Here is the scenario played out thousands of times a day in rural America, pt comes in has TKR,THA,colon resection breast Aug, etc etc. No anesthesiologist is involved in any way whatsoever because there is not one there. CRNA's do not NEED to get rid of anesthesiologists cause they are NOT THERE in so many places and guess what patients do just fine, if there were another person who could perform surgery with equivalent outcomes and at lower cost then you bet that battle would be raging. But there is not so the last argument is not at all applicable.