ASA Reports: Doctors Fight for Seniors' Rights to Keep Safest Anesthesia Care Available

Mar 22, 2000, 00:00 ET from American Society of Anesthesiologists

    WASHINGTON, March 22 /PRNewswire/ -- In an effort to halt a Medicare
 proposal that would eliminate a critical Medicare benefit for all seniors and
 will likely even endanger their lives, hundreds of physicians converged on
 Capitol Hill today to urge members of Congress to intervene in what has become
 a bureaucratic quagmire with Medicare's regulatory agency.
     The physician members of the American Society of Anesthesiologists are
 turning to their representatives and senators to block a Health Care Financing
 Administration (HCFA) proposal that would remove ANY physician supervision of
 anesthesia.  The ramifications are that nurses, often with less than two years
 of technical training, could be the sole providers of anesthesia to the
 nation's oldest and potentially sickest segment of the population.
     Senator Jon Kyl, R-AZ, told the doctors in Washington, D.C., on Tuesday
 that he will now join the other co-sponsors of the Safe Seniors Assurance
 Study Act of 1999 (S. 818/ H.R. 632), because it appears that HCFA has not
 sufficiently reviewed current data or conducted new studies to ensure that
 seniors will be safe if the requirement for physician supervision of nurse
 anesthetists is removed.
     "It is obvious now that all concern for patient safety has been lost to
 bureaucracy," said Ronald A. MacKenzie, D.O., president of the national
 physician group of more than 35,000 members.  "HCFA is saying that it has made
 this proposal based on reasoning that anesthesia is 'relatively safe' now and
 that there is no evidence to compare the differences between
 anesthesiologists' care and nurses' care.  That reasoning is dangerously
 flawed.
     "If HCFA goes ahead and removes this safeguard, seniors stand to lose not
 only a critical Medicare benefit, but even more frightening, people will die.
 Is that the evidence that HCFA needs?" Dr. MacKenzie asked.
     While he agrees that patient safety in this country has improved over the
 last few decades, from 1 in 10,000 deaths to less than 1 in 250,000 deaths,
 Dr. MacKenzie notes that this safety level was only achieved WITH THE
 INVOLVEMENT OF ANESTHESIOLOGISTS.  In fact, a recent scientific study of more
 than 65,000 Medicare patients in 219 hospitals in Pennsylvania revealed that
 there was a 28-percent higher rate of deaths and a 21-percent lower chance to
 rescue seniors who have complications after receiving anesthesia from a nurse
 anesthetist who is not supervised by an anesthesiologist.
     "These are frightening figures," Dr. MacKenzie said.  "We could turn back
 the patient-safety clock to the 1960s when ether was still being used.  Yet
 when we met Monday with HCFA's Administrator [Nancy-Ann Min DeParle], I was
 told the Pennsylvania study is not relevant to HCFA's decision.  How can the
 increased risk of seniors dying NOT be relevant?"
     HCFA claims that its proposal would not affect care but only defer the
 scope-of-practice issue to the states.  Dr. MacKenzie notes, however, that
 Medicare is a national program, and as such, needs to set national minimum
 standards.  The current physician supervision requirement has been in effect
 since the Medicare program was established in 1966.
     "This is about people, not government," Dr. MacKenzie said.  "It's about
 patients' rights, not states' rights, the right of Medicare beneficiaries in
 every state to the best available medical care during anesthesia.  If HCFA's
 proposal is approved, Medicare patients would be subject to potentially 50
 different levels of anesthesia care in this country, not only where they live
 but where they may travel as well."  All Medicare patients, even those living
 in rural areas, are now assured of the same level of care because physician
 supervision is all that is required, and surgeons would continue to be
 available for supervision in those areas, Dr. MacKenzie said.
     Furthermore, this proposal will not save any money for the government,
 hospitals or patients, Dr. MacKenzie added.  "It costs the government the same
 if a nurse anesthetist is supervised by a physician or not."  In fact, studies
 show that costs are actually lower when anesthesiologists are involved because
 of the reduced need for additional medical consultations and preoperative
 tests, he said.
     Dr. MacKenzie said members of the American Society of Anesthesiologists
 will do everything in their power to continue to advocate for their patients,
 now not only in the operating room, but before every appropriate agency and
 congressional committee in Congress to seek a resolution that keeps seniors
 safe.
     "HCFA does not need to do anything but leave the long-standing and safe
 standards in place for Medicare patients.  Seniors would then be assured that
 they will continue to receive good quality medical care.  Only if a scientific
 study proves that unsupervised nurse anesthetists are just as safe should this
 sensible patient safety rule be changed," Dr. MacKenzie said.
     Founded in 1905, the American Society of Anesthesiologists is a scientific
 and educational association of anesthesiologists 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 with more than 35,000 members.
 
 

SOURCE American Society of Anesthesiologists
    WASHINGTON, March 22 /PRNewswire/ -- In an effort to halt a Medicare
 proposal that would eliminate a critical Medicare benefit for all seniors and
 will likely even endanger their lives, hundreds of physicians converged on
 Capitol Hill today to urge members of Congress to intervene in what has become
 a bureaucratic quagmire with Medicare's regulatory agency.
     The physician members of the American Society of Anesthesiologists are
 turning to their representatives and senators to block a Health Care Financing
 Administration (HCFA) proposal that would remove ANY physician supervision of
 anesthesia.  The ramifications are that nurses, often with less than two years
 of technical training, could be the sole providers of anesthesia to the
 nation's oldest and potentially sickest segment of the population.
     Senator Jon Kyl, R-AZ, told the doctors in Washington, D.C., on Tuesday
 that he will now join the other co-sponsors of the Safe Seniors Assurance
 Study Act of 1999 (S. 818/ H.R. 632), because it appears that HCFA has not
 sufficiently reviewed current data or conducted new studies to ensure that
 seniors will be safe if the requirement for physician supervision of nurse
 anesthetists is removed.
     "It is obvious now that all concern for patient safety has been lost to
 bureaucracy," said Ronald A. MacKenzie, D.O., president of the national
 physician group of more than 35,000 members.  "HCFA is saying that it has made
 this proposal based on reasoning that anesthesia is 'relatively safe' now and
 that there is no evidence to compare the differences between
 anesthesiologists' care and nurses' care.  That reasoning is dangerously
 flawed.
     "If HCFA goes ahead and removes this safeguard, seniors stand to lose not
 only a critical Medicare benefit, but even more frightening, people will die.
 Is that the evidence that HCFA needs?" Dr. MacKenzie asked.
     While he agrees that patient safety in this country has improved over the
 last few decades, from 1 in 10,000 deaths to less than 1 in 250,000 deaths,
 Dr. MacKenzie notes that this safety level was only achieved WITH THE
 INVOLVEMENT OF ANESTHESIOLOGISTS.  In fact, a recent scientific study of more
 than 65,000 Medicare patients in 219 hospitals in Pennsylvania revealed that
 there was a 28-percent higher rate of deaths and a 21-percent lower chance to
 rescue seniors who have complications after receiving anesthesia from a nurse
 anesthetist who is not supervised by an anesthesiologist.
     "These are frightening figures," Dr. MacKenzie said.  "We could turn back
 the patient-safety clock to the 1960s when ether was still being used.  Yet
 when we met Monday with HCFA's Administrator [Nancy-Ann Min DeParle], I was
 told the Pennsylvania study is not relevant to HCFA's decision.  How can the
 increased risk of seniors dying NOT be relevant?"
     HCFA claims that its proposal would not affect care but only defer the
 scope-of-practice issue to the states.  Dr. MacKenzie notes, however, that
 Medicare is a national program, and as such, needs to set national minimum
 standards.  The current physician supervision requirement has been in effect
 since the Medicare program was established in 1966.
     "This is about people, not government," Dr. MacKenzie said.  "It's about
 patients' rights, not states' rights, the right of Medicare beneficiaries in
 every state to the best available medical care during anesthesia.  If HCFA's
 proposal is approved, Medicare patients would be subject to potentially 50
 different levels of anesthesia care in this country, not only where they live
 but where they may travel as well."  All Medicare patients, even those living
 in rural areas, are now assured of the same level of care because physician
 supervision is all that is required, and surgeons would continue to be
 available for supervision in those areas, Dr. MacKenzie said.
     Furthermore, this proposal will not save any money for the government,
 hospitals or patients, Dr. MacKenzie added.  "It costs the government the same
 if a nurse anesthetist is supervised by a physician or not."  In fact, studies
 show that costs are actually lower when anesthesiologists are involved because
 of the reduced need for additional medical consultations and preoperative
 tests, he said.
     Dr. MacKenzie said members of the American Society of Anesthesiologists
 will do everything in their power to continue to advocate for their patients,
 now not only in the operating room, but before every appropriate agency and
 congressional committee in Congress to seek a resolution that keeps seniors
 safe.
     "HCFA does not need to do anything but leave the long-standing and safe
 standards in place for Medicare patients.  Seniors would then be assured that
 they will continue to receive good quality medical care.  Only if a scientific
 study proves that unsupervised nurse anesthetists are just as safe should this
 sensible patient safety rule be changed," Dr. MacKenzie said.
     Founded in 1905, the American Society of Anesthesiologists is a scientific
 and educational association of anesthesiologists 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 with more than 35,000 members.
 
 SOURCE  American Society of Anesthesiologists