California to Vote on Proposition 46 | Web version

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November 3, 2014

Institute for Civil Justice

California to Vote on Proposition 46

On Tuesday, voters in California will cast their ballots on Proposition 46, or the "Troy and Alana Pack Patient Safety Act of 2014." If approved, this ballot initiative will enact important changes to the calculation of medical malpractice lawsuit payments. The state's cap on medical malpractice liability would be increased from the existing $250,000 to more than $1 million and be automatically increased according to inflation.

New RAND analysis provides an objective look at Proposition 46 and how its changes could affect patients, doctors, plaintiffs, lawyers, the health care industry, and the general public. RAND publications address several common questions about the initiative and its potential effects.

Would Proposition 46 Decrease the Number of Physicians?

Yes. Evidence suggests that increasing physician liability would slightly reduce the number of doctors in high-risk specialties in a typical state, although forecasting changes for any particular state is difficult.

Some specialties face higher malpractice risk

Some specialties faces higher malpractice risk

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Would Proposition 46 Increase Costs Per Malpractice Claim for Physicians and Their Insurers?

Yes. Evidence suggests that passing Proposition 46 might lead to about a 20 percent increase in average payments per claim. Pediatrics, obstetrics, and gynecology might have larger increases than average.

Is there evidence that Prop 46 would increase costs per malpractice claim for physicians and their insurers?

Vertical bars represent change in average malpractice claim payment in dollars.

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What Effect Would Proposition 46 Have On Malpractice Trial Awards for Plaintiffs?

Plaintiffs and their lawyers both benefit. Injured patients will, on average, be able to keep a higher proportion of their original jury awards, and their lawyers will also benefit.

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Would Proposition 46 Make It Easier for Injury Victims to Find Attorneys?

Yes. Because expected awards to some malpractice plaintiffs will increase and fees are typically calculated based on the award, it will be easier for some plaintiffs to find attorneys to take on their cases.

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Explore what RAND research reveals about the potential effects of Proposition 46 »

Read more of RAND's medical malpractice research »

Please don't hesitate to contact me at (703) 413-1100, ext. 5299 or if you would like additional information from RAND, would like to speak to a researcher, or have any questions.


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