CONGRESS HAS not quite given up the year-long attempt to block rules that would make the nation's organ transplant network more equitable. House leaders are maneuvering to undo a deal reached by conferees allowing the rules to go into effect--even threatening to block an unrelated authorization for research and training at children's hospitals if the organ rules are not delayed further.
The rules' issuance last year touched off furious counter-lobbying by the supporters of small local transplant centers, who feared that a new system based more on finding the patients with the most urgent need, and less on keeping organs near home, would force smaller centers to close. Never mind if it also would save lives.
Currently, when an organ becomes available, it is offered locally first, then regionally. That leads to situations in which people languish on long waiting lists in some places while the wait in other regions is much shorter. The wealthy can get on multiple waiting lists and fly to wherever a liver or a kidney becomes available.
Since some 4,000 people a year die while waiting for an organ, you'd think a proposal to purge the distribution system of some of its inefficiencies would have been welcomed. Instead, local transplant centers turned to Congress, which twice attached riders to appropriations bills delaying the regulations' effective date. They also turned to state governments, many of which passed laws that bar "harvested" organs from being used out of state. Finally, conferees reached a compromise that would delay the rules six more weeks for comment, then let them go into effect.
Now, though, House Commerce Committee Chairman Thomas Bliley (R-Va.) is said to be blocking a Senate bill that authorizes money for health research and for children's hospitals--sponsored by Sens. Edward Kennedy and Bill Frist--unless it contains a rider postponing the organ rules. Mr. Bliley's office won't comment; his district is home to the United Network for Organ Sharing, which strongly opposes the new rules. Neither should be allowed to derail a compromise that achieves a significant public good.