Agent Orange cases may cost billions more

By Mike Baker
Wednesday, September 1, 2010

Because of a possible link to Agent Orange, about 270,000 Vietnam War veterans - more than a quarter of the 1 million receiving disability checks - are being compensated for diabetes, according to Department of Veterans Affairs records.

More Vietnam veterans are being compensated for diabetes than for any other malady, including post-traumatic stress disorder, hearing loss or general wounds.

Tens of thousands of other claims for common ailments of age - erectile dysfunction among them - are getting paid as well because of a possible link, direct or indirect, to Agent Orange.

And taxpayers may soon be responsible for even more: VA said Monday that it will add heart disease, Parkinson's disease and certain types of leukemia to the list of conditions that might be connected to Agent Orange. The agency estimates that the new rules, which will go into effect in two months unless Congress intervenes, will cost $42 billion over the next 10 years.

Former senator Alan Simpson (R-Wyo.) said Tuesday that such a system seems contrary to efforts to control federal spending. "The irony [is] that the veterans who saved this country are now, in a way, not helping us to save the country in this fiscal mess," said Simpson, an Army veteran who once led the Senate Veterans' Affairs Committee. He is the co-chairman of President Obama's deficit commission.

Simpson declined to say whether the issue would become part of his work on Obama's panel examining the nation's debt. He looked to Congress to make a change.

Sen. Daniel K. Akaka (D-Hawaii), the current Veterans' Affairs Committee chairman, said Tuesday that he will address the broader issue of "presumptive conditions" at a hearing previously set for Sept. 23. The panel will look to "see what changes Congress and VA may need to make to existing law and policy," Akaka said in an e-mail.

In a 2008 report, a group of scientists said the decision to grant benefits to so many on such little evidence was "extreme."

"There needs to be a discussion about the costs, about how to avoid false positives while also trying to be sure the system bends over backwards to be fair to the veterans," said Jonathan M. Samet, who led that study and now serves as director of the Institute for Global Health at the University of Southern California.

VA uses a complex formula when awarding benefits and does not track how much is spent for a specific ailment, but Associated Press calculations based on the records suggest that Vietnam veterans with diabetes should receive at least $850 million each year. That does not include the hefty costs of retroactive payments or additional costs for health care. The agency spends $34 billion a year on disability benefits for all wars.

Victoria Anne Cassano, director of radiation and physical exposures at the Veterans Health Administration, part of the VA, pointed to the wording of the 1991 federal law on Agent Orange that said officials should find a positive link to diseases "if the credible evidence for the association is equal to or outweighs the credible evidence against the association." It's a low bar. But Cassano said the law requires the VA to act without consideration of cost. She also said it is the best way to ensure that deserving veterans don't get lost in the shuffle.

"Does it make you take a deep breath? Does it give you pause? Yes," she said. "But you still do what you think is the right thing to do."

Agent Orange was a dioxin-laden defoliant that was sprayed over jungles to strip the Viet Cong of cover. American forces often got a soaking, too, and Agent Orange was later conclusively linked to several horrific health ailments, including cancers. So Congress and VA set up a system to automatically award benefits to veterans, who needed only to prove that they were in Vietnam at any time during a 13-year period and later got one of the illnesses connected to Agent Orange.

The VA, interpreting that 1991 law and studies that indicated potential associations, has over time added ailments that have no strong scientific link to Agent Orange. The nonprofit Institute of Medicine's biennial scientific analysis of available research, to which the VA looks for guidance, has repeatedly found only the possibility of a link between Agent Orange and diabetes, and that even a chance of a correlation is outweighed by factors such as family history, physical inactivity and obesity.

- Associated Press

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