Chairman Buyer and distinguish members of the House Veterans
Affairs Committee, on behalf of Vietnam Veterans of America (VVA) and our
National President John P. Rowan, I thank you and your distinguished
colleagues for the opportunity to testify before you today regarding our
views on VA research programs.
VVA has been concerned about the use of VA Medical & Prosthetic Research &
Development (R&D) funds for many years. As you know, VVA strongly believes
that the VA health care system must move toward becoming a true veterans’
health care system and not just a general health care system that happens to
be for veterans. Similarly, the R&D funds that VA receives should be spent,
in the main, on research that will directly impact the quality of care of
veterans, and particularly will help VA practitioners better care for those
wounds and maladies that are a result of the veterans’ military service.
VVA has testified to this effect countless times over the years before this
Committee. We have made our case to a succession of Secretaries and other
officials at the VA, including a succession of Directors of Research &
Development. In 2002 we thought that finally we had a director of that
activity that would be responsive to this most central need of the VA health
care system. However, that R&D Director left the VA, and the Deputy Director
that also agreed with that key central priority was also forced out.
Dr. Kupersmith has now been the head of Research & Development for more than
a year now, and has yet to even meet with the veterans service organizations
to ask any of us what we think the priorities should be in this area.
Despite the lack of reaching out on his part, many of us have repeatedly
made clear two things to the Congress, to the Undersecretary, and to others:
one, our commitment to having adequate research funds at the VA in order to
attract and retain the best physicians is of high priority; and, two,
research at VA should be related to the wounds, injuries, and maladies that
are or may have been caused by virtue of military service.
The National Institutes for Health (NIH) has a budget that is so much larger
than the VA research budget that it is no exaggeration to say the VA program
is “decimal dust” in comparison to the funding accorded to NIH. The VA is
doing an increasingly good job of seeking out cooperative research
arrangements, and in many cases outside research funding for specific
projects. However, there just is not enough in the way of resources to try
and “be all things to all people” in the research undertaken at VA and the
affiliated schools that use the VA facilities.
I believe that we are all very much aware of how much has been done with
comparatively little at the VA, from the revolutionary “C” leg that has made
such a dramatic positive difference in the lives of high bi-lateral
amputees, to the recent advances in research regarding Parkinson’s disease,
to the identification of the Hepatitis C, to the work that led to the first
successful liver transplants ever, all of which were done at VA facilities
or affiliated institutions. There is also much work that has contributed to
the understanding of the deep brain functions, and much extraordinary and
extremely valuable work that has been done on schizophrenia. As the onset of
this terrible disease typically happens in the late teens or early twenties,
when many young Americans are serving in the military, there is the
opportunity to study this disease with an abundance of subjects. While much
of this work has been done through the Mental Illness Research & Educational
Centers (MIRECC), much has been done through the, a great deal has also been
done via funding from the Research office as well.
VVA has consistently strongly advocated before this committee and the
Appropriations committees for more funding for research at the VA, at the
same time as we have pressed for more focus on the needs of veterans.
National Institutes of Health (NIH)
VVA also wishes to bring to the attention of this committee the fact that as
VA becomes more adroit in securing grants from NIH entities to do vitally
needed research at VA or VA affiliated facilities, the NIH continues to
refuse to pay for administrative overhead at the normal rate they would
reimburse any other grant recipient at any other grantee’s institution. This
is nothing short of outrageous on the part of NIH.
The above noted difficulty with securing administrative overhead cost
reimbursement is, we believe, just one more instance of NIH not being
sensitive to the needs of our nation’s veterans, even as we are in a time of
Another such instance is the fact that we know of no “veteran specific”
grant from any of the National Institutes. The NIH has subgroup specific
grants for seemingly every other discrete group of Americans, but not for
veterans. Even the grants awarded to the VA are not really veteran specific,
but rather “general” research grants. The problem with the way in which most
of these projects are carried out, however, is that unless veteran status
(and thus hazardous exposures) that veterans have is taken into account and
tested against the “null hypothesis” then it is not only not going to be of
maximum use to treating veterans at the VA and elsewhere, but it is just bad
VVA urges you to reach out to your colleagues in the committee of
jurisdiction in the House to address both of these issues outlined above
before the end of the 109th Congress, to set the stage for definitive and
effective corrective action next year.
The Secretary of Veterans Affairs has announced that the VA is launching a
major and very expensive multi-year effort to map the genes of every living
American veteran, or at least those who utilize the VA and who are in the
military today, who will soon become veterans.
VVA believes that this is an interesting idea, but one that is fraught with
problems and difficulties. First, VVA opposes this expenditure of funds from
the VA’s relatively meager resources. There are many research projects that
can be done that will result in better and more effective treatment for
veterans within just a few short years, whereas it is a long shot as to
whether this project will ever be useful to VA physicians in the direct care
of the specialized wounds and maladies that veterans suffer by virtue of
military service to country.
It is said that this effort will benefit all Americans. If so, let the NIH
do it and/or pay the total and complete cost of it.
Second, until the complete privacy of any additional personal information
held by VA can be certified, VVA opposes the gathering of any additional
data. The policies and Information Technology (IT) systems that VA has now
are not nearly stringent enough for the data they already have, as witness
the mess that has come to light in the past month.
Third, VVA questions the fact that there are funds to mount this very
expensive effort, which may or may not be of some use to veterans at least
indirectly at some time in the distant future, but there is no money to meet
the requirements of Public Law 106-419 and complete the National Vietnam
Veterans Longitudinal (Lifetime) Study? This is just preposterous and a
matter of legitimate outrage to VVA, as it should be to all of the
distinguished Members of this Committee.
National Vietnam Veterans Longitudinal Study
In 1984 the Congress directed VA to initiate a large-scale survey of the
psychiatric and socio-medical components of Post Traumatic Stress Disorder (PTSD)
in Vietnam and Vietnam-era veterans. VA contracted with the Gallup
organization to produce the statistically valid sample populations, and with
Research Triangle Institute (RTI) to actually conduct the study, which
included face-to-face interviews. This study, commonly referred to as the
National Vietnam Veterans Readjustment Study (NVVRS), is the largest
nationwide psychiatric study ever done to date.
Results of the NVVRS demonstrated that some 15.2 percent of all male and 8.5
percent of all female Vietnam theater veterans were current PTSD cases
(i.e., at some time during six months prior to interview). Rates for those
exposed to high levels of war zone stress were dramatically higher (i.e., a
four-fold difference for men and seven-fold difference for women) than rates
for those with low-moderate stress exposure. Rates of lifetime prevalence of
PTSD (i.e., at any time in the past, including the previous six months) were
30.9 percent among male and 26.9 among female Vietnam theater veterans.
Comparisons of current and lifetime prevalence rates indicate that 49.2
percent of male and 31.6 percent of female theater veterans, who ever had
PTSD, still had it at the time of their interview.
The NVVRS also found that while African American veterans and Latino
veterans had a higher rate of PTSD, they were much less likely to seek
assistance. This and other findings made it possible for VA to better shape
policies and service delivery mechanisms to deliver more effective services
to veterans, especially combat veterans.
The NVVRS was a landmark investigation in which a national random sample of
all Vietnam Theater and Vietnam era (those who served at the time, but not
in Southeast Asia) veterans, who served between August 1964 and May 1975,
provided definitive information about the prevalence and etiology of PTSD
and other mental health readjustment problems. The study over-sampled
African-Americans and Latinos, as well as women, enabling conclusions to be
drawn about each subset of the veterans’ population. A small follow up study
was done shortly thereafter that produced similar results regarding Native
Initially it was only through the NVVRS that the American public and medical
community becomes aware of the high rates of current and lifetime PTSD, and
of the long-term consequences of high stress war zone combat exposure.
Because of its unique scope, the NVVRS has had a large effect on VA
policies, health care delivery and service planning. In addition, because
the study clearly demonstrated high rates of PTSD and strong evidence for
the persistence of this disease, it became a seminal work in the field that
has made possible such effective efforts as administering to those who
suffered PTSD as a result of being involved directly in the attacks on 9/11.
In 2000 Congress, by means of Public Law 106-419, mandated the VA contract
for a subsequent report, using the exact same participants, to assess their
psychosocial, psychiatric, physical, and general well being of these
individuals. It would enable it to become a longitudinal study of the
mortality and morbidity of the participants, and draw conclusions as to the
long-term effects of service in the military period, as well as about
service in the Vietnam combat zone in particular. The law requires that VA
use the previous report as the basis for a longitudinal study. In 2000 the
VA solicited proposals for non-VA research institutions to conduct a
longitudinal study of the physical and mental health status of a population
of Vietnam era veterans originally assessed in the NVVRS. Research Triangle
Institute (RTI) was awarded the contract.
It is apparent that a longitudinal follow-up to the NVVRS is necessary in
order to meet the requirements of the law, and to do just what makes sense
in both policy and scientific terms. Not only has the VA failed to meet the
letter of the law, there has been no effort to build upon the resources
accumulated from this unique and comprehensive study of Vietnam veterans in
a highly cost-efficient and scientifically compelling manner. More
important, however, is that such a longitudinal study could provide clues
about which VA health care services are effective and about ways to reach
the veterans who receive inadequate services or do not seek them at all. And
this has important consequences for America’s current and future veterans.
VA Acting in a Contemptuous Manner
It is now clear that the VA is being contemptuous of the law and the
Congress, and plain refusing to do the study. They are trying to justify
this by means of specious pseudo-scientific reasons, and use the failed
“Twins” study data base at the Centers for Disease Control (CDC) because
they do not want a longitudinal study nor do they want to have validated the
results of what the NVVLS may demonstrate in regard to very high mortality
and morbidity of Vietnam veterans, especially those most exposed to combat.
While VVA has written to the Secretary regarding this matter, we have never
received a substantive reply that makes any sense.
Frankly, VVA would take them to Federal court after exhausting
administrative remedy which we have done), but the case law demonstrates
that the judiciary in the last twenty years believes that it is up to the
Congress to enforce such mandates on the Executive branch to perform such
studies. The only way for the Congress to force VA to comply with the law is
by means of the appropriations process and/or by means of this Committee
publicly and vocally refusing to absorb this blatant disrespect for the
clear need, the law, and for this Committee.
Mr. Chairman, there is much that is excellent and deserving of great respect
in the Research program, and in the qualities of the individuals who are the
top leaders of the Veterans Health Administration (VHA) and of VA in
general. However, their behavior in regard to this study can only be
regarded as inimical to their own principles. The reasons for not proceeding
with the NVVLS, at a cost of about $17 million, are seemingly that they do
not want the results or the information that they think might be contained
in the results of the longitudinal study. This is not a medical or a
scientific decision, as that would involve the search for truth wherever it
led. Sadly, one can only draw the conclusion that this is a political
Hopefully, with your bold leadership and help in this matter Mr. Chairman,
this study can be completed within the next tow to two and one half years,
so that we will be better prepared to meet the needs of our veterans
returning from OIF/OEF, as well as better meeting the needs of Vietnam
Mr. Chairman, again all of us at VVA thank you for this opportunity to
present our testimony before you today. I will be pleased and honored to
answer any questions that you or your distinguished colleagues may have.
VIETNAM VETERANS OF AMERICA
June 7, 2006
The national organization Vietnam Veterans of America (VVA) is a non-profit
veterans membership organization registered as a 501(c)(19) with the
Internal Revenue Service. VVA is also appropriately registered with the
Secretary of the Senate and the Clerk of the House of Representatives in
compliance with the Lobbying Disclosure Act of 1995.
VVA is not currently in receipt of any federal grant or contract, other than
the routine allocation of office space and associated resources in VA
Regional Offices for outreach and direct services through its Veterans
Benefits Program (Service Representatives). This is also true of the
previous two fiscal years.
For Further Information, Contact:
Director of Government Relations
Vietnam Veterans of America.
(301) 585-4000, extension 127
Richard F. “Rick” Weidman serves as Director of Government Relations on the
National Staff of Vietnam Veterans of America. As such, he is the primary
spokesperson for VVA in Washington. He served as a 1-A-O Army Medical
Corpsman during the Vietnam War, including service with Company C, 23rd Med,
AMERICAL Division, located in I Corps of Vietnam in 1969.
Mr. Weidman was part of the staff of VVA from 1979 to 1987, serving
variously as Membership Service Director, Agency Liaison, and Director of
Government Relations. He left VVA to serve in the Administration of Governor
Mario M. Cuomo as statewide director of veterans’ employment & training
(State Veterans Programs Administrator) for the New York State Department of
He has served as Consultant on Legislative Affairs to the National Coalition
for Homeless Veterans (NCHV), and served at various times on the VA
Readjustment Advisory Committee, the Secretary of Labor’s Advisory Committee
on Veterans Employment & Training, the President’s Committee on Employment
of Persons with Disabilities - Subcommittee on Disabled Veterans, Advisory
Committee on Veterans’ Entrepreneurship at the Small Business
Administration, and numerous other advocacy posts. He currently serves as
Chairman of the Task Force for Veterans’ Entrepreneurship, which has become
the principal collective voice for veteran and disabled veteran
Mr. Weidman was an instructor and administrator at Johnson State College
(Vermont) in the 1970s, where he was also active in community and veterans
affairs. He attended Colgate University (B.A., 1967), and did graduate study
at the University of Vermont.
He is married and has four children.