Vote No on Prop 45 and Prop 46

By Stuart A. Bussey, M.D., J.D., UAPD President

If they pass, Propositions 45 and 46 will amount to nothing but trouble for doctors. Take Proposition 45. Up to this point California’s insurance rates have been regulated by an independent commission.  Prop 45 would shift that awesome power to one political figure, the Insurance Commissioner. He or she would undoubtedly become the pressure point from a variety of political and special interest sources. From a human and organizational perspective this model  is unfair and  unstable. In the health care insurance arena carriers are already restricted by the ACA to 20% administrative fees. Anything more than 20% must revert back to patient services. Under Prop 45 Covered California, which arduously negotiated rates for millions of lives, might have to reboot all their negotiations. But from the strictly self-serving perspective of doctors, the biggest danger of 45 is the probable reduction in our reimbursements. This would undoubtedly occur if rates to health plans were ratcheted downward.

As for Proposition 46 you probably have already heard all the arguments against it in the media or in our Spring UAPD CME. That it is a money grab by trial attorneys that will pad their pockets via more frivolous lawsuits. That higher malpractice awards will spawn higher insurance premiums for both patients and doctors. It could drive specialists out of practice. That the random drug testing policies under Prop 46 are capricious and potentially mischievous. That the mandatory use of the CURES database would be cumbersome, expensive and potentially compromise patient privacy.  There are other, more practical ways to provide consumers medical care at lower cost, as well as restitution for bad outcomes. These two propositions, as written, are a null set.