A24 EZ RE THE WASHINGTON POST.SUNDAY, AUGUST 2 , 2020
LETTERS TO THE EDITOR[email protected]S
OME 33 Americans die every day for lack of
transplantable organs to save their lives.
Many more wait, crowding into dialysis
centers and other health-care offices in the
midst of a pandemic. Much of this death and
waiting is unnecessary, because the organs would
be available if those responsible for collecting and
transporting organs did a better job. It is past time
the government demanded it of them.
Before covid-19 hit, the Trump administration
had seen the problem and proposed a sweeping
reform of the nation’s organ procurement system. It
must follow through. Lives are on the line.
President Trump last July signed an executive
order aiming to improve kidney care in the United
States. The order included a mandate to revise
“Organ Procurement Organization (OPO) rules and
evaluation metrics.” OPOs are the 58 nonprofit
groups responsible for collecting organs from the
deceased, each assigned a geographic zone. These
groups are supposed to send people to hospitals to
persuade families to allow their relatives’ organs tobe transplanted. Theoretically, federal authorities
can decertify underperformers in this crucial
mission. But they report their own success rates.
Research from the University of Pennsylvania has
found that those self-reported metrics are wildly
inflated.
The OPO covering central New York state
reported a 71 percent recovery rate between
2012 and 2014. The researchers revealed that the
real rate was more like 27 percent. In north-central
California, the reported rate was 82 percent and the
real rate 28 percent. Meantime, executives at even
some of the worst-performing OPOs enjoyed high
salaries and perks. OPOs that have changed
management have seen drastic improvements —
and, therefore, saved more lives — showing that
these organizations can do better.
Often, improving public health requires spend-
ing more money. Not in this case. The government
spends an astonishing amount treating kidney
disease, the costs of which Medicare covers to the
tune of $35 billion on dialysis alone. Dialysistreatment costs the government some $89,000 per
person per year. By contrast, kidney transplants
cost $35,000 per person.
The Trump administration late last year pro-
posed evaluating the OPOs based on numbers they
cannot juice, using Centers for Disease Control and
Prevention data. Real numbers in hand, regulators
would demand that OPOs perform well or face
penalties as stringent as decertification.
Some health-care organizations worry that de-
certifying OPOs would disrupt organ procurement.
But in a system in which these nonprofits have an
effective monopoly on organ recovery within their
zones, there are few incentives for them to improve
unless decertification is a serious possibility. The
Trump administration should stick with its origi-
nal instincts and finalize the rule, as soon as
possible.
Reform advocates suggest the nation could
recover 28,000 more organs every year. That would
be 28,000 fewer people wondering whether they
will get a new organ — or die waiting.No one should be left waiting to die
The administration is right to push for more accountability in the country’s organ procurement system.
T
HE CHIEF EXECUTIVES of the country’s
four most prominent technology titans
earned a new nickname from Congress in
landmark antitrust hearing last week: cyber-
barons. Now that lawmakers have had a chance to
bark at the 21st- c entury economy’s juggernauts,
they must decide whether (and how) to bite.
Most Republicans spent their allotted time at the
more than five-hour hearing grandstanding about
supposed censorship of conservative viewpoints;
Democrats spent theirs grandstanding about anti-
trust. Because this was an antitrust hearing, the
latter approach was preferable — but still far from
ideal. Interrupted so frequently, the witnesses could
hardly say anything illuminating. Instead, the ma-
jority on the House Commerce subcommittee devot-
ed to scrutinizing market power staged a public, if
somewhat anecdotal, reveal of evidence they have
gathered over a year-long investigation.
Amazon, whose founder, Jeff Bezos, owns The Post,
was accused of leveraging its access to proprietary
data of third-party sellers in its marketplace to drive
competitors out of business. Apple was accused of
pulling a similar trick against developers in its app
store, using its control as a cudgel to extract a cut of
their profits as well as target software that threatens
its own. Facebook, lawmakers charged, adopts a
“copy, acquire, kill” strategy to snuff out any start-up
that could prove a rival — enough so that Instagram’s
founder feared Mark Zuckerberg would enter “de-
stroy mode” if he didn’t consent to the purchase of his
firm. Google, they said, stole other sites’ content to
improve its own products, and then privileged those
products to drive the other sites into obscurity.
The through line here is clear: Congress argues
that these companies exploit their dominance in
various marketplaces to maintain their dominance.
This argument leans heavily on harm to competitors,
even though antitrust law has been interpreted in
recent decades to protect against harm to consum-ers, chiefly through higher prices. But that’s why the
legislative branch is getting involved: to consider
whether antitrust doctrine needs an update in the
digital age, when big data skews what regulators
thought they knew about pricing, and when unfore-
seen and often immeasurable harms may arise from
the concentration of too much control in too few
hands.
This is a worthy task. Yet the line-drawing be-
tween good business and bad behavior may not be aseasy as legislators make it seem, and these firms
often help even as they can harm. Apple’s disservice
to the inventor of the most popular downloadable
flashlight app, for instance, was probably a service to
iPhone users, who benefited when the company
installed the feature directly into their devices.
When lawmakers issue a final report next month,
they will propose remedies. They must take care that
those remedies address clear and concrete injuries —
and that they don’t cause new ones.21st-century
antitrust
Drawing the line between
good business and bad behavior.ABCDE
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The Washington Post
1301 K St. NW, Washington, D.C. 20071 (202) 334-6000The July 28 op-ed by Miami Mayor Francis Suarez
and Vin Gupta, “Without enforcement, mask man-
dates won’t work,” said success in our fight against
the novel coronavirus hinges on “clear and consis-
tent enforcement” of mask orders. D.C. Mayor
Muriel E. Bowser (D) clearly needs to do more
immediately to enforce her July 22 mask order. It is
an order, not a suggestion, and she intended for it to
be enforced.
Where I live, about a third of the people I see out
walking are without a mask. Six days after Ms. Bows-
er’s order, I asked a D.C. police officer what she is
doing about those not wearing masks. She had no
idea an order exists nor that it can be enforced. Her
response: “Well, you can’t make people wear a
mask.” Yes, you can. Mr. Suarez “has assigned at least
39 police officers to make sure that residents are
following the city’s mandatory mask ordinance.”
If D.C. police do not enforce Ms. Bowser’s order,
we could end up where Miami is right now.
Arlene Alligood, WashingtonD.C. police, enforce the mask order
The conclusion in David Ignatius’s July 29 op-ed,
“When protests turn violent, Trump gains the upper
hand,” that keeping protests peaceful is a challenge
for former vice president Joe Biden, the presumptive
Democratic nominee for president, was off the mark.
The solution lies in the hands of the local political,
civic and community leaders.
In any protest movement, the ranks are going to
include anarchists, agents provocateurs and hired
thugs whose mission is to create chaos, incite
violence and provide a convenient target for govern-
ment forces to disrupt and attack. They provide
ammunition to President Trump’s consiglieri to
label the protests as an attack on the government
that the government has a duty to protect.
In Portland, Ore., and Seattle, responsible leaders
need to persuade protesters to exercise their consti-
tutional rights away from federal buildings troops
are defending. Such a step would defang the forces
using violence to crush protesters.
Some could argue that this would allow
Mr. Trump to say he won. On the contrary, communi-
ty leaders could legitimately characterize it as an
intelligent tactical maneuver.
The protests don’t provide a challenge to
Mr. Biden; they give him an opportunity to use in his
campaign against Mr. Trump. Local leaders need to
up their game.
Joseph Winder, BethesdaNot a problem for Mr. Biden
It’s hard to imagine a more succinct indictment of
U.S. foreign and domestic policy than Richard
Haass’s July 28 Tuesday Opinion essay, “What
Pompeo doesn’t get about China and foreign policy.”
While reminding us of the rationale and undeniable
benefits of five decades of U.S.-China engagement,
Mr. Haass exposed the glaring weakness of the
Trump/Pompeo approach.
The Chinese are not “ten feet tall,” as Mr. Haass
implicitly noted. Like us, they have p roblems, and
the last thing either country needs is a new Cold War.
Beijing doesn’t seek it, our friends and allies in Asia
and Europe don’t want and won’t support it, and we
can’t win it alone.
We would do far better by treating China with
respect. The multilateralism Mr. Haass advocated
would enable us to deal more effectively with
challenges Beijing poses and the far greater chal-
lenges of climate change, Middle East instability,
Russia, nuclear proliferation and the pandemic.
This is an election year, which can bring out the
worst in foreign policy ideas; but come November,
we’ll have to take stock. Mr. Haass provided a
valuable guide.
William F. Rope, Washington
The writer is a former deputy assistant secretary
of state for Political-Military Affairs and former
director of the State Department China Desk.Missing from the July 29 n ews article “Report
blasts Pompeo’s leadership at State Dept.” was that
Mike Pompeo was the first secretary of state since Al
Haig in 1981 to meet with the Iran hostages of 1979 to
1981 and their families. Mr. Pompeo and then-Spe-
cial Envoy for Hostage Affairs (now national security
adviser) Robert C. O’Brien did not just “meet” with
the former hostages. They also drew out the hostag-
es’ histories of abuse, beatings, mock executions and
family hardship at the hands of Iran. It was a
powerful meeting that was deeply appreciated by
the Iran hostages and their families.
Under Mr. Pompeo’s leadership, the hostage af-
fairs office has taken its obligations seriously, work-
ing quietly and tirelessly to free U.S. citizens
held hostage around the world. The Iran hostages
and their families are thankful for these efforts.
Certainly, Mr. Pompeo will be the subject of parti-
san attacks. However, a balanced approach to
assessing his work might allow the United States to
advance a broader foreign policy agenda.
V. Thomas Lankford Jr., Alexandria
D.E. Wilson Jr., Arlington
The writers are attorneys for the Iran hostages
and their families.Mr. Pompeo’s leadership
It was interesting to read the July 29 news article
“Election scenarios stir speculation on mili-
tary.” Salman Rushdie speculated on such a scenar-
io in his June 4 Thursday Opinion essay, “I’ve seen
dictators rise and fall. Beware, America.”
Having been a political prisoner, euphemistical-
ly known as a detainee, for nearly two years in
India, I never thought such a discussion would take
place in the United States. Thanks to President
Trump, we are discussing the demise of democracy
here. The next step is to make sure that does not
happen.
For civilians or military personnel, “power” is
alluring. People grab it to keep it. In the face of
being arrested or losing a job or putting a friend or a
relative in trouble, very few people would stand up
for truth or justice. It is all downhill from there.
It may be cliche to say eternal vigilance is
the price of liberty. In Trump’s America, this cliche
is very relevant.
Anadi Naik, FrederickPreventing democracy’s demise
J
OHN G. ROBERTS JR., chief justice of the
U.S. Supreme Court, may rightly be regarded as
a powerful man. So it may strike him and other
Americans as odd to know that the Trump
administration regards compliance with feder-
al court orders as optional, even those arising from
his own written opinions.
In separate cases, the Supreme Court and a federal
appeals court have ruled that the Trump administra-
tion was unjustified in ending an Obama-era pro-
gram that grants work permits and temporarily halts
deportations for hundreds of thousands of “dream-
ers,” young undocumented immigrants who grew up
in this country. Chief Justice Roberts wrote the high
court’s opinion, in June.
Citing those rulings, a federal district court judge
in July ordered the administration to restore the
protections and benefits it tried to abolish when it
rescinded the program, Deferred Action for Child-
hood Arrivals, in 2017. The administration has re-
fused to comply.
Instead, it has declined new applications for
DACA, maintaining a three-year-old freeze. It hasdone so even though hundreds of thousands of
dreamers remain eligible, some having never ap-
plied in the first place and others having turned 15,
the minimum age of eligibility. And it has cut work
permits for roughly 640,000 dreamers currently
enrolled in DACA to last only one year instead of two.
Meanwhile, the Department of Homeland Securi-
ty has launched what it calls a “comprehensive
review” of DACA, whose outcome is foreordained
given the president’s hostility. This time, one as-
sumes the government will adhere to established
procedures as it abolishes the program; it was the
slapdash failure to follow rules that resulted in its
losses in court. “Now we have to start this process all
over again,” President Trump tweeted after the
Supreme Court’s ruling.
In fact, Homeland Security’s “comprehensive re-
view” is a fig leaf obscuring the president’s intent to
terminate a program that enjoys enormous biparti-
san support. Mindful of the political risk, Mr. Trump
prefers to bury the issue for now rather than launch a
new frontal assault on DACA.
Don’t be fooled. While he has at times pledged his“great love” for the dreamers, Mr. Trump also said
that “many” DACA recipients are “hardened crimi-
nals,” a false statement given that criminal convic-
tions disqualify dreamers from eligibility. If
Mr. Trump is reelected, he will rescind DACA, and
dreamers, protected since the program was estab-
lished in 2012, will be at risk of deportation.
As Mr. Trump plays politics with the lives of
hundreds of thousands of blameless young migrants,
it’s worth remembering who they are, as Chief
Justice Roberts did in rendering his decision. Quot-
ing from a brief in the case, he wrote that many
dreamers have “enrolled in degree programs, em-
barked on careers, started businesses, purchased
homes and even married and had children.” Strip-
ping DACA recipients of work permits under DACA,
he noted, could cost the U.S. economy $215 billion
over the coming decade.
In planning DACA’s demise, the president is strik-
ing another blow against America’s growing diversi-
ty, which he clearly abhors. In the process, he also
threatens the futures of individuals and communi-
ties whose fortunes are bound up in America’s own.Plotting DACA’s demise
Mr. Trump ignores a Supreme Court ruling and continues to undermine ‘dreamers’ and American diversity.
ABCDE
AN INDEPENDENT NEWSPAPER
EDITORIALSTOM TOLESLOCAL OPINIONSRegarding the July 28 editorial “Racial inequities
are going strong at a Va. school”:
While sitting with my daughter in the elementary
school office, waiting to talk to the counselor (my
daughter had been called out for supposedly cheating
because she did all her work in her head), I overheard
the counselor, a wonderful, kindly woman of color,
talking with the family of an African American boy
who had qualified for the center-based gifted and
talented school. She was advising the family against
enrolling because “he wouldn’t like being with those
kids.” Center-based gifted and talented schools are
certainly the main track to get into Thomas Jefferson
High School for Science and Technology.
My daughter was a product of the center-based
gifted and talented program and ultimately graduated
from Thomas Jefferson. People of color were sorely
underrepresented throughout her time in the system.There were kids from every kind of background, and
there was some social discrimination among some of
the kids, but generally, being part of that program
created a lasting bond that made this the exception
rather than the norm. I fervently believe the counselor
was dead wrong. If kids qualify for center-based gifted
and talented schools, that’s where they belong. Color is
not an issue. Maybe the problem isn’t with Thomas
Jefferson’s stringent entrance exams but with what
happens in the counselor’s office in second grade.
Nancy Spivack, Falls ChurchDiscrimination in schools starts early
If kids qualify for center-based gifted
and talented schools, that’s where they
belong. Color is not an issue.
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