Wednesday, January 16, 2019

Voters resoundingly defeat Prop. 46

Voters resoundingly defeat Prop. 46

Dear Colleagues,

When I took office as President of the California Medical Association just over a year ago, I felt the weight of our future on my shoulders. As your leader, representing our 40,000 members, I vowed to do everything I could do to ensure the defeat of the trial attorneys and their deceptive work.

Shortly after I assumed my role, it became clear that the Consumer Attorneys of California and their front group, Consumer Watchdog, would indeed be moving forward with a three part ballot measure that would be put before voters. With my family and my colleagues, I was determined to commit to you and to fight for you.

It is with a humbled gratitude, a thankful heart and a smile that I can say, we did it. And I mean when I say that WE did it. Without your commitment, dedication and fortitude, we could not have come out victorious last night.

Yesterday, the voters of California spoke loudly and definitively, sending the trial lawyers' Proposition 46 to defeat by a vote of 67 to 33. The message is clear – Californians simply don’t want to increase health care costs and reduce health access so trial attorneys can file more lawsuits.

An increase in the Medical Injury Compensation Reform Act (MICRA) cap on non-economic damages has been rejected in California again and again: 10 times in court, 5 times in the Legislature and now overwhelmingly by voters. This idea now has its own dedicated spot in California’s political trash heap. 

But this time, we energized the membership of CMA as a whole to fight the fight together, as one unified voice of medicine, representing the patients we so deeply care about and the care that we have committed to provide them.

This has been a long haul. It was May of 2013, when I was called upon, as President Elect, to respond to a press conference that Consumer Watchdog held on the steps of the State Capitol. At that point, we didn't know exactly what the proposition would say, but we knew that it was going to be deceptive.

And, soon enough we would see that the trial attorney sponsors added provisions like random and mandatory drug testing of doctors to help “sweeten” the deal. The bottom line is that they knew voters wouldn't approve a measure that raises health care costs for everyone and decreases access – especially for those that need it most.

One of the secret weapons of this effort was the size and diversity of our coalition. We helped amass one of the largest and most diverse coalitions in California history. The breadth of the coalition — which includes labor, business, local government, health providers, community clinics, Planned Parenthood, ACLU, NAACP, taxpayers, teachers, firefighters and more – underscores just how important affordable, accessible health care is to every Californian.

I cannot express my thanks to each of you enough, members of this esteemed organization. It is with great honor that I hand over the torch to Luther Cobb, M.D., as he now takes the seat as your CMA President. It has been my honor to serve you during this pivotal year. I would like to offer my sincerest gratitude to the physicians of California who rallied their patients, families, friends and colleagues to defeat Prop. 46.

This has truly been an example of just how much stronger we are when we speak together with one voice to ensure that our patients continue to have access to quality patient care.

This was one of the most contentious and high-stakes ballot fights in California history and we rose to the occasion. We must use this unity moving forward and showcase to our colleagues the value the California Medical Association brings to our great profession and stay united for whatever comes our way next.

Thank you!

Richard Thorp, M.D., FACP
Immediate Past President, California Medical Association

Proposition 46 isn't the CURE(S)

On November 4, voters will be asked to weigh in on Proposition 46, a costly and deceptive measure funded and sponsored almost exclusively by trial lawyers. In addition to raising health care costs and reducing access to quality medical care, Prop. 46 could put patient prescription drug history at risk of being hacked and would force physicians and pharmacist to use an unworkable database.

The Controlled Utilization Review and Evaluation System, or CURES, is a statewide, government-run database that allows physicians to know which medications patients are taking. In concept, it could be a helpful tool in ensuring that patients don’t “doctor shop” – or visit several doctors to get multiple prescriptions for controlled substances.

Though the database already exists, it is underfunded, understaffed and technologically incapable of handling the massively increased demands this ballot measure will place on it. In its current form, the CURES database is plagued with system errors and major deficiencies. The state staffer in charge of CURES recently testified that the database is “not sufficient enough to carry out the mission that we need.” To see excerpts of his testimony, click here.

In fact, in evaluating Prop. 46 the independent, non partisan Legislative Analyst noted, “Currently CURES does not have sufficient capacity to handle the higher level of use that is expected to occur when providers are required to register beginning in 2016.”

While a potentially useful database, CURES simply isn’t able to handle what’s being asked of it. The health care community helped to pass SB 809, which will increase funding for the database and update the technology along with adding funds for more staff; unfortunately upgrades won’t be ready until the middle of 2015, at the earliest.

Despite all of this, Prop. 46 includes a provision that would mandate physicians and pharmacists check the CURES database before prescribing Schedule II or III drugs – a list of medications that is far too long for this newsletter. This “CURES mandate flaw” puts physicians in the untenable position of either breaking their professional oath to give patients the best possible care or breaking the law.

What’s more, the CURES mandate comes without any increased security to ensure that the database is up and running efficiently, effectively and safely before legally making health care professionals check it.

That’s a risky gamble in these days of massive data breaches.

Many of you reading this know firsthand the difficulties of the CURES database and have yourselves tried to use it to improve and advance patient safety. You then also know how unlikely it is that the CURES mandate will work. 

In the few weeks left between now and Election Day, RCMA cannot stress enough how important it is to spread the word about the dangers of Prop. 46.

No on 46 - get engaged

By now, many of you are familiar with the Medical Injury Compensation Reform Act (MICRA) lawsuit initiative that will appear on the November 4, 2014, ballot. Proposition 46 is being opposed by a coalition of doctors, community health clinics, Planned Parenthood Affiliates of California, local governments, working men and women, business groups, taxpayer groups, hospitals and educators, all of whom know that the measure will lead to more lawsuits and higher health care costs. What’s more, it will threaten personal privacy and jeopardize people’s access to their trusted doctors or clinics. Practices are encouraged to get engaged now!

What you can do

Sign up formally (as an organization, practice or individual) in opposition to the campaign. Visit the campaign website at to add your name to the growing list of groups and organizations opposing Prop. 46.

Request a CMA staff member to speak to your group, hospital or specialty society. Let your local county medical society or CMA know and we can ensure you’re hearing from the right people about the most recent campaign updates.

Participate in message/media training. The campaign is looking for physicians interested in taking on a more public role speaking to community groups about why this ballot measure should be defeated. Contact Molly Weedn at for more information.

Speak to your colleagues, patients and community. Use the resources at to talk to your colleagues, patients, friends and family. Don’t forget to speak to community members as well – groups such as Rotary, Kiwanis, Soroptimist and more provide great venues for presentations.

Order campaign collateral. Download the Order Form to receive office posters, English- and Spanish-language patient brochures, campaign buttons, message cards and more. You can also order directly online by visiting

Spread the message on social media. If you’re active on social media, start by following the California Medical Association and No on Prop 46. Retweet and repost the information that is being put out to help spread the word about how dangerous and costly Prop. 46 will be for everyone. For questions about how to start a Twitter or Facebook account or how to engage with CMA, please contact Brooke Byrd at

CMA: @cmaphysicians
No on 46: @NoOn46

No on 46:

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