22 April 2014

Military Times: VA "Games" IOM Investigations

      Note: this was reported by Patricia Kime, Military Times Reporter. The significant point is that VA not only carefully words its "charge" or detailed specifics of a proposed investigation into veterans' health, but also attempts to influence the results of the Institute of Medicine committee work while underway. Veterans have long complained that the IOM process leaves the VA in too great a control over issues: (1) VA choses whether or not to order a study, (2) choses the specifics about the study and very carefully choses the words of the IOM "charge," (3) decides how much to pay for it, and (4) then decides whether to even accept the study's conclusions and recommendations. 
     Four acknowledged significant controls over what is generally misunderstood as being an independent process. Kime reports on another, a fifth control over the IOM process.       
     Here, the questionable influence was exerted by officials of the Veterans Benefits Administration, but the "charge to the committee" was issued to the IOM by a different organization, the Veterans Health Administration. Reporter Kime illustrates how one top official in the VA exerted influence over the IOM's activities in a manner apparently meant to direct the "independent" OM results into a form more acceptable to VA perspectives.     
     Kime did not note the sixth control VA exerts: VA refuses to honor Freedom of Information Act requests, denying the IOM and interested parties all essential unclassified information regarding its studies, resources, communications, and other relevant documents. For years VA has simply denied C-123 and other veterans' FOIAs by claiming information exists, not even their own web pages. Lawsuits forcing release of the information are resolved years after the IOM studies conclude, thus tainting the scientific record with incomplete data. 
     Veterans can only trust in the integrity of the IOM committee staff and members. Veterans and the public trust that, regardless of appropriate – or inappropriate – influence by VA, the IOM will seek the truth and the cleanest science in its activities
After the Institute of Medicine in March recommended using the term “Gulf War illness” to describe symptoms affecting more than 200,000 Persian Gulf War veterans, a top Veterans Affairs Department official expressed concern that such a change would imply a direct causal link between service in the 1990-’91 conflict and long-term illness.
That potentially explosive news was contained in an email sent by an IOM staffer to panel members who made the recommendation, including chairman Dr. Kenneth Shine. A copy was obtained by Military Times through a third party and later verified as genuine.
In the email, the IOM staffer said Allison Hickey, VA’s undersecretary for benefits, questioned the use of “Gulf War illness” rather than the VA-favored “chronic multisymptom illness” in a briefing on the report, “Chronic Multisymptom Illness in Gulf War Veterans.“
Hickey “was concerned that changing the name from CMI to GWI might imply a causal link between service in the Gulf and poor health which could necessitate legislation for disability compensation for veterans who served in the Gulf,” according to the email.
The statement appears to confirm what many ill Gulf War veterans have long suspected: VA has dodged references to Gulf War illness and research into the condition because officials fear a flood of new disability benefits claims and costly payouts — greatly complicating VA’s highly publicized goal to eliminate its backlog of benefits claims by the end of 2015.
Further fueling some veterans’ suspicions: Why was Hickey, VA’s top benefits official, weighing in on what is, at its core, a health issue?

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