[Congressional Record Volume 144, Number 152 (Thursday, November 12, 1998)]
[Extensions of Remarks]
[Page E2309]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   CONFERENCE REPORT ON H.R. 4328, DEPARTMENT OF TRANSPORTATION AND 
               RELATED AGENCIES APPROPRIATIONS ACT, 1999

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                           HON. LOUIS STOKES

                                of ohio

                    in the house of representatives

                      Thursday, November 12, 1998

  Mr. STOKES. Mr. Speaker, I am pleased to support the fiscal year 1999 
budget agreement. However, I am disturbed by a provision in the bill 
that calls for a study--and declares a one year moratorium--on the 
Department of Health and Human Services (HHS) Secretary's regulations 
to reduce fundamental unfairness in the nation's organ transplant 
network.
  The issues of organ procurement and allocation are of particular 
importance to the African-American community. Yet, the current organ 
transplant network is founded on a system that discriminates against 
patients on the basis of where they live. It is biased, inequitable and 
particularly unfair to minorities. In fact, according to the Inspector 
General of the Department of Health and Human Services, African-
Americans wait twice as long as white Americans for kidney transplants. 
In 1994, African-American patients waited more than 3 years for a 
kidney transplant, while white patients waited an average of 1 year and 
8 months. Some of the disparity is due to biological matching problems. 
But not all of it. Minorities are clustered in urban areas with long 
organ transplant waiting lists.
  This dire situation is magnified by--what renowned organ transplant 
surgeon and founder of the national minority organ/tissue transplant 
education program, Dr. Clive Callender commonly refers to as the 
``green screen.'' This is a barrier that prevents patients who lack 
fiscal resources from being added to the transplant waiting list. Many 
of them die without having been given the option of transplantation.
  African-Americans and other minorities are not the only Americans who 
suffer as the result of an unequitable organ allocation system. 
Depending on where they live, some of our citizens wait five times 
longer than others for liver transplants, even though their medical 
conditions are similar. I believe that the current system, which makes 
life and death decisions on the basis of geography, is unfair and 
should be changed. I support the organ transplant regulations issued by 
the Department on the April 2nd. They provide the best opportunity to 
reduce geographic bias and put all Americans in need of 
transplantation, regardless of race or geographic status, on an equal 
playing field.
  The HHS rule does not dictate medical policy. Rather, it simply calls 
upon the community of transplant professionals to devise uniform, 
fairer policies for the organ transplant network. It requires only that 
the medical criteria be used as the basis of any new policies for the 
organ transplant. Through this rule, HHS is taking a stand for 
fairness.
  Mr. Speaker, it is for these reasons that I support the Department of 
Health and Human Services' rule on the organ transplant network. I urge 
my colleagues to do likewise.

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