Why the Green Party Opposes Proposition 46

from the Green Party of Alameda County Voter Guide:

Drug Testing of Doctors and Medical Negligence Lawsuits

Trial lawyers want to raise the current state $250,000 limit (instituted in 1975) on “pain and suffering” damages that can be assessed in medical negligence lawsuits to $1.1 million, to keep up with inflation.
Prop 46 adds two arguably peripheral measures, in theory to improve the quality of health care: a) drug and alcohol testing of doctors and reporting of positive tests to the California Medical Board, and b) requiring health care practitioners to consult a state prescription drug history database before prescribing certain controlled substances.

Supporters include Consumer Attorneys of California, Consumer Watchdog, and Senator Boxer. Opponents include physician groups, led by the California Medical Association, insurers, hospitals, allied health professionals, most labor unions, the ACLU, the Chamber of Commerce, the NAACP, and the CA School Boards Assoc. CA Dems and California Nurses' Association are staying neutral.

Greens could argue either side of the payment issue. Our broken health care system does need to address patient safety and compensate those who have been harmed. But will payouts, and the resulting rise in malpractice insurance, drive medical care costs even further out of reach? The Congressional Budget Office says it will not significantly raise costs, but a coalition of medical clinics say it will.

The drug testing section is also problematic. Health practitioners may already be subject to either random drug testing or testing for cause if suspected of drug diversion or impaired practice. The tests used may not be sensitive or specific enough to be useful.

However, the third section to this omnibus bill is the most worrisome, and it isn’t even reflected in the proposition's title. It would REQUIRE health care practitioners to consult a state-level proprietary-software prescription drug history database before prescribing certain controlled substances (DEA Schedule II and III). The database already exists, but it is not required to be used (currently only 8% of MD's do it).

The intent of this section is to keep people from getting quantities of the same or similar drugs (painkillers, diet aids, psychological aids, steroids) from doctors who are not aware the person has already obtained such drugs elsewhere. Even if a voter applauds this (debatable) goal, the implementation is unworkable and even frightening. For example,
.. this requirement could make it impossible to get honestly-needed drugs when the database is down. Since only 8% of MD's voluntarily do it now, that means a more than ten times traffic increase on this web-based system, which is likely to cause crashes.
.. what is considered a controlled substance is open to political manipulation over time. This law would thus take personal control even further away from individuals.
.. your entire prescription drug history will be in this web-based database for all the world to see, if it gets hacked. People who might be looking for something to use against you (reporters, custody lawyers, job background checkers, Big Brother) could find a way to get access. There was already a lawsuit about privacy concerns around this database, and the patient apparently lost.

This bill should have been three separate propositions. Again, what we need is Improved Medicare for All (Single Payer) Now. Vote NO.