The Law And The Evidence

[boardman]

The Law And The Evidence
BY PATRICK WELCH, CHAIR, WITH GOVERNMENT AFFAIRS STAFF

Sen. Tom Coburn (R-Okla.) finds much to dislike and disagree with in regard to many government programs, and the appropriations that fund them. He made a big splash over the summer by joining Sen. John McCain (R-Ariz.) in proposing an amendment to H.R. 2055, the military construction and Veterans Affairs appropriations bill that would have significantly restricted benefits to Vietnam veterans who have health conditions associated with exposure to Agent Orange.

The Coburn amendment would have altered the 1991 Agent Orange Act to require that veterans prove a "causal relationship" rather than a significantly "positive association" of an adverse health condition to Agent Orange exposure in order for a veteran to receive benefits. This would have meant that most diseases would no longer be covered if you can't prove that your illness was directly caused by Agent Orange and could not have been caused by another source.This would have effectively undermined the expansion of the list of health conditions such as diabetes, certain cancers, and ischemic heart disease as service-connected illnesses. VVA and others vigorously opposed this amendment.

"This measure is wrong-headed," VVA President John Rowan said. "It is out of touch with science – and with the intent of the Agent Orange Act of 1991. It attempts to undo two decades of policy. If they develop certain maladies that the VA Secretary has determined, on the basis of sound scientific and epidemiological evidence, that a positive association exists between the exposure and the occurrence of the disease, they are entitled not only to health care but to disability compensation.

"Congress, in part, settled on this mechanism because it was nearly impossible for Vietnam veterans to prove that their exposure to Agent Orange caused their health conditions, some of which are fatal. Requiring a causal relationship, which is well nigh impossible to demonstrate, would essentially mean that benefits due to Agent Orange exposure would be out of reach for Vietnam veterans."

The amendment did not pass. But it was not rejected outright, either. Rather, it was tabled – it can conceivably be brought back for discussion at some future time during this session of Congress – by a vote of 69-30. We believe that this issue will come back in one form or another during the next few years.

After not funding any research on Agent Orange and very limited research on other toxins that troops have been exposed to in combat, some in Congress now want to make us prove that there is a causal relationship, as opposed to a statistically significant association.

Had Sen. Coburn's amendment been law a decade ago, Vietnam veterans with diseases such as diabetes, prostate cancer, lung cancer, and some blood-borne illnesses would not have been eligible for VA health care and disability compensation.

In making a determination that a particular malady is service-connected, the Secretary of Veterans Affairs must take into account the biennial reports from the Institute of Medicine of the National Academies of Science, along with other sound medical and scientific information and analyses. Under the law, the Secretary has the authority to declare a particular health condition to be "presumptive" as a service-connected disability.

Secretary Eric K. Shinseki carefully studied both the law and the scientific evidence, and then did the right thing. Sen. Coburn, on the other hand, wants to drastically change the law to impose a different standard for veterans that is unfair and goes beyond standards in the civilian sector.
NEED TO EDUCATE NEW MEMBERS

The fiscal climate in Washington, D.C., augurs ill for veterans' benefits. A recent article in Congressional Quarterly began with this:

"The caps on security spending in the proposed debt deal will force cuts in defense spending, but on a proportional basis the axe is likely to fall even more heavily on spending for foreign aid, homeland security and veterans."

Although the Senate followed the House of Representatives in approving the annual spending bill for military construction and veterans' programs, future funding of discretionary programs for veterans is among the accounts that many fear will be targeted for de-funding or, at the very least, scaling back.

And with fewer veterans in Congress than at any time since before World War I, we're all going to have to work extra hard to educate new members of Congress that caring for veterans is part of the continuing cost of the national defense. It is up to us to educate these new members – and some not-so-new members as well.