I brought up a point in another thread that I thought was reasonable. Perhaps it's not, but I'd really be interested in what people have to say about it-- People think that CRNAs are going to compete MDs out of jobs because they're cheaper. They look at the average salaries of a CRNA and a MDA, and since MDAs make more money, they conclude that if we had nothing but CRNAs, we'd save a lot of money. However, CRNA and MDA reimbursement under Medicare is EXACTLY the same. MDAs generally make more money because they can supervise multiple cases, and get reimbursed for all of them, while CRNAs can only get paid for one case at a time. However, the government's bill per case is exactly the same, the only difference being who the money goes to. In general, most insurance companies follow the lead of Medicare. Some companies reimburse extra 10-20% for doctor's care, but that's a relatively small change, and is not the primary reason for the difference in salaries. At worst, that extra 10-20% would go away, and we would still have essentially the status quo. So, CRNAs won't save the nation as a whole any money. Some CRNAs are hired by the hospital. In those cases, the hospital gets the money, so they could pay the CRNAs an arbitrarily low salary. So, maybe hospitals could save some money. However, CRNAs are allowed to independently bill for their services, and work in independent practice groups, just like doctors. Why would they want to work for the hospital and give up the billing money that they could keep for themselves? One last thought-- CRNAs have been legally allowed to perform anesthetics by themselves (not counting surgeon "supervision") for a long time, in all fifty states. If they really were so advantageous, why are there so many anesthesiologists in the first place? There must be some reason why hospitals in urban areas that can attract anesthesiologists ask for them instead of asking for CRNAs.