republican Party and L.A. County Democratic party to say no to Prop 46.
They strongly oppose Prop. 46 because it would increase the cost of health care for consumers, place a substantial financial burden on local taxpayers, and stress the budgets of local governments.
The proposition would also conflate several unrelated policy issues, e.g., physician discipline and consumer transparency, into one ballot proposal. This would not be allowed in a single legislative proposal because it would violate the constitutionally mandated single subject rule. In reality, Prop 46 is an exercise in crass opportunism which we must reject.
In September 1975, Governor Brown signed the Malpractice Insurance Compensation Reform Act (MICRA). It was a model for the nation. It remains so to this day for good reason. Doctors cannot practice without malpractice insurance. If the awards for malpractice lawsuits are allowed to rise, as they will under Prop 46, it will be the 1975 malpractice insurance crisis revisited.
The state's non-partisan Legislative Analyst projects that Prop 46 could increase state and local government costs by hundreds of millions of dollars annually; costs that would be passed down to health insurance consumers in the form of higher monthly premiums and more expensive medical procedures.
If you think you will be untouched by Prop 46, think again. Prop 46 would likely result in higher taxes for residents statewide. Counties are self-insured. Counties operate hospital systems and employ hundreds of thousands of doctors, nurses, hospital staff and healthcare workers.
L.A. County alone operates four major hospitals that treat millions of patients each year. Prop 46 is a financial threat to all of them, including the top-rated Rancho Los Amigos Rehabilitation Center, where 4,000 inpatients and 71,000 outpatients with life-changing injuries are treated annually.
The ballot initiative could also imperil the soon-to-be opened Martin Luther King, Jr. Community Hospital serving the Watts-Willowbrook community. This desperately needed state-of-the-art medical center is a beacon of medical hope for South Los Angeles residents. We cannot allow Prop 46 to make it too costly to operate what will be an essential healthcare resource for more than a million L.A. County residents.
The added costs created by Prop 46 will burden L.A County's health system. But L.A. County won't bear these rising costs alone. Counties throughout California will pay the price as well when medical malpractice insurance premiums begin to spike, just as they did 39 years ago. We cannot allow Prop 46 to deny California residents the essential health services they need.
That's why the L.A. County Board of Supervisors has voted to oppose changes to MICRA since it became law in 1975. The Board reaffirmed its opposition to MICRA changes in 1999 and again in 2007, 2008, 2009, 2010, 2011, 2012 and 2013. Now, here we are again in 2014 with the latest MICRA change before us.
Our answer to the proponents of Prop 46 is simple: Didn't you hear us the first time or haven't you heard us for the last 40 years? Let's make it clear: We can't afford Prop 46 and our residents don't deserve to pay higher taxes to pay for what it would cost. If Prop 46 wins, the people of our county will lose and they'll pay dearly with their health and their pocketbooks.
If voters approve Prop 46, hospital officials say they would have to pay higher medical malpractice premiums. Self-insured health facilities -- the vast majority of which are county-run public hospitals, comprehensive health centers and clinics -- might have to seek tax increases from county boards of supervisors to keep their doors open and pay doctors and nurses properly.
If Prop 46 passes on November 4, it would do more damage. Prop 46 would walk back the positive strides we've made through the Affordable Care Act that is putting health insurance coverage within the monthly financial reach of working families of modest means.
Matt Cate, executive director of the California State Association of Counties said:
"Prop 46 will make it much harder for California county governments to deliver vital care to millions of patients. Prop 46 will increase costs for public hospitals by hundreds of millions of dollars each year. Prop 46 is fiscally irresponsible. Prop 46 must be defeated to protect low-income patients who depend on their county hospital, health centers and clinics for care."
We couldn't have said it better. When it comes to Prop 46, Democrats and Republicans are in bipartisan agreement. We urge all California voters to vote No on Prop 46.
Supervisor Mark Ridley-Thomas, a lifelong Democrat represents Los Angeles'. County's Second District. Supervisor Don Knabe, Chairman of the Board of Supervisors, a lifelong Republican, represents the County's Fourth District.