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Zeitgueist posted:Maybe we can get someone to bring a court case that says once and for all that drug testing in most professions is an invasion of privacy, now that rich folks are having to deal with it. Especially surgeons and anesthesiologists, ie some of the top earners in the field.
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Oct 30, 2014 21:36
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H.P. Hovercraft posted:Good to know that you're totally cool with the nation's first-ever statewide 24/7 drug testing program for any profession, which would even include dragging these employees in from vacation in order to meet an arbitrary 12 hour time limit for testing. Doctors would not be the first profession - by a long shot - to face mandatory drug testing. Airline pilots have done so for years, for example. If you want to make the case that no profession should have this requirement be my guest (and good luck with that), but treating medical doctors like some sort of special class seems inconsistent to me.
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Oct 30, 2014 21:36
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Family Values posted:Doctors would not be the first profession - by a long shot - to face mandatory drug testing. Airline pilots have done so for years, for example. This proposition would enact an unprecedented round-the-clock drug/alcohol testing program, which literally no profession in the country is subject to. If you aren't tested within 12 hours of randomly being selected or the testing is triggered due to a patient's "critical event" then your license to practice is suspended and you are investigated. This could happen regardless of your whereabouts, be you at home asleep or hiking in the mountains. It's completely indefensible and certainly unconstitutional, though you seem to be making a effort to state otherwise (and good luck with that).
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Oct 30, 2014 21:41
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H.P. Hovercraft posted:It's completely indefensible and certainly unconstitutional, though you seem to be making a effort to state otherwise (and good luck with that). Well, I'm not a Constitutional Engineer like you, so I'll let it play out in the courts if it passes. I'm glad you're conceding on the inflation indexing, though.
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Oct 30, 2014 21:46
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Family Values posted:Well, I'm not a Constitutional Engineer like you, so I'll let it play out in the courts if it passes. I'm simply pointing out how people seem to be against this type of proposition because it's horribly draconian, and the consequences of such a thing were it to pass. But it's important to you to be able to feel like you've "won", isn't it?
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Oct 30, 2014 21:49
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H.P. Hovercraft posted:It's important to you to be able to feel like you've "won", isn't it? If you don't like being challenged on misinformation, then don't post it.
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Oct 30, 2014 21:51
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Family Values posted:If you don't like being challenged on misinformation, then don't post it. If you don't like being looked down upon for supporting monstrous policies lobbied by malpractice lawyers that negatively affect a noble field like medicine, then don't post in support of it.
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Oct 30, 2014 21:54
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H.P. Hovercraft posted:If you don't like being looked down upon for supporting monstrous policies lobbied by malpractice lawyers that negatively affect a noble field like medicine, then don't post in support of it. Demonizing lawyers is something you usually see coming from the likes of ALEC when they lobby for 'tort reform'.
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Oct 30, 2014 22:00
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H.P. Hovercraft posted:If you don't like being looked down upon for supporting monstrous policies lobbied by malpractice lawyers that negatively affect a noble field like medicine, then don't post in support of it. Let me guess, you're doctor or are related to one aren't you?  Because you pretty much just filled in my AMA lobbyist bingo card.
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Oct 30, 2014 22:00
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Family Values posted:Demonizing lawyers is something you usually see coming from the likes of ALEC when they lobby for 'tort reform'. Your reticence to discuss the unprecedented far-reaching effects of this drug testing proposition is quite telling. Especially when you discount the criticism coming from inside the affected field. Demonizing physicians is something you usually see coming from the likes of the right wing. Trabisnikof posted:Let me guess, you're doctor or are related to one aren't you? Let me guess, you're of the opinion that you won't be affected by the ridiculously invasive and heavy-handed effects of this proposition upon your healthcare providers. Because you pretty much just filled in my "doesn't have employer-provided healthcare insurance" bingo card.
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Oct 30, 2014 22:10
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H.P. Hovercraft posted:Let me guess, you're of the opinion that you won't be affected by the ridiculously invasive and heavy-handed effects of this proposition upon your healthcare providers. Because you pretty much just filled in my "doesn't have employer-provided healthcare insurance" bingo card. Yes, call your opponents "right wing" while mocking who has employer provided healthcare or not The fact you've completely ignored the other half of the bill and have been unwilling to admit you've wrong when you are, makes it pretty clear you're unwilling to have an actual discussion about the topic and instead want to spit talking points. I'd love to get the cap lifted without the drug testing, but I'd rather lift the cap and let the well-armed and well-funded doctors lobby go after the drug testing in court. But please explain how the drug testing is both blatantly unconstitutional but also not so unconstitutional that the courts will block it.
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Oct 30, 2014 22:15
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Tacier posted:There's some good watershed restoration and other eco-friendly stuff in Prop 1, but $2.7 billion of the $7 billion is earmarked for "water storage projects, dams and reservoirs", which seems pretty ridiculous considering our reservoirs are practically empty and we already built dams in most of the sensible locations half a decade ago. Water storage includes underground, e.g. aquifer replenishment. And, many of our dams and reservoirs are a hundred years old and need maintenance or reconstruction. And, it leaves it up to the legislature to direct that funding where needed, so any entirely new project would still have to pass environmental impact studies, etc. H.P. Hovercraft posted:I'm simply pointing out how people seem to be against this type of proposition because it's horribly draconian, and the consequences of such a thing were it to pass. Random drug testing is not "horribly draconian" or "monstrous," and if it were "certainly unconstitutional" there'd have been constitutional challenges of it before. I actually agree that it's unlikely random drug testing is going to have much impact on patient safety, because I doubt there's an epidemic of drug-addled alcoholic doctors out there. But I also don't think it's so big of an imposition. While alcohol can remain in the system for a long time after consumption, so do its affects, and the science of testing takes into account levels in the blood as they compare to levels of impairment. In other words, if you still have significant levels of a drug in your system (and by "significant" I do not mean nonzero, at least wrt alcohol, I mean "above some specified threshold") then you are also still potentially impaired, and impaired people should not be actively practicing medicine. Perhaps most importantly: if you're angry about people in general being subjected to the invasion of privacy that is a drug test, you should probably address that on the much broader level. Right now, construction workers, athletes, pilots, air traffic controllers, transit workers, and many many more are subjected to the same level of testing and for similar reasons. Regardless of whether this particular bill passes or fails, all manner of people's privacy is invaded daily on the premise that people impaired by drugs or alcohol cannot be allowed to work in occupations where that impairment can threaten the public safety. (Or the integrity of our precious sports, apparently.) Certainly doctors (and many other health care workers) belong in that set of workers. Go ahead and lobby for a constitutional protection against random drug and alcohol testing if you like, but it's not really that relevant to this particular bill.
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Oct 30, 2014 22:15
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You know what's "monstrous"? People who have been crippled for life by a medical fuckup being unable to get any compensation, because their lost earnings potential is too low for a lawyer to bother with, given the cap on pain and suffering damages. There is a class of patients whose primary compensation would be for the pain and suffering, and they cannot get representation. Raising the cap by re-indexing it from the inception in 1975 to inflation from that point (and that's exactly what this bill does: the cap is indexed to inflation) will allow patients whose botched medical treatment led to enormous pain and suffering, but not enormous lost wages, to get justice. And the total cost to consumers for medical malpractice insurance is trivial, despite what terrible television commercials and Republican party anti-trial-lawyer propaganda would have you believe.
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Oct 30, 2014 22:21
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Trabisnikof posted:Yes, call your opponents "right wing" while mocking who has employer provided healthcare or not No, I've clearly addressed it earlier; he would rather try and argue about the minutiae of whether the interpretation is in fact an automatic increase chained to inflation (it isn't) or whether it would require annual legislative action in order to do so (it will), instead of addressing the much larger portion of Proposition 46 which affects an entire class of employee. All while handwaving away any criticism from those most qualified to criticize it as well as any notion that bundling this type of legislation together is problematic, particularly when presented with the history of this type of legislation in the state. "Let the courts decide" is a complete cop-out, and is most definitely not a position that is to be lauded.
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Oct 30, 2014 22:21
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I'm fine with an increase to malpractice payouts, and while I don't like drug testing I suspect it doesn't hold up because rich doctors won't like it.
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Oct 30, 2014 22:23
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Zeitgueist posted:I'm fine with an increase to malpractice payouts, and while I don't like drug testing I suspect it doesn't hold up because rich doctors won't like it. Oh well sure, that's not really a controversial issue at all, even within the medical community. It's not like they're talking about removing the cap entirely; even the people lobbying for it recognize that non-economic damages eventually become bullshit. Pretty much everyone who outright hates it is the insurance industry (of course) and people who are against 24/7 off-the-job drug testing, particularly those affected by it.
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Oct 30, 2014 22:26
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From the official California voter's guide on Proposition 46:quote:What Your Vote Means
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Oct 30, 2014 22:29
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Don't you see you're wrong because a noble Doctor said otherwise and noble Doctors know best about legislative practices and interpretations of California propositions!
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Oct 30, 2014 22:31
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H.P. Hovercraft posted:No, I've clearly addressed it earlier; he would rather try and argue about the minutiae of whether the interpretation is in fact an automatic increase chained to inflation (it isn't) or whether it would require annual legislative action in order to do so (it will), instead of addressing the much larger portion of Proposition 46 which affects an entire class of employee. What else could the law say other than what it did? That the amount shall be adjusted annually to account for inflation? What are you looking for here? The law says it's to be adjusted annually, and if someone somehow tried to prevent that that would be a gimme lawsuit. quote:All while handwaving away any criticism from those most qualified to criticize it as well as any notion that bundling this type of legislation together is problematic, particularly when presented with the history of this type of legislation in the state. The bolded part I agree with, it is problematic; that's perhaps the only legitimate critique of the law, IMHO. But I think the benefits outweigh that - however reasonable people can disagree as I said earlier this morning. Concern trolling about drug testing - especially when you said "Especially surgeons and anesthesiologists, ie some of the top earners in the field" are the heaviest drug users - seems to mostly be a cover for  trial lawyers
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Oct 30, 2014 22:32
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Family Values posted:Concern trolling about drug testing - especially when you said "Especially surgeons and anesthesiologists, ie some of the top earners in the field" are the heaviest drug users - seems to mostly be a cover for Aaaahaha yes calling the nation's first-ever statewide off-the-job 24/7 drug testing program "draconian" is certainly concern trolling aahahahaha Because that's clearly a minor issue of this prop compared to tort reform or the exact mechanism of cap increases. I mean gosh those trial lawyers must a greater interest in the public's well-being compared to physicians, it's not like they actively worked to kill a more effective physician wellness bill for substance abuse treatment earlier this year or anything hahaha
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Oct 30, 2014 22:47
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H.P. Hovercraft posted:Aaaahaha yes calling the nation's first-ever statewide off-the-job 24/7 drug testing program "draconian" is certainly concern trolling aahahahaha Its funny because you keep screaming about the "off-the-job 24/7" drug testing that strangely isn't in Prop 46.... quote:When a physician was responsible for the care and treatment of a patient within 24 hours prior to an adverse event. (Adverse events include such things as mistakes made during surgery, injuries associated with medication errors, or any event that causes the death or serious disability of a patient.) So they could only get tested for 24 hours after treating a patient that had a medical mistake, died or had serious disability because of treatment. Much in the same way many industries are drug tested after a workplace accident. But if you think the SoS is biased, here's the actual text of those two sections: quote:2350.25. (a) Upon the effective date of the regulations adopted by the board to implement this article, hospitals shall conduct testing for drugs and alcohol on physicians as follows: Trabisnikof fucked around with this message at 23:07 on Oct 30, 2014 |
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Oct 30, 2014 23:05
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Trabisnikof posted:Its funny because you keep screaming about the "off-the-job 24/7" drug testing that strangely isn't in Prop 46.... The problem is that these events that trigger it aren't necessarily the result of any immediate action, and it requires an investigation to determine this. A good example would be an infection that progresses to a status change while the attending physician is at home sleeping off a 36 hour shift. Whoops, your coma patient just died; better wake your lazy rear end up and come in for some drug testing at your expense since you just read his chart and had the nurse push some vitamins into him this afternoon. Now repeat for every mortality and turn for the worse. That you can't see the problem with anything that you just posted is frankly laughable. It's not at all analogous to something like testing a pilot, and there is absolutely a reason why the media is referring to it as the most invasive drug testing policy ever proposed. But hey, surely I must be an AMA lobbyist for calling this a horrible, ineffective policy. This is certainly something that your average citizen of a left-leaning state like California would just eat up, right?
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Oct 30, 2014 23:17
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H.P. Hovercraft posted:But hey, surely I must be an AMA lobbyist for calling this a horrible, ineffective policy. This is certainly something that your average citizen of a left-leaning state like California would just eat up, right? I'd hesitate to call Cali "left-leaning". Liberal-leaning, sure. But huge swathes of the state are conservative and the liberals aren't that lefty. Compared to like, Idaho or something, yeah.
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Oct 30, 2014 23:21
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Zeitgueist posted:I'd hesitate to call Cali "left-leaning". Liberal-leaning, sure. But huge swathes of the state are conservative and the liberals aren't that lefty. Oof, good point. And I'm sure it's proponents did some preliminary/exploratory polling to determine its attractiveness too, not to mention the current polling 
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Oct 30, 2014 23:25
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H.P. Hovercraft posted:The problem is that these events that trigger it aren't necessarily the result of any immediate action, and it requires an investigation to determine this. A good example would be an infection that progresses to a status change while the attending physician is at home sleeping off a 36 hour shift. Whoops, your coma patient just died; better wake your lazy rear end up and come in for some drug testing at your expense since you just read his chart and had the nurse push some vitamins into him this afternoon. Now repeat for every mortality and turn for the worse. Once again, you're just wrong. Doctors will only be tested when someone dies if: quote:if any physician who was responsible for the care and treatment of a patient during an adverse event failed to follow the appropriate standard of care. I bolded the key part for you. So unless your peers or the hospital thinks you failed to follow the standard of care, wouldn't you be tested within that 24 hour window. Notice how I cite the actual text, and you cite "the media"?
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Oct 30, 2014 23:28
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Trabisnikof posted:Once again, you're just wrong. Doctors will only be tested when someone dies if: Which requires and investigation to determine, which triggers the drug testing countdown, which means that you're now testing a physician when they are off the clock, every single time you have a mortality. It's pretty simple stuff. Here, let me relink the article written by a doctor that explains all of this.
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Oct 30, 2014 23:35
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H.P. Hovercraft posted:Which requires and investigation to determine, which triggers the drug testing countdown, which means that you're now testing a physician when they are off the clock, every single time you have a mortality. That is an extremely biased op-ed article. It is not helping you make a case.
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Oct 30, 2014 23:39
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Well then here is the Mother Jones article that also details why this type of testing is unworkable and ineffective. Here's the quote from the article link to the East Bay Express: In addition, the measure would establish mandatory drug tests in the case of so-called "adverse events." That term refers to a wide range of medical errors, including administering an incorrect medication leading to a fatality or serious disability. Under Prop 46, physicians who were responsible for a patient during an adverse event or 24 hours prior to it would have to immediately submit to a drug test. "If there's an adverse event, you have to return in twelve hours, or you are presumed negligent," said Richard Thorp, president of the California Medical Association, and president and CEO of Paradise Medical Group in the Central Valley. In some cases, he noted, an adverse event may not come to light for days or even weeks after a patient received care. That means that a drug test would not reveal anything about whether the doctor in question was under the influence while on duty. It could also be difficult for doctors to provide immediate urine samples if they are traveling or on vacation, he said. And under this part of the measure, doctors could have their licenses suspended simply because they did not submit to a drug test in the twelve-hour period. "It is so overreaching and so draconian," Thorp said. "This isn't an effective way to do this, and the reason is, this was just hastily thrown together by proponents of the ballot measure."
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Oct 30, 2014 23:41
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H.P. Hovercraft posted:Which requires and investigation to determine, which triggers the drug testing countdown, which means that you're now testing a physician when they are off the clock, every single time you have a mortality. How is this uniquely draconian compared to what other professions that are routinely drug tested face?
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Oct 30, 2014 23:43
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H.P. Hovercraft posted:Which requires and investigation to determine, which triggers the drug testing countdown, which means that you're now testing a physician when they are off the clock. You can only be tested off the clock within 24 hours of treating a patient that has both an adverse event and there was a failure to follow the appropriate standard of care. Yes, that can mean off the clock, but that isn't 24/7 as you kept saying. Even the op-ed you link says they'll only be tested up to 12 hours after an adverse event with a failure to follow the appropriate standard of care. I want the malpractice reform and I think whatever of the drug testing survives the almighty doctor's lobby is worth it to get the reform. There are reasons to disagree, but the text of the proposition isn't that hard to read so its not that hard to be accurate about it.
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Oct 30, 2014 23:43
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Family Values posted:How is this uniquely draconian compared to what other professions that are routinely drug tested face? Because of the timeframes involved. Prior to this, all drug testing was on-the-job, after clear violations that warrant it.
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Oct 30, 2014 23:44
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Trabisnikof posted:Yes, that can mean off the clock, but that isn't 24/7 as you kept saying. No, that's literally what it means.
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Oct 30, 2014 23:44
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H.P. Hovercraft posted:In some cases, he noted, an adverse event may not come to light for days or even weeks after a patient received care. That means that a drug test would not reveal anything about whether the doctor in question was under the influence while on duty. It could also be difficult for doctors to provide immediate urine samples if they are traveling or on vacation, he said. That's simply incorrect. If days or weeks have passed since an adverse event occured before it is identified, then the 12 hour period has already expired and no drug test would be required. It'd be nonsensical to ask someone to do so anyway, and plainly outside the intent of the proposed law. Also it's worth emphasizing, because it seems like maybe you're missing this; simply losing a patient is not an adverse event. There has to have been some kind of breach in the customary standard of care. It should be very rare that the standard requiring a mandatory urine test is met.
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Oct 30, 2014 23:46
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Leperflesh posted:That's simply incorrect. If it's been days or weeks before an adverse event is identified, then the 12 hour period is already expired and no drug test would be required. It'd be nonsensical to ask someone to do so anyway, and plainly outside the intent of the proposed law. Yes, it's almost like the proponents of the ballot measure hastily threw this together in order to make raising the non-economic malpractice caps more palatable to the public
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Oct 30, 2014 23:49
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H.P. Hovercraft posted:Yes, it's almost like the proponents of the ballot measure hastily threw this together in order to make raising the non-economic malpractice caps more palatable to the public Yeah I'm sure they faked their kids' deaths too
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Oct 30, 2014 23:51
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H.P. Hovercraft posted:Yes, it's almost like the proponents of the ballot measure hastily threw this together in order to make raising the non-economic malpractice caps more palatable to the public LOL you seriously thought pee-tests were a strategy to make suing doctors more palatable?
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Oct 30, 2014 23:53
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Zeitgueist posted:LOL you seriously thought pee-tests were a strategy to make suing doctors more palatable? That's the official no-on-46 line, yes. Argument Against Proposition 46 posted:California special interests have a history of qualifying ballot propositions that appear to be about one thing but are really about another. Here's another one.
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Oct 30, 2014 23:54
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Zeitgueist posted:LOL you seriously thought pee-tests were a strategy to make suing doctors more palatable? Lol do you not? It flagrantly breaks the single-subject rule for ballot propositions, after all. I'm mildly surprised that the ACLU didn't just straightup mention this in their opposition to it.
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Oct 30, 2014 23:59
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Trabisnikof posted:That's the official no-on-46 line, yes. Oh whoops, Bob Pack even came right out and said so: "Pack said the idea of drug testing physicians attracted significant support in focus groups. 'In LA and Northern California, many people thought doctors were already drug tested. ... Everybody really thinks this is where it should go,' he said. He said that, according to the internal surveys conducted by the Prop 46 campaign, 76 percent of likely voters support random drug tests for doctors."
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Oct 31, 2014 00:01
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H.P. Hovercraft posted:Lol do you not? It flagrantly breaks the single-subject rule for ballot propositions, after all. Because preventing medical malpractice and improving awards for victims of medical malpractice aren't single subject enough for you? Do you feel the same way about Prop 45? It changes the process for creating health insurance regulations and forbids auto or home insurance companies from using credit history. What about Prop 47? It both changes the criminal penalties and a creates Safe Neighborhoods and Schools Fund.
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Oct 31, 2014 00:04
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