Today we are standing at the crossroads of a once-in-a-lifetime opportunity for change, and there are multiple social issues that we must get right for the next generation. One of the direst needs is to finally bring equity to health care. This is a matter of life and death here in Philadelphia and across the nation. While many are exhausted by the never-ending headlines about the COVID-19 pandemic, I am proud that my City Council colleagues recognize other critical health care areas that also demand our tireless attention.
One of these is organ donation and transplant. Nationwide, lifesaving organs are procured by regional, federally licensed nonprofits called organ procurement organizations (OPOs), and we are truly blessed in Philadelphia to have one of the best, the Gift of Life Donor Program. In 2021, the nonprofit organ procurement and transplant system set an all-time record of over 40,000 transplants across America, a number that represents yearly increases for over a decade in procurement and transplants.
Despite its resounding success, improvements must be made to address the health equity disparities in our organ procurement and transplant system. As of September 2021, more than 106,000 men, women and children remain on national transplant lists in the United States. While one person can donate up to eight lifesaving organs, only 3 in 1,000 people die in a manner that allows for organ donation. According to the U.S. Department of Health and Human Services’ Office of Minority Health, “the number of organ transplants performed on Black/African Americans in 2019 was 25.8% of the number of Black/African Americans currently waiting for a transplant. The number of transplants performed on white Americans was 47.6% of the number currently waiting.”
At a critical juncture when the federal government should be encouraging cooperation, alignment and shared best practices to improve the system, in the closing days of the previous administration, the Centers for Medicare and Medicaid Services (CMS) adopted a new final rule that will effectively undermine these important goals.
Instead of adopting protocol to improve donation and transplant in high-risk areas, including those that primarily serve communities of color, federal regulators in the prior administration chose to mandate that a set percentage of the 57 current lifesaving nonprofits be closed every cycle regardless of overall performance. The rule, presumably advanced in the name of efficiency, ignores both common sense and sound public health policy by decertifying these organizations based on transplant rates, a factor over which OPOs have no control. As a result, this blanket standard will disproportionately impact OPOs aiding under-resourced and underserved minority populations.
We urge CMS to promote science-based cooperation and outcome improvement in the system rather than injecting private sector-style competition into a sensitive nonprofit network. Experience clearly shows us that communities of color will suffer in this scenario. Attitudes, population health, disease rates, and access to transplants are not the same in Omaha, Nebraska, or in Columbia, South Carolina, or in many other regions of our richly diverse nation, as they are right here in Philadelphia. The vast, specific needs of the organ transplant system must be considered in analyzing and improving the metrics of organ procurement organizations.
For this reason, my Council colleagues and I have unanimously passed Resolution 220012 calling on Secretary Xavier Becerra and the Department of Health and Human Services to reconsider the implementation of the rule instituted by the prior administration and to instead develop a national task force of recognized experts in the organ donation and transplantation community to ensure equitable access to resources through established and trusted OPOs, particularly in communities of color.
Philadelphia City Councilmember Cherelle L. Parker represents the Ninth Council District, which stretches throughout Northwest and Northeast communities, including East Mount Airy, West Oak Lane, East Oak Lane, Olney, Lawncrest, Lawndale, Burholme and Oxford Circle.
