Artifact 4: SPCH 140 Outline

Format for Speech Preparation Outline

Name: Will Capell

Specific Purpose Statement: I want my audience to understand the benefits and drawbacks of the
opt-out policy regarding anesthesia administered in healthcare facilities.

I. Introduction.
A. Gain Attention: Open with Joan Rives passing away, which occurred September
4th, 2014, and mention likely causes of her death.

B. Thesis Statement: The opt-out policy has generated serious debate in the
healthcare field.

C. Preview: In the next few minutes, I will first describe what the opt-out policy is.
Then, I will outline the controversy surrounding this policy by discussing its pros
and cons

II. Body
A. What is the opt-out policy?
1. Explain the purpose of anesthesia in the hospital, and how it is
administered.
a. There are many types of Anesthesia (general anesthesia, laughing
gas, epidurals, etc.)
b. Outline the difference between the roles of a CRNA and an MD in
most hospitals.
2. The policy
a. On November 13, 2001, the Centers for Medicare and Medicaid
Services amended the requirement for CRNAs to be supervised by
anesthesiologists.
b. There are already 17 states that have opted out of the federal
requirement.
c. Provide example of Kentucky gubernatorial letter (cite)
3. Why should we care?
a. Many college students have not been through surgery
b. The policy will affect our loved ones and our futures.

Transition: Now that you hopefully have a general understanding about opting-out, I will
explain the controversy surrounding it.

B. What are the benefits of the opt-out policy?

1. The policy demands less training for health care employers administering
anesthesia.
a. It takes 7-8 years to become a CRNA and 12-13 to become an MD.
b. List the difference in cost between CRNA training and MD
 training
i. It costs between $15,000 - $127,000 for in-state CRNA programs
ii. It costs roughly $130,000 to get an in-state MD
2. The policy makes healthcare more affordable for patients.
a. Affordable healthcare is extremely important.
b. Mention ObamaCare.
c. Current system requires patient to pay for two people
administering anesthesia.
d. List costs of anesthesia for various procedures (cite)
i. An appendectomy costs $748
ii. A colonoscopy costs $525
iii. A bypass surgery costs $2,490
iv. Liposuction costs $626

Transition: With these policy benefits in mind, opting out seems like a straightforward
and advantageous adjustment. (Who doesnt want cheaper healthcare?) However,
arguments have been made that question the policy itself and its potential implications.

C. What are the drawbacks of the opt-out policy?

1. The policy does not address the difference in education between CRNAs
and MDs.
a. It takes 7-8 years to become a CRNA, and 12-13 years to become an
MD.
b. Education difference may affect the competence of the individual
administering anesthesia.
c. Paint scenario, highlighting a patients comfort level with a
supervising MD, or just a CRNA.
2. The policy may compromise patient safety.
a. The end result of all surgery is the betterment of a patient.
b. Provide morbidity statistic (cite)
c. The experimental results of CRNA vs anesthesiologist care are
conflicting.
d. Critiques of the opt-out policy argue that patient safety is more
important than saving money.

III. Conclusion
A. Review: To wrap up, the opt-out policy has been an important change in the healthcare
field. Benefits of the policy have been identified, such as more efficient employer
training, and financial cuts for patients. Additionally, potential drawbacks of the policy
have been pointed out. These include a disregard for the education gap between CRNAs
and MDs and also a compromise in patient safety.

B. Restate thesis: Indeed, The opt-out policy has generated serious debate in the
healthcare field
 C. Peroration: With all the other changes occurring in medicine, such as ObamaCare, it
will be interesting to see how this policy plays out.

Bibliography

Beshear, Steven L. Letter to Administrator Marilyn Tavenner. 25 Apr. 2012. Aana.com. American
Association of Nurse Anesthetists, 2015. Web. 25 Feb. 2015.
Healthcare Bluebook. CAREOperative, 2015. Web. 25 Feb. 2015.
Pine, Michael, Kathleen D. Holt, and You-Bei Lou. Surgical Mortality and Type of Anesthesia
Provider. American Association of Nurse Anesthetists Journal 71.2 (2003): 109-116.
Web