[Congressional Record Volume 147, Number 27 (Monday, March 5, 2001)]
[Senate]
[Pages S1826-S1827]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE:
  S. 457. A bill to amend title 38, United States Code, to establish a 
presumption of service-connection for certain veterans with Hepatitis 
C, and for other purposes; to the Committee on Veterans' Affairs.
  Ms. SNOWE. Mr. President, I rise today to reintroduce legislation I 
first

[[Page S1827]]

introduced in the 105th Congress to address a serious health concern 
for veterans specifically the health threat posed by the Hepatitis C 
virus.
  The legislation I am introducing today would make Hepatitis C a 
service-connected condition so that veterans suffering from this virus 
can be treated by the VA. The bill will establish a presumption of 
service connection for veterans with Hepatitis C, meaning that the 
Department of Veterans Affairs will assume that this condition was 
incurred or aggravated in military service, provided that certain 
conditions are met.
  Under this legislation, veterans who received a transfusion of blood 
during a period of service before December 31, 1992; veterans who were 
exposed to blood during a period of service; veterans who underwent 
hemodyalisis during a period of service; veterans diagnosed with 
unexplained liver disease during a period of service; veterans with an 
unexplained liver dysfunction value or test; or veterans working in a 
health care occupation during service, will be eligible for treatment 
for this condition at VA facilities.
  I have reviewed medical research that suggests many veterans were 
exposed to Hepatitis C in service and are now suffering from liver and 
other diseases caused by exposure to the virus. I am troubled that many 
``Hepatitis C veterans'' are not being treated by the VA because they 
can't prove the virus was service connected, despite the fact that 
hepatitis C was little known and could not be tested for until 
recently.
  We are learning that those who served in Vietnam and other conflicts, 
tend to have higher than average rates of Hepatitis C. In fact, VA data 
shows that about 20 percent of its inpatient population is infected 
with the Hepatitis C virus, and some studies have found that 10 percent 
of otherwise healthy Vietnam, Veterans are Hepatitis C positive.
  Hepatitis C was not isolated until 1989, and the test for the virus 
has only been available since 1990. Hepatitis C is a hidden infection 
with few symptoms. However, most of those infected with the virus will 
develop serious liver disease 10 to 30 years after contracting it. For 
many of those infected, Hepatitis C can lead to liver failure, 
transplants, liver cancer, and death.
  And yet, most people who have Hepatitis C don't even know it--and 
often do not get treatment until it's too late. Only five percent of 
the estimated four million Americans with hepatitis C know they have 
it; yet with new treatments, some estimates indicate that 50 percent 
may have the virus eradicated.
  Vietnam Veterans in particular are just now starting to learn that 
they have liver disease likely caused by Hepatitis C. Early detection 
and treatment may help head off serious liver disease for many of them. 
However, many veterans with Hepatitis C will not be treated by the VA 
because they must meet a standard that is virtually impossible to meet 
in order to establish a service connection for their condition--this in 
spite of the fact that we now know that many Vietnam-era and other 
veterans got this disease serving their country.
  Many of my colleagues may be interested to know how veterans were 
likely exposed to this virus. Many veterans received blood transfusions 
while in Vietnam. This is one of the most common ways Hepatitis C is 
transmitted. Medical transmission of the virus through needles and 
other medical equipment is also possible in combat. Medical care 
providers in the services were likely at increased risk as well, and 
may have, in turn, posed a risk to the service members they treated.
  Researchers have discovered that Hepatitis C was widespread in 
Southeast Asia during the Vietnam war, and that some blood sent from 
the U.S. was also infected with the virus. Researchers and veterans 
organizations, including the Vietnam Veterans of America, with whom I 
worked closely to prepare this legislation, believe that many veterans 
were infected after being injured in combat and getting a transfusion 
or from working as a medic around combat injuries.
  I believe we will actually save money in the long run by testing and 
treating this infection early on. The alternative is much more costly 
treatment of end-stage liver disease and the associated complications, 
or other disorders.
  Some will argue that further epidemiologic data is needed to resolve 
or prove the issue of service connection. I agree that we have our work 
cut out for us, and further study should be done. However, there is 
already a substantial body of research on the relationship between 
Hepatitis C and military service. While further research is being 
conducted, we should not ask those who have already sacrificed so much 
for this country to wait--perhaps for years--for the treatment they 
deserve.
  Former Surgeon General C. Everett Koop, well respected both within 
and outside of the medical profession, has said, ``In some studies of 
veterans entering the Department of Veterans Affairs health facilities, 
half of the veterans have tested positive for HCV. Some of these 
veterans may have left the military with HCV infection, while others 
may have developed it after their military service. In any event, we 
need to detect the treat HCV infection if we are to head off very high 
rates of liver disease and liver transplant in VA facilities over the 
next decade. I believe this effort should include HCV testing as part 
of the discharge physical in the military, and entrance screening for 
veterans entering the VA health system.''
  Veterans have already fought their share of battles--these men and 
women who sacrificed in war so that others could live in peace 
shouldn't have to fight again for the benefits and respect they have 
earned.
  We still have a long way to go before we know how best to confront 
this deadly virus. A comprehensive policy to confront such a monumental 
challenge can not be established overnight. It will require the long-
term commitment of Congress and the Administration to a serious effort 
to address their health concern.
  I hope this legislation will be a constructive step in this effort, 
and I look forward to working with the Veterans Affairs Committee, the 
VA-HUD appropriators, Vietnam Veterans of America and other veterans 
groups to meet this emerging challenge.

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