When Science Is Too Slow: Doing Good by Burning Pit Victims
EEarlier this month, the Senate Veterans Affairs Committee approved legislation that would improve access to health care for post-9/11 veterans exposed to burning fireplaces and other toxic substances in the during their military service.
The “Health Care for Burn Pit Veterans Act” passed the 18-member committee unanimously, hailed by Democrats and Republicans as landmark legislation, and in the words of Republican Senator Jerry Moran of Kansas, co- sponsor of the bill, it is “an important first step in ensuring that our veterans receive the care they need.
But a prominent Republican senator, who is not on the committee, is far from happy with the “first step”, which he says is far too tentative.
“Veterans who suffer from debilitating illnesses and die because they cannot get care deserve better than half measures,” said Republican Florida Sen. Marco Rubio. “Specifically, the bill does not provide a presumption of service connection for the major conditions affecting many veterans who were exposed to toxic combustion fireplaces.”
“Even if the bill were to become law, the onus would still be on veterans to prove that their illness was a direct result of their deployment to receive essential benefits,” Rubio said in a statement.
Rubio and New York Democratic Senator Kirsten Gillibrand introduced a competing bill last year, the “Alleged Benefits for War Veterans Exposed to Burn Pits and Other Toxins Act,” which also has bipartisan co-sponsors in the House and goes much further in cutting red tape. barriers to care.
The measure would establish an automatic presumption that more than 20 categories of cancers, lung diseases and respiratory problems are linked to military service – even though medical science has yet to establish a definitive causal link between the exposure and the sickness.
“More than 3 million service members could have been exposed to toxic combustion sources, but the [Department of Veterans Affairs] continues to deny them care by placing the burden of proof on veterans suffering from rare cancers, lung diseases and respiratory illnesses,” Gillibrand said. “The bottom line is that our veterans have served our country, they are sick and they need health care – period.”
One of the key lessons from years of treating so-called Gulf War illnesses in the 1990s is that policymakers cannot afford to wait for science to establish a clear link between exposure and a specific disease.
Science is slow, methodical, can take wrong turns and even reach dead ends before finally landing on accepted truth – as the changing advice on COVID-19 has illustrated.
What’s particularly difficult to prove is that a small amount of exposure to something toxic, which produced no symptoms or ill effects at the time, can cause serious illness years or even decades later.
Take the case of Marine Major Randy Hebert, who testified before Congress in 1996.
Hébert, who has amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, could barely speak and had trouble showing up for his swearing-in ceremony before the House committee.
Hebert told lawmakers he believed his exposure in 1991 to a chemical mine explosion in Iraq triggered the onset of his ALS and that the government was covering it up.
“My view is that the Pentagon knew this from day one,” he said.
Scientists warn that “correlation is not causation”, saying that just because one thing happened after another doesn’t mean the first caused the second.
But it’s human nature to think so.
Otherwise, how do you explain why a perfectly healthy young Marine returned from Iraq only to be told years later by doctors that he had Lou Gehrig’s disease and had three years at most to live?
Except young, healthy people get Lou Gehrig’s disease all the time. Like Lou Gehrig, for example.
For epidemiologists, the first step in establishing probable cause and effect is to determine whether victims of exposure are sicker at a higher rate than the general population or a comparable demographic group.
For ALS, it would take 10 years before a major study of VA showed a clear correlation.
Among the approximately 700,000 American soldiers who served in the Gulf War from August 1990 to July 1991, the rate of ALS was found to be double that of the 1.8 million soldiers who did not deploy.
When the study was published in 2001, the VA had identified 40 Gulf War veterans with ALS, nearly half of whom had since died.
And even this study did not determine why.
That’s why Senators Rubio and Gillibrand aren’t happy with the Veterans Affairs Committee’s slow-moving approach to the bill, which would allow the VA to continue to decide which illnesses are considered presumed causes.
“We don’t have time for studies,” Rubio said. “People who are affected by this do not benefit from a study of several years where an expert will end up concluding no matter what. It will then be too late. It’s happening now, and for too many people it’s already too late.
But Moran, one of 18 co-sponsors of the bill, said the legislation is just “the first step in a continuum” of measures to ensure victims of exposure receive the medical care they need. they need.
“We will continue to work with the Department of Veterans Affairs to ensure in the next phase, the next step, that the deemed benefits are addressed,” Moran said at a news conference this month.
Last year, the VA added asthma, rhinitis and sinusitis to the list of conditions that are presumed to have been caused by burn pit exposure, and Moran noted that the agency has “a pilot program that tests the process by which the presumptions come into force”. existence.”
With some 250,000 veterans now on a national registry, the problem Moran sees is that qualifying them all at once would overwhelm the system and disadvantage veterans already waiting for care.
“We want to make sure we’re doing this right so that the AV has the ability to care for each veteran and not disadvantage another veteran in the process,” Moran said.
This argument is not enough with Gillibrand and Rubio.
“We are in an urgent crisis, people dying of cancer are not covered by VA,” Gillibrand said during a session with reporters last summer. “And as a result, they have to use their own money and go into bankruptcy and lose their homes and fall into other financial ruins.
“We can’t trust the VA bureaucracy to get it right, and we don’t need excuses anymore,” Rubio said, announcing his opposition to the committee’s approach. “What we need to do is pass a bill with presumed benefits.”
As for Hébert, the Marine who was told in 1995 that he would probably die of ALS in three years, according to the latest news, he was defying the odds.
According to local media, Hebert is approaching 60 and lives in Emerald Isle, North Carolina, with his family, and through the efforts of his wife, Kim, his community has built a wheelchair-friendly walkway to the beach and the named “Randy’s”. Path.”
Jamie McIntyre is the Washington Examiner senior writer on defense and national security. His morning newsletter, “Jamie McIntyre’s Daily on Defense”, is free and available by e-mail subscription at dailyondefense.com.