In 1975, California became the first state to enact caps on non-economic damages (such as pain and suffering) in medical malpractice cases. While the idea was progressive and became a template for other states, the law has faced increasing scrutiny over the last few years. The cap is set at $250,000, which in 1975 was a lot more than what it is worth today. ($250,000 in 1975 is worth about $58,000 in today’s dollars.)

A new ballot initiative, slated for 2014, is intended to remedy that by raising the cap to $1.1 million. The ballot initiative is already causing a commotion. The California Medical Association has spent $5 million to defeat the measure so far, and more than $31 million has already been raised to oppose the measure.

The increase in malpractice caps is only one part of the initiative. The measure also aims to reduce harm caused by physicians under the influence of drugs or alcohol, and requires random drug and alcohol testing for physicians, as well as mandatory testing after an unexpected death or injury to a patient.

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The ballot measure – called the Troy and Alana Pack Patient Safety Act of 2014 – was authored by Bob Pack whose seven-year-old daughter and 10-year-old son were killed by a drugged driver who fell asleep at the wheel and ran the children over. The driver turned out to be a doctor-shopping prescription drug addict whose medications were not being monitored by his various physicians. One of the measures called for in the ballot initiative is mandatory use of the electronic CURES database, which tracks prescriptions dispensed in California in order to identify drug-seekers.

The initiative needs about 750,000 valid signatures to make it onto next year’s ballot.