Biden administration pushes ‘diversity’ in kidney transplants
The Biden administration hopes to incentivize hospitals to start factoring in “diversity” when choosing which patients will receive kidney transplants.
The proposal
A 381-page proposal published this month by the Health and Human Services Department (HHS) would give performance-based incentive payments to hospitals that participate in a program called Increasing Organ Transplant Access (IOTA).
Under the IOTA program, hospitals will be scored in three areas with a possible total of 100 points per year. A facility can earn up to 60 points for the number of transplants given, up to 20 points for its acceptance rate, and up to 20 points for success after the transplants.
‘Low-income patients’ prioritized
Participating hospitals would receive extra points for giving transplants to “low-income patients,” as follows:
We propose to apply a health equity performance adjustment, a 1.2 multiplier, to each kidney transplant furnished by an IOTA participant to a patient, 18 years of age or older at the time of transplant, that meets the low-income population definition. That is, each kidney transplant that is furnished to a patient who meets the low-income population definition would be multiplied by 1.2, thus counting that transplant as 1.2 instead of 1. The resulting count of the overall number of kidney transplants performed during the PY [performance year], after the health equity performance adjustment is applied, would then be compared to the transplant target.
Does ‘low-income patients’ mean ‘patients of color’?
Some believe the term “low-income” is being used to refer to people of color. The HHS notes nearly 30 times throughout the proposal that Black and Hispanic Americans receive less kidney transplants than White Americans.
HHS Secretary Xavier Becerra also made clear in a press release about the proposal that the goal is to start prioritizing color in kidney transplantation.
“The organ transplant industry, like every other part of society, is not immune to racial inequities,” said Becerra. “Black Americans disproportionately struggle with life-threatening kidney disease, yet they receive a smaller percentage of kidney transplants. The Biden-Harris Administration is taking concrete steps to remove racial bias when calculating wait times and rooting out profiteering and inequity in the transplant process.”
‘Purely on the basis of race’
Kidney specialist and Do No Harm Founder Dr. Stanley Goldfarb says the Biden administration knows it cannot explicitly say, “We’re doing this for black patients.”
“And so I think what they’ve just decided is, ‘We’ll just give an incentive to the hospitals to do this and let them figure out how to do this,'” Dr. Goldfarb told the Daily Caller. “But I don’t know that there’s a real system in place to allow that. So either you’re going to have a system that ends up being purely on the basis of race, or it’s going to be a system that fails totally.”
