State ballot initiatives are supposed to be limited to a single subject. In the case of Proposition 46, backers claim that's patient safety. But the initiative on the Nov. 4 ballot actually has three distinct provisions packaged together as a take-it-or-leave-it deal.
While we agree with two of the proposals, the third, random drug testing of all doctors with hospital privileges, goes too far. Initiative backers have failed to demonstrate such privacy intrusion is justified. Consequently, we urge voters to reject the measure.
Let's begin with the primary objective for trial lawyers, the main financial backers of Prop. 46. For years they have been seeking to increase the state's financial cap on malpractice awards.
Currently an injured patient can sue for actual financial losses such as medical bills and loss of income plus up to $250,000 for pain and suffering. That $250,000 limit has not been raised since 1975.
Prop. 46 would adjust it for inflation since then, increasing the limit to about $1.1 million today. That's reasonable. It still protects doctors against huge judgments that drive up medical costs.
The initiative's second part stems from the death of two Danville children killed when a driver who had been drinking and taking pain medications veered off the road and struck them.
The driver had consumed about 120 Vicodin pills in about 20 days, medication obtained from multiple doctors. California now has a tracking system for prescriptions of addictive drugs, but doctors aren't required to use it, and most don't. The initiative would require they do.
If only the initiative sponsors had stopped there. Unfortunately, they added the random drug testing because it reportedly tested well in focus groups to boost support for the measure. But it's bad policy -- and legally questionable.
The U.S. and California constitutions protect against unreasonable searches. The state Constitution also protects privacy. That's why courts generally limit drug-testing of employees after they've been hired to those in safety-sensitive positions.
Unquestionably, medical errors can lead to serious injury or even death. And doctors have their share of alcoholism and drug addiction. But Prop. 46 backers haven't demonstrated that substance-abusing doctors are the ones causing most injuries, nor that drug testing all specialties with hospital privileges is merited.
The initiative doesn't specify what levels of alcohol or drugs, ranging from opiates to marijuana, would constitute a positive test. But a positive finding would require suspension of a doctor's license -- and, effectively, income -- until the state Medical Board rules. It could be months or years.
That's a drastic measure that requires more thought and supporting data. We urge a no vote on Prop. 46.