PARK RIDGE, Ill., Jan. 25 /PRNewswire/ -- On the day his appointment
received Senate confirmation, Secretary of Health and Human Services
(HHS) Tommy Thompson received a comprehensive outline that explains why a
last-minute rule from the Clinton administration needs to be stopped so safe
anesthesia care for Medicare and Medicaid patients can be preserved.
Secretary Thompson will have an opportunity to take appropriate regulatory
action to rescind a rule put forward by the Clinton administration two days
before going out of office. The rule would allow nurse anesthetists to
provide care to Medicare and Medicaid patients without the involvement of a
"Quick action by President Bush, just hours after he was inaugurated,
extends the effective date of this 'midnight' rule to at least mid-May. This
will permit Secretary Thompson to do a deliberate and comprehensive review of
this critical issue," said Neil Swissman, M.D., president of the American
Society of Anesthesiologists.
The rule would defer to the varying state laws and regulations on
anesthesia care without setting a federal minimum standard. "States and
hospitals can always exceed basic Medicare rules, but seniors should not have
to worry about their Medicare coverage based on where they live or where they
travel," Dr. Swissman said.
The medical association, which represents 36,000 physician members
nationwide, sent documented information to Secretary Thompson outlining why
the burden of proof should be on those who would lessen physician involvement
in patient care. "In the name of patient safety, we are urging the Secretary
to conduct a thorough review of all available and verifiable data on this
subject," Dr. Swissman said.
"This is a significant opportunity to overturn a grave mistake, one that
was based on politics and not on science," Dr. Swissman said.
At a U.S. Senate subcommittee hearing on June 7, Medicare program
administrators, members of the Clinton administration, members of Congress and
the public at-large were made aware of a new study conducted at the University
of Pennsylvania of 217,000 Medicare patients. That study showed that there
will be 25 needless deaths for every 10,000 surgeries unless an
anesthesiologist is involved in the patients' care.
The author of that study, Jeffrey H. Silber, M.D., who is not an
anesthesiologist, said that it was measurably safer to have an
anesthesiologist involved in administering or supervising anesthesia.
"I studied outcomes research so I can try to improve medical care through
identifying factors that could be changed to reduce mortality. It seems to me
that this regulation is not going to help the situation ... and it could
possibly hurt," Dr. Silber testified.
The University of Pennsylvania study was the fifth study to show that
anesthesia is much safer when doctors are involved. After a similar push by
nurse anesthetists to remove physician supervision in 1992, the Health Care
Financing Administration (HCFA) said that it would not change the rule because
there was insufficient information to support changing the supervision
"Despite this and the fact that the only new evidence to emerge since then
supports the current involvement of a physician, HCFA caved in to political
pressures and issued this inappropriate, dangerous new rule," Dr. Swissman
ASA said it was gratifying to see seniors get deeply involved in
communicating their strong opposition to this change in their current Medicare
benefits. Congress, the White House, media outlets nationwide and HCFA
received more than 75,000 e-mails and faxes supporting the continuation of
this important safety net. In addition, in two national surveys, more than 80
percent of the seniors polled said that they want to continue to have a doctor
involved in their anesthesia care.
"In the interest of public safety, the federal government has historically
set nationwide standards for a number of programs operated by the states,
including the recent blood-alcohol limits for drunk driving. Why? Because
it's the right thing to do," Dr. Swissman said.
"It is also vitally important that senior citizens feel confident that
they will continue to receive the safest possible anesthesia care involving a
doctor, regardless of where they live or where they travel in the United
States," Dr. Swissman said.
Founded in 1905, the American Society of Anesthesiologists is a scientific
and educational association of anesthesiologists and other scientists that was
organized to advance the practice of anesthesiology and to improve the quality
of care of the anesthetized patient. It is the largest organization of
anesthesiologists in the world.
SOURCE American Society of Anesthesiologists