Originally created 04/08/00

House right on organ vote

Generally speaking, localities are more effective at handling their problems than the federal government, because local folks have a better handle on their community's needs than bureaucrats sitting in Washington.

This rule applies to organ transplants, too, and that's why the U.S. House vote to strip the Department of Health and Human Services of its power to set transplant policy is in the best interests of Americans, especially very sick Americans.

The House action was triggered by the longtime tension that exists between the federal government and the United Network for Organ Sharing, the private organization HHS contracts with to run the program. The House measure rightfully transfers policy-making to the network.

What brought the turf battle to a head was HHS' new regulation requiring that organs be sent to the sickest patients wherever they live, instead of to the sickest patients within the network's geographically defined areas.

Why does this matter? Because decisions about where scarce heart, liver and kidney organs go would be made in Washington, and the delicate and complex surgeries would likely end up being done at a handful of large regional centers that have the most patients and longest waiting lists.

Such a prospect poses a threat to scores of transplant networks -- and the medical expertise therein -- in communities all across the nation. This is why grass-roots hospitals and transplant surgeons are kicking up a fuss and getting Congress' attention.

The 275-147 House votes sends a clear message that the folks back home support the networks and, more importantly, want medical and transplant experts, not bureaucrats, to make sensitive transplant decisions. HHS is simply not qualified to dictate the nation's organ allocation policies.

Another key reason to strengthen organ networks is that the HHS regulation might discourage organ donations. When broached on the grisly subject, most people prefer to donate to persons with whom they have a sense of kinship -- that is, patients in their own community or state.

Incidentally, the House bill also contains provisions to encourage more organ donations, which all sides support, and allows states to write laws to keep organs within their borders. Doctors and transplant centers are now turning their attention to the U.S. Senate, which doesn't want to deal with the controversy this year, but may have to if it becomes a campaign issue.


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