The change in Medicare rules affecting elderly people that Mr. Bush delayed could have led to problems if critical, unexpected complications were to occur during surgery. Administering anesthesia during surgery has become relatively safe during the past two decades. Medical officials reported only one anesthesia-related death per 400,000 operations during that period. Prior to the early 1980s, officials were reporting one death per 10,000 operations. Credit for the improvement goes to research and the team approach in which anesthesiologists supervise the nurse anesthetists who administer anesthesia during operations.
Many anesthesiologists supervise two or more surgeries at a time, moving between operating rooms.
Changing the rule requiring that supervision could ruin the collaborative approach by removing the anesthesia expert on the team, the anesthesiologist. Surgeons told federal officials who crafted the rule change that they value the participation of anesthesiologists during operations, especially if something goes wrong. Most troubling of all, the Clinton administration pushed through the rule change without conducting a study to determine if dropping the supervision requirement could harm patients. The Bush administration acted properly when it delayed the rule change. Patient-safety concerns dictate a thorough study of the risks before changing the anesthesia requirement for elderly Medicare patients.