McDowell Memo: Trump scores a victory

President Trump will order a broad overhaul of the nation’s organ transplant and kidney dialysis systems Wednesday in an executive order designed to prolong lives and save the government billions of dollars, according to people familiar with the plan.

Trump will outline proposals to keep people with kidney disease off dialysis longer and make treatment less expensive; encourage more live donation of kidneys and livers; and force the 58 nonprofits that collect transplant organs to improve their performance, people briefed on the plan said. He also will try to reduce discards of less-than-perfect organs by transplant surgeons.

In all, the government believes it can make 17,000 more kidneys and 11,000 more hearts, livers, lungs and other organs available for transplant every year, as well as save money for Med

President Trump will order a broad overhaul of the nation’s organ transplant and kidney dialysis systems Wednesday in an executive order designed to prolong lives and save the government billions of dollars, according to people familiar with the plan.

Trump will outline proposals to keep people with kidney disease off dialysis longer and make treatment less expensive; encourage more live donation of kidneys and livers; and force the 58 nonprofits that collect transplant organs to improve their performance, people briefed on the plan said. He also will try to reduce discards of less-than-perfect organs by transplant surgeons.

In all, the government believes it can make 17,000 more kidneys and 11,000 more hearts, livers, lungs and other organs available for transplant every year, as well as save money for  Medicare and Medicaid, which cover much of the cost of dialysis and transplantation. The United States has a severe shortage of tranplant organs. More than 113,000 people are waiting for them; most need kidneys. 

Medicare spent about $35 billion on dialysis patients in 2016--more than $89,000 per person, according to the kidney foundation. Transplant patients, in contrast, cost Medicare $35,000 per person. 

A key to boosting transplantation will be cracking down on “organ procurement organizations,” the 58 nonprofit groups that collect organs from deceased donors and send them to transplant centers for implantation. Each OPO holds a monopoly over a chunk of U.S. territory and collects and reportsits own data on how successful it is. Some poor performers have manipulated the numbers, researchers have shown.

New York’s OPO, for example, has consistently fallen short of government performance standards but has been able to block HHS efforts to shut it down because current data is so unreliable.

Thank You President Trump almost everyone has a loved one in need of a transplant or dialysis .You are helping our most needy.