I take great issue with two of the statements in the Aug. 14 letter by Thomas McCune ["Kidneys for Transplant"].

Dr. McCune states that "patients who came from outside the state of Maryland to be listed at the University of Maryland and Johns Hopkins University will not be affected by this moratorium. Those patients will be able to return to their regional transplant centers, where they will be listed for organs."

Dr. McCune is neglecting a fact of life known as "managed care." It is managed care that is sending patients to these facilities and other "centers of excellence," thereby causing the great disparity in organ sharing.

In 1994 my wife received a kidney-pancreas transplant from Inova Fairfax Hospital in Virginia. At that time we were covered by a traditional fee-for-service insurance plan. She had to meet a $100 deductible and had a $1,000 out-of-pocket limit before the insurance paid 100 percent vs. 80 percent.

Now she is covered under a managed care plan. Guess where the plan will send her for a second transplant. The University of Maryland. To go back to Fairfax Hospital to the same surgeon who performed her transplant originally would now cost us a $400 deductible and a $5,000 out-of-pocket limit.

It is in fact the patients who are going to suffer from this moratorium. Meanwhile, my insurance company and other managed care plans can sit back and count the dollars they are saving by having patients at the University of Maryland and Johns Hopkins wait even longer for their transplants.