Proponents of Safe Anesthesia Care Bring Critical Issue to New HHS Secretary For Review
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 doctor. "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 standard. "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 said. 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
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