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Mr. President, let me update my colleague. I do plan to call up this amendment, and I do plan to ask for a vote on it because it is important. I will call up the amendment in a moment.
What has happened--the Senator from Arizona has had the disease melanoma, cancer melanoma at his age. We kind of know somebody at his age, if they have large amounts of Sun exposure over prolonged periods of time on nevuses or birthmarks, can develop melanoma. There is causation related to that. I have also had melanoma, but I had it as a very young man. What science also knows is that one can develop melanoma without any Sun exposure to a birthmark or a nevus or a mole.
What has happened within the VA, we have taken and gone away from causation and gone to any association that could ever be made.
I am a survivor of colon cancer. What we know is, our risk for colon cancer goes way up if we eat a highly refined diet, with very few vegetables, and have that kind of a diet associated also with high levels of sugar. I did not have any of those things, but yet I had colon cancer. Because there is an association, we cannot infer causation.
So what is happening now?
The Secretary of Veterans Affairs has put us on the hook for people who have no causation but do have association. This amendment, which I will call up, does not change our ability to do that in the future when we, in fact, would see causation. But the presumption that association with the Sun caused my melanoma is wrong. The assumption that my diet caused my colon cancer is wrong. It does cause colon cancers, but we cannot show causation.
Nobody can speak for veterans better than John McCain, having served the amount of time he did in Vietnam as a prisoner of war. He has the body image that shows his sacrifice. Let me tell you what has happened.
We are transferring $ 1/2 million to veterans under this decision by Secretary Shinseki for people who weigh 350 pounds, smoke three packs of cigarettes a day, and have hyperchol-esterolemia because they will not take their medicine. We are saying the reason they have heart disease is because, at some point in time they were in Vietnam, because they moved from causation to association.
I can think of nothing unfairer to those who are truly needing to benefit from this than to give the benefit to somebody whose lifestyle absolutely caused their heart disease, and there is no association with dioxin or Agent Orange, the active ingredient that causes disease, which we know several of them actually did have. But now we have moved to a whole new level where we are saying if someone was exposed, both above or in Vietnam, and they have any of these other diseases which he has listed, that there can be an association.
Let me remind you that an association doesn't prove anything about cause. It just says there is a statistic out here, and it may be right or may not in fact be right. All of the evidence is the other way. The Secretary has chosen to spend $42 billion--counting last year and this year--on this program for diseases that are not caused by Agent Orange. How is that fair? How is it fair to the people who are administering this? I found out about it because VA workers called me and said: This cannot be right. What are you all doing? Why are you giving money to people who have no association with the disease caused by that? Yet you are paying them out of money that should be reserved for those who have a disease really caused by Agent Orange. Consequently, we are going to spend $42 billion that we don't have to pay people.
Another interesting fact is, I have a brother who has idiopathic pancreatitis. The VA told him that under this new guideline he can be eligible for Agent Orange compensation. He served in Korea, but because he has a chronic disease now, they are lining him up to get a payment from the VA because he has idiopathic pancreatitis. He is going to get approved. There is absolutely no association or causation with that. Yet that is what is happening.
Mr. President, I ask unanimous consent that amendment No. 564 be called up, and the pending amendment be set aside.
The PRESIDING OFFICER. Is there objection? Without objection, it is so ordered.
The clerk will report.
The assistant legislative clerk read as follows:
The Senator from Oklahoma [Mr. Coburn] proposes an amendment numbered 564.
Mr. COBURN. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment is as follows:
(Purpose: To require evidence of casual relationships for presumptions by the Secretary of Veterans Affairs of service connection for diseases associated with exposure to certain herbicide agents)
On page 112, between lines 2 and 3, insert the following:
Sec. 230. (a) Section 1116(b) of title 38, United States Code, is amended--
(1) in paragraph (1), by striking ``positive association'' and inserting ``causal relationship''; and
(2) by striking paragraph (3).
(b) The amendments made by subsection (a) shall apply with respect to determinations made by the Secretary of Veterans Affairs under section 1116 of such title after the date of the enactment of this Act.
Mr. McCAIN. Will the Senator yield for a question?
Mr. COBURN. Yes, I will.
Mr. McCAIN. Mr. President, I want to make it clear that in this amendment there is no desire to deprive someone who was actually exposed to this herbicide called Agent Orange and suffered physical consequences as a result; that this amendment basically draws a difference among three words: One is ``causation,'' which is generally the criteria used in any of these cases, the causation, and that would replace the current ``positive association.''
As the Senator just described, positive association could be most any encounter that anybody would have had who served. I always thought it was in Vietnam, but now he tells me it is even adding someone who served in Korea.
Isn't it true that we are not trying to deprive anyone who was legitimately exposed to Agent Orange and shows the causation, and that they are entitled to benefits from the taxpayers of America? What we are talking about, isn't it true, is that ``positive association'' is such an amorphous definition that it leads to an enormous waste of taxpayer dollars, while there are veterans out there who are in need of these taxpayer dollars for their legitimate reasons?
Mr. COBURN. Mr. President, the answer is that the Senator is absolutely correct. We have a lot of science that shows causation with this herbicide and disease. We have made the assumption that any other association should fall into that same category, such as hairy cell leukemia, and we know lots of things about this group to which there is only an association, statistical association, and no correlation, no causation, such as if someone has Parkinson's, they are compensated from Agent Orange. Yet there is not one scientific study that will show there is any causal relationship between those two diseases.
I will answer that I want every veteran to get the compensation due them when they have a disease related to this chemical. If we find in the future more science that would say so, then we will go on the science.
Now, we have had a Secretary who doesn't understand the difference between association and causation, and we are going to spend $42 billion that we don't have, giving it to people whose diseases were not caused by Agent Orange. That is my problem.
As a physician, I could never defend myself in a court of law using this logic on anything I would do in practicing medicine. As I stated while the Senator was talking with the chairman, we have both had melanoma. The Senator's came from something that we know is associated with it and also a cause--it is called the Sun, ultraviolet radiation. Mine didn't come from that because I didn't have that kind of exposure, and I experienced it at a very young age. Under the guidance of the Secretary, we both would be compensated as if ultraviolet light was the cause of both of our melanomas--the Senator from Arizona, appropriately; me, inappropriately.
So the fact is, no one ever wants to move back, but this is a mistake the Secretary made. My intent is not to harm any veteran who has a disease that is truly caused by Agent Orange. My intent is to make sure we can have the ability to take care of our veterans in the future by spending money wisely to compensate those who are truly injured, truly inhibited and limited by their exposure to that as a result of their service to this country.
With that, I yield the floor and suggest the absence of a quorum.
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