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The dispute over a proposed Medicare rule that would allow certified nurse anesthetists to provide services without physician supervision in states where such practice is allowed by state law shows no sign of abating. (For more on the controversy, see State Health Watch, March 2001, cover story.)
In the latest salvo, the American Society of Anesthesiologists released the results of a survey the group sponsored that found that 92% of Medicare beneficiaries want to have the "same benefits and quality of care" in all 50 states and 94% of adults who are not yet covered by Medicare but will be some day said benefits and care should be the same regardless of where patients live.
The survey, conducted by The Tarance Group in Alexandria, VA, also found that 75% of seniors surveyed had had an operation requiring general anesthesia, most of them while covered by Medicare, and 86% of those who had an operation said they were very satisfied or extremely satisfied with the care they received under the current Medicare physician supervision rules.
Neil Swissman, MD, society president, said the doctors’ concern has been that "by leaving it up to the states to decide who will care for Medicare patients, a patchwork-like quilt of regulations will result. A patient ends up with various degrees of medical coverage depending on where that patient lives or visits. In essence, people are then forced into the unrealistic position of anticipating their illnesses and injuries and then picking where they will occur."
Swissman said that almost 80% of those surveyed oppose or strongly oppose dropping the rule that requires nurse anesthetists to be supervised by a doctor.
The anesthesiologists are calling on the Bush administration to reverse what they say was a "politically motivated decision" to approve the rule in the waning days of the Clinton administration.