Medical Injury Compensation Reform Act Ballot Initiative for Cost of Living Adjustment

• Author: Y. Tony Yang
• DOI: http://doi.org/10.1002/wmh3.141
• Published date: 01 June 2015
• Date: 01 June 2015

Medical Injury Compensation Reform Act Ballot

Initiative for Cost of Living Adjustment

Y. Tony Yang

Californians overwhelmingly voted down Proposition 46 on November 4, 2014, an initiative that

would have adjusted the noneconomic medical malpractice cap for inf‌lation. The high-spending

battle over Prop. 46 pitted two special-interest groups in the state against each other: doctors and

trial lawyers. The bitter f‌ight over the initiative created the most expensive campaign in the state in

2014. This commentary summarizes current empirical evidence of the effects of caps. It analyzes

whether the initiative would have accomplished what proponents claimed and whether the initiative

would have led to the problems opponents feared. It concludes that in light of the current evidence of

the impact caps have, this proposed adjustment for inf‌lation would likely have had relatively limited

effects. The public’s collective energy would be best spent deliberating other measures that may

develop a more just, reliable, and accessible liability system that promotes patient safety.

KEY WORDS: medical malpractice, tort reform, patient safety

Background

The November 2014 ballot initiative in California proposed to increase the

noneconomic medical malpractice damage cap to approximately $1.1 million—

essentially an adjustment for inf‌lation—and would have provided that the cap

be adjusted for inf‌lation in the future. The ballot measure was met with a

considerable degree of opprobrium, most prominently from within the

medical community. Proponents and opponents of the initiative bombarded

Californians with tens of millions of dollars’ worth of television spots and

other propaganda. Doctors, hospitals, and liability insurers committed more

than $57 million to defeating the measure, roughly seven times more than

advocates, led by trial lawyers and consumer advocates (Ballotpedia, 2014).

Thebitterf‌ightovertheinitiativecreated the most expensive campaign in the

state in 2014 (Ballotpedia, 2014). Although early polls for the proposal showed

promising support in favor, the support dwindled after campaign ads began

in earnest, and ultimately the no votes outnumbered yes votes by a 2-to-1

margin (Ballotpedia, 2014).

World Medical & Health Policy, Vol. 7, No. 2, 2015

152

1948-4682 #2015 Policy Studies Organization

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