A presidential panel, warning that the government's credibility was at stake, urged the Clinton administration yesterday to seek enactment of a "permanent, statutory" program of benefits and health care for the thousands of veterans who have been stricken with mysterious ailments after serving in the Persian Gulf War.
Such a program would reassure the ailing veterans that the government intends to make good on promises to care for their undiagnosed sicknesses, the Presidential Advisory Committee on Gulf War Veterans' Illnesses declared as it approved its final recommendations at a meeting in Alexandria.
Committee members, meeting for the last time after two years of study, combined their potentially costly recommendation with warnings that they had failed to uncover any single source of the myriad of illnesses that many veterans contend were caused by their service during the brief 1991 war.
"I want to caution the veterans than we may never know what is the cause of their illnesses. . . . There may be answers, but there may not ever be answers," said Andrea Kidd Taylor, a health policy consultant who served on the panel.
Spokesmen for the Department of Veterans Affairs and several legislators applauded the committee's recommendations. VA officials said the department had made "an implicit commitment to provide lifelong health care" to the Gulf War veterans and said it supported "the overall intent" of the committee's recommendations.
The committee also voted to recommend that the White House strip the Defense Department of control of ongoing studies of low levels of exposures to chemical and biological warfare agents, saying the military's objectivity was in question. The committee, which has been harshly critical of the Pentagon's years of denial that U.S. troops were exposed to chemical agents during the war, had considered making such a recommendation in an earlier report but had dropped the proposal.
Yesterday, the committee endorsed its recommendations to President Clinton without debate. The call for independent review of the Pentagon research reflected what committee chair Joyce C. Lashof described was the continuing tension between the Defense Department and the panel.
Those tensions came to the surface Thursday when committee staff members warned Bernard Rostker, the Pentagon's top Persian Gulf illness official, that he was hurting the government's credibility by refusing to accept as certain the two incidents in which soldiers are widely believed to have been exposed to chemical nerve agents.
Rostker said he preferred to label the exposures "likely" rather than "certain" or "definitely," terms the committee preferred. In one instance an individual soldier suffered a blister wound and in the other thousands of troopers were exposed to the fallout from explosions of Iraqi weapons at the Khamisiyah weapons depot after the war.
The Pentagon's phrasing "feeds the perception that DOD is unwilling to bite the bullet" and accept those incidents as true, said James C. Turner, a senior policy analyst on the committee staff.
Created two years ago to explore veterans' complaints, the presidential panel held out hope that newly authorized research "may clarify the conundrum surrounding Gulf War veterans' illnesses."
In a January report, the committee had declared it could not find "a causal link" between the frequently reported symptoms of fatigue, headaches, sore joints and rashes -- loosely called "Gulf War syndrome" -- and many of the suspected causes. But that report suggested that stress was "likely to have been an important contributing factor," a finding that the panel left intact yesterday over veterans' objections.
The committee did not place a price tag on the veterans program it was proposing, saying it would leave details about the legislation for the Department of Veterans Affairs to resolve with Congress. VA officials noted that the department was backing similar legislation, offered by Rep. Cliff Stearns (R-Fla.) in the House.
The bill would relax a requirement that any free treatment of a Gulf War veteran be linked to exposure to a chemical or environmental hazard, a VA official said. Sen. John D. "Jay" Rockefeller IV (D-W.Va.), the ranking minority member of the Senate Veterans Affairs Committee, said he would propose legislation "close to what is being suggested" by the presidential panel. Rep. Bernard Sanders (I-Vt.) said legislation that would fund independent research into the chemical exposures would come to the House floor Monday.
Earlier this year the life of the 11-member presidential committee was extended by Clinton until Oct. 30, with a mandate to continue to monitor the government's response to its January report and the mid-1996 disclosure that some U.S. troops were exposed to chemical and biological agents at Khamisiyah shortly after the war. The panel will use the remaining time preparing a final report.
Lashof, the former dean of the school of public health at the University of California at Berkeley, said that with the exception of the Pentagon's handling of chemical exposures questions, the government has accepted most of the committee's earlier criticisms. "On the whole, they've implemented them very well," she said. "Great progress has been made."
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