Bill Overview
Title: Protect Lifesaving Anesthesia Care for Veterans Act of 2022
Description: This bill prohibits the Department of Veterans Affairs (VA) from modifying its policy relating to anesthesia care in a manner that would provide any medical professional other than a physician anesthesiologist with full practice authority for the furnishment of anesthesia care to veterans under VA health care laws. The VA is also prohibited from finalizing, implementing, or enforcing the provisions relating to anesthesia care of the proposed rule titled Advanced Practice Registered Nurses (81 Fed. Reg. 33155), or any substantially similar rule.
Sponsors: Rep. Scott, David [D-GA-13]
Target Audience
Population: Veterans receiving healthcare through VA
Estimated Size: 9000000
- The target population is veterans receiving healthcare through the Department of Veterans Affairs (VA).
- Veterans are a specific group of individuals who have served in the military and are eligible for VA healthcare.
- There are around 19 million veterans in the United States, of which approximately 9 million are enrolled in the VA healthcare system.
- The bill specifically addresses anesthesia care, impacting veterans who require surgical or procedural interventions where anesthesia is needed.
- Physician anesthesiologists and other healthcare providers within the VA system will also be affected by changes to their practice authority.
Reasoning
- Veterans requiring anesthesia for surgeries or procedures will directly feel the impact of this policy; hence, they are the primary focus for these interviews.
- Physician anesthesiologists within the VA system are directly impacted because the policy maintains their exclusive authority for providing anesthesia care.
- Nurse anesthetists, who are not granted full practice authority under this policy, might also have opinions on the implications of this act.
- There is a secondary effect on the broader healthcare team and support staff within the VA system, as their workflow and collaboration may be influenced by the practice environment.
- Considering diverse demographics and geographic settings of veterans, we aim to reflect varied impacts across these interviews.
- We must also consider the length of time it takes for the policy changes to manifest in the everyday experiences of veterans and healthcare professionals.
Simulated Interviews
Retired (Texas)
Age: 68 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 14/20
Statement of Opinion:
- I'm relieved that the policy maintains the status quo. Having been through heart surgeries, I trust physician anesthesiologists more.
- I worry about extended wait times since only physicians are authorized, but safety is my priority.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Nurse anesthetist (California)
Age: 44 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I believe nurse anesthetists are competent and should have full practice authority.
- This policy limits my professional growth opportunities and might lead to job dissatisfaction.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 5 |
| Year 2 | 4 | 6 |
| Year 3 | 4 | 7 |
| Year 5 | 5 | 7 |
| Year 10 | 5 | 7 |
| Year 20 | 5 | 7 |
Veteran advocate (Florida)
Age: 72 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- Veterans deserve the best care possible, which often means ensuring our most trained personnel handle complex procedures.
- I'm concerned this policy does not address issues of accessibility and personnel shortages.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Physician anesthesiologist (New York)
Age: 55 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- This policy ensures that patients receive care from highly trained professionals like myself.
- However, it may strain our workforce without nurse anesthetists being able to take on more responsibility.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
VA healthcare administrator (Ohio)
Age: 37 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- I understand the intentions behind the policy, but we must also consider operational challenges and possible bottlenecks in services.
- Ensuring a balance between safety and efficiency is crucial.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 6 |
| Year 2 | 5 | 7 |
| Year 3 | 5 | 7 |
| Year 5 | 6 | 7 |
| Year 10 | 6 | 7 |
| Year 20 | 6 | 7 |
Retired (North Carolina)
Age: 62 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 13/20
Statement of Opinion:
- I want the surgery done safely, and I'm glad it's with a physician anesthesiologist.
- With only doctors doing anesthesia, I hope I don't have to wait longer for my surgery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Active duty transitioning to veteran (Virginia)
Age: 25 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I'm new to the system and want to ensure I have top care during my transition.
- Hearing that qualified professionals handle anesthesia is comforting.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Military spouse (Washington)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 18/20
Statement of Opinion:
- My husband uses VA services, and I believe anesthesia care should be by those most qualified.
- I worry about service delays but trust experienced professionals.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Veteran with chronic pain (Illinois)
Age: 59 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- As someone who frequently accesses VA care, I hope this policy improves service quality.
- My main concern is if this will make accessing anesthesia services slower.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 4 | 3 |
| Year 3 | 4 | 3 |
| Year 5 | 4 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 4 | 3 |
Veteran seeking mental health services (Kentucky)
Age: 30 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 0.0 years
Commonness: 16/20
Statement of Opinion:
- I'm not directly impacted by anesthesia policies yet, but future surgeries can be a concern.
- I appreciate knowing there's professional oversight on sensitive health issues.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Cost Estimates
Year 1: $15000000 (Low: $10000000, High: $20000000)
Year 2: $15000000 (Low: $10000000, High: $20000000)
Year 3: $15000000 (Low: $10000000, High: $20000000)
Year 5: $15000000 (Low: $10000000, High: $20000000)
Year 10: $15000000 (Low: $10000000, High: $20000000)
Year 100: $15000000 (Low: $10000000, High: $20000000)
Key Considerations
- Maintaining current VA anesthesia care practices aligns with ensuring experienced physician anesthesiologists oversee veteran anesthesia care, which can be seen as maintaining quality assurance.
- However, this approach may not maximize potential cost efficiencies available through leveraging a broader scope of practice for anesthesia providers.