Right-wing, wacko...Anesthesiologists?

Apparently the American Society of Anesthesiologists (ASA) is an "un-American" organization because they are encouraging their members to show up at town-hall meetings and protest, according to Nancy Pelosi and Steny Hoyer's NY Times editorial last Monday. A "Congressional Recess update and action alert" posted on the ASA website says "NOW IS NOT THE TIME FOR REST, BUT FOR ACTION" (caps are theirs).

What is the ASA's objection? They call it their "33 percent problem" - "GAO, the investigatory arm of Congress, has found that Medicare pays anesthesiologists 33 percent of what private insurers pay for anesthesia services." The public plan proposed in H.R. 3200 will continue to use this rate, which the ASA says doesn't even come close to covering their costs, which include very high malpractice premiums.

This "33 percent problem" prompted an editorial in today's WSJ by anesthesiologist Ronald Dworkin which points out:

Every medical student learns an old adage: You can skimp on some medicine, but you can't skimp on obstetrics or anesthesiology. An elderly surgeon explained it to me this way, "In surgery, people die in days and weeks—a doctor has time to fix a mistake. But in obstetrics and anesthesiology, they die in minutes and seconds."

Also:

In no medical specialty is the spread between the Medicare rates and private insurance rates greater. Progressives expect to pay anesthesiologists Medicare rates, which are 65% less than private insurance rates, without any change in the system. But there will be changes. Some anesthesiologists will leave the field. They are already faced with lawsuits at every turn.

There is already a shortage of anesthesiologists, and Dworkin gives his thoughts on the possible effects of losing more of them:

Quality of care will inevitably decline. That decline will come first in obstetrics. At the hospital where I work, two anesthesiologists work in obstetrics almost around the clock, so that a woman in labor need not wait more than five minutes for her epidural. Other hospitals are less fortunate, and have on staff at most one anesthesiologist in obstetrics. The economic crunch will eventually force these hospitals to cover obstetrics "when anesthesiology is available," meaning in between regular operating room cases.

During an obstetrical emergency, these short-staffed anesthesia departments will scramble to send someone to perform the C-section. Don't forget, a baby has only nine minutes of oxygen when the umbilical cord prolapses, so time is of the essence.

At the very least, pregnant women will be waiting a lot longer for epidurals.

After this, further shortages become a matter of life and death according to Dworkin:

More pain on the labor floor is only the beginning. If hospitals delay the administration of anesthesia because Congress skimped, needless deaths will certainly result.

On the other hand, this rules out the "death panels". There won't be enough anesthesiologists to perform the euthanasia.