ORGAN-DONOR DEBATE IS HEALTHY EXCHANGE

The nation's potential organ-transplant recipients should be following the Tommy Thompson confirmation hearings with great interest.

At stake is the way the medical facilities in the United States divvy up organs from donors. As it stands right now, they're distributed by community, then by prescribed regions and then nationally.

Thompson, Wisconsin's governor and probably the next secretary of the Department of Health and Human Services, likes it that way.

It works well for his state because Wisconsin has one of the highest organ-donor rates in the nation. Nobody knows why, but it stands to reason that those needing transplants in Wisconsin, because of the parochial system, are going to get organs in a more timely manner than elsewhere.

But HHS officials in the past have seen it differently. In 1998, HHS Secretary Donna Shalala declared that patients are dying because of where they live, meaning transplants should be based on need, not geography. Her statement kicked off a two-year war in Congress and with the United Network for Organ Sharing, the nationwide agency that oversees organ distribution.

Shalala issued regulations that demanded the network write new distribution policies. After a fight over whether she had the right to set policy at all, Congress approved the regulations last year, and HHS signed a revamped contract with the transplant network.

In the meantime, Wisconsin sued HHS to try to stop the department from making any changes.

In the end, the transplant network didn't change a single procedure. And now they may not have to.

Network officials welcome Thompson. They believe the system works the way it is. But HHS staff members hope Thompson comes to see things their way once he's the leader of a national agency instead of one state.

Which way is the right way to distribute organs remains up for debate, but one thing is certain: Any sort of discussion like this is healthy. Both sides can come up with compelling reasons for doing things their way, reasons that we can review and then decide as a nation.

But perhaps the most interesting fact is being overlooked in this debate. The government should tap into Wisconsin's secret for getting its people to donate their organs in such large numbers, thereby saving lives by the thousands.