AANA Strongly Supports The Proposed Rule Because It Would Ensure Greater Access To Anesthesia Care For Patients, Eliminate Physician

The American Association of Nurse Anesthetists (AANA) is the professional association that represents over 28,000 Certified Registered Nurse Anesthetists (CRNAs), which is approximately 94 percent of the practicing nurse anesthetists in the United States. I appreciate the opportunity to testify today regarding nurse anesthetists and our history of promoting competition in the anesthesia marketplace, especially as it pertains to the Health Care Financing Administration's (HCFA) proposed rule to defer to the states on the issue of physician supervision of nurse anesthetists. As you may know, nurse anesthetists have a long history of promoting and protecting competition between health care providers in order to provide the highest level of care and access to patients. Nurse anesthetists and anesthesiologists are frequently in direct competition with each other. We believe that this competition is helpful to consumers and to the marketplace, as long as the playing field is level. AANA has on numerous occasions supported this position with Congress and federal agencies.

1. The Proposed HCFA Rule Promotes Competition.

If finalized, the 1997 proposed HCFA rule that would defer to the states on the issue of physician supervision of nurse anesthetists would promote greater competition between nurse anesthetists and anesthesiologists. AANA strongly supports the proposed rule because it would ensure greater access to anesthesia care for patients, eliminate physician concerns regarding liability, and enable hospitals and ambulatory surgical centers greater flexibility while maintaining a high level of care.

2. The Current Antitrust Laws are Crucial to Protect Competition and Consumer Choice.

We believe that strong antitrust laws and robust enforcement are crucial to protect competition and consumer choice in the health care system. We have testified before the House Judiciary Committee recently on proposed changes to these laws and expressed our position: changes to these laws would allow anesthesiologists to form cartels that could discriminate against or exclude nurse anesthetists from the marketplace; changes could eliminate competition between anesthesiologists and nurse anesthetists by their use of spurious claims regarding patient health and safety; and changes could unnecessarily drive up the cost of health care coverage for all Americans without any concomitant increase in the quality or availability of health care