Fact: Although you may want to pass off the impression that you are competent to do everything that a CRNA can do you should improve your research. AA's cannot develop and independently institute the anesthetic plan of care...just follow orders. I haven't recently been made aware of any AA's trained and liscensed for pain management or maintaining a succesful private practice. Fact: The study you allude to which I believe came out of UHC not CCF is a ACT practice so it is not valid to determine what the outcome would be between CRNA's working independently and AA's working for the anesthesiologist. Fact: malpractice rates for independent CRNA's are lower than the anesthesiologists, primarily because CRNA's have a safety record that even your ASA mothership cannot overcome. Fact: Last I checked 14 states have opted out of any supervision requirement for CRNA's. Fact: AA's are trained to meet the growing need for tertiary hospitals and practices that follow the ACT approach, CRNA's are trained to function as independent practitioners but many chose to work in the ACT setting as well. The entire "autonomy" arguement is ridiculous because whether your an AA or a CRNA in the ACT model neither have complete "autonomy". Fact: don't let "rural anesthesia" fool you, I've done major vascular and major trauma in the rural setting just as much as I have in the tertiary setting. The only difference is that I work closely with the surgeon and any other ancillary departments necessary rather than consulting with an anesthesiologist.
Bottom line is we have an excellent healthcare system and we all have an important part providing "all" patients with the best possible care. Goodluck with the ongoing debate!