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

AuthorY. Tony Yang
Published date01 June 2015
Date01 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
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
1948-4682 #2015 Policy Studies Organization
Published by Wiley Periodicals, Inc., 350 Main Street, Malden, MA 02148, USA, and 9600 Garsington Road, Oxford, OX42 DQ.

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