Revisiting the June 9, 1999 House of Representatives hearing (Part 1)


What:  Hearing on VA OUTREACH TO VETERANS AT RISK FOR HEPATITIS C INFECTION

Where:  House of Representatives, Subcommittee on National Security,  Veterans Affairs, and International Relations,Committee on  Government Reform, Washington, DC.

The top guys from the VA were Dr. Thomas L Garthwaite, Veterans Administration, Deputy Under Secretary for Health, and Dr. Tom Holohan, Chief Patient Care Services Officer.  (Dr. Garthwaite left the VA and has held several job since then.  Dr. Holohan has left too.  He doesn’t even list his VA employment on Linkedin.  Wonder what happened? Pushed out?)

Rep. Vic Synder had a bill making HCV a presumptive SC illness.  The following exchange about dating the onset of HCV infections and SC claims is telling.   It’s a doctor-to-doctor exchange.  As Nod advises, use their own words to bolster your positions.

Mr. Snyder. I have been grappling with this issue of how a veteran picked up an illness in 1968 and we didn’t test for until 1989 or 1990. No. 1, do any of you have any comments on this issue of how well we are doing in the VA system in terms of our accuracy of either affirming or turning down claims for service connection with regard to hepatitis C? And No. 2, what do we think at this current state of knowledge is the percentage of those with hepatitis C that we don’t have a good guess what the etiology is and we just put them in the unknown category? I don’t know who to direct those questions to.

Dr. Garthwaite. With regards to the accuracy of ratings, no one here is really an expert on that. We could get you for the record obviously what a reasonable response is about the rating decisions that have been made. We are reviewing I believe your bill on presumption and getting comments on that so I think as part of our analysis of that rating, the rating decisions being made, we would like to provide that for the record. Tom, do you have any comment on the other part?

Dr. Holohan. I think the bottom line is that in an individual case from a medical point of view, not a medical legal necessarily but from a medical point of view, it is almost impossible to determine what the precise proximate cause of infection with hepatitis C is. A patient may have one, two or many risk factors and to determine which which was in fact the approximate cause of the disease is in my opinion impossible.

Mr. Snyder. And that does have some revocations. I like your phrase almost impossible to determine because in 20 to 30 years of history, some risk factor may be service connected and some risk factors may not be service connected. I don’t know if my bill is the best way to get at this problem. I haven’t seen anything better out there and I think there really are some challenges, having talked to some of the people who do the ratings. I am a family doctor and I would hate to be the one who had to flip that coin and make that kind of determination on this illness. I think doctors are used to making evaluations on things that you can evaluate, but this is different. You are talking about a point in time. We are physicians, not detectives. At what point in time did that virus enter that bloodstream. I will say any comments,criticisms, suggestions on H.R. 1020, I would be more than receptive to. We are trying to solve what I think is a problem for some veterans. Thank you, Mr. Chairman.

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4 Responses to Revisiting the June 9, 1999 House of Representatives hearing (Part 1)

  1. asknod says:

    Tragic, isn’t it? Did they leave yet? Can we come out of hiding? Or the flip side. Well, No one is absolutely certain the blue dress was being worn when this happened. Pure Conjecture. What is important is that we come up with a blue dress probability rating and express it as “B”. Then we can assign a probability percentage to it . The whole theory is still in its infancy so we hesitate to commit to a belief or theory just yet. Get back to us when they’re all dead.

  2. RobertG says:

    Another piss poor briefing before the questions are asked. A doctor without a logical opinion? Horseshit in the kitty litter has an etiology and a “possible” explanation. Who has the set of balls here? Impossible to determine? Doctors are medical historians who search many data bases for unanswered questions. Their so called logic and reason formulates a etiology and they consult other doctors to make a medical decision. YES HCV should be a presumptive SC illness!! How many more of us have to die waiting for the obvious conclusion?

  3. randy says:

    Sounds like the typical BS merry go round to me. Well Bob how are Marge and the kids? Good, thank you and Tom would you like to add something to the fact that Marge and the kids are fine? Bob – thank you Tom for acknowledging that they are fine may I now kiss someone elses _ _ _? Sure Bob Ed is available. Ignorant ranting by me!!!!!!!!!!

    • HCVet says:

      Too funny randy… but so true… We were on a roll back then with bills that eventually lead to presumption service connection for all vets… not just combat vets. it was a start…. until 2001 when vA, CDC, GAO, to name a few… had a meeting and HCV became an STD. Soon the pharmaceuticals joined and the band played on….. The funding stream became conditional.

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