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Proposition 46 isn't the CURE(S)



On November 4, voters will be asked to weigh in on Proposition 46, a costly and deceptive measure funded and sponsored almost exclusively by trial lawyers. In addition to raising health care costs and reducing access to quality medical care, Prop. 46 could put patient prescription drug history at risk of being hacked and would force physicians and pharmacist to use an unworkable database.

The Controlled Utilization Review and Evaluation System, or CURES, is a statewide, government-run database that allows physicians to know which medications patients are taking. In concept, it could be a helpful tool in ensuring that patients don’t “doctor shop” – or visit several doctors to get multiple prescriptions for controlled substances.

Though the database already exists, it is underfunded, understaffed and technologically incapable of handling the massively increased demands this ballot measure will place on it. In its current form, the CURES database is plagued with system errors and major deficiencies. The state staffer in charge of CURES recently testified that the database is “not sufficient enough to carry out the mission that we need.” To see excerpts of his testimony, click here.

In fact, in evaluating Prop. 46 the independent, non partisan Legislative Analyst noted, “Currently CURES does not have sufficient capacity to handle the higher level of use that is expected to occur when providers are required to register beginning in 2016.”

While a potentially useful database, CURES simply isn’t able to handle what’s being asked of it. The health care community helped to pass SB 809, which will increase funding for the database and update the technology along with adding funds for more staff; unfortunately upgrades won’t be ready until the middle of 2015, at the earliest.

Despite all of this, Prop. 46 includes a provision that would mandate physicians and pharmacists check the CURES database before prescribing Schedule II or III drugs – a list of medications that is far too long for this newsletter. This “CURES mandate flaw” puts physicians in the untenable position of either breaking their professional oath to give patients the best possible care or breaking the law.

What’s more, the CURES mandate comes without any increased security to ensure that the database is up and running efficiently, effectively and safely before legally making health care professionals check it.

That’s a risky gamble in these days of massive data breaches.

Many of you reading this know firsthand the difficulties of the CURES database and have yourselves tried to use it to improve and advance patient safety. You then also know how unlikely it is that the CURES mandate will work. 

In the few weeks left between now and Election Day, RCMA cannot stress enough how important it is to spread the word about the dangers of Prop. 46.




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