A decade ago American veterans' healthcare system had become notorious for its deteriorating facilities and mediocre quality of care. It was no way to treat our veterans. But under President Clinton the VA system underwent a sea change. Where it had mainly offered inpatient care in often dirty, antiquated hospitals, the VA system was rebuilt to focus on outpatient care in modern clinics built in locations readily accessible to veterans. Equally important, eligibility requirements were changed so that every veteran could enroll. The number of patients doubled to nearly 5 million a year, and the quality of care rose with it. By 2003 a study in The New England Journal of Medicine found that veterans' healthcare, once ridiculed by conservatives as a travesty of "socialized medicine," had come so far that it equaled or surpassed the quality of even the most expensive private healthcare systems in America. VA healthcare had transformed into a promising model for a full-scale public healthcare system.

Unfortunately, this success story might not have a happy ending. No matter how well run the system is, each year brings a new budget fight in Congress to keep it afloat. Every year, President Bush's requests have been far too modest to fund the VA system fully. Despite Democrats' efforts, the Republican majority in Congress refuses to meet the system's needs. As a result, the Secretary of Veterans Affairs has had to take action--most notably, preventing nondisabled veterans with incomes of $25,000 or more from receiving care.

In the future the VA's shortfall will likely grow worse, as thousands more soldiers come back from Iraq and Afghanistan physically disabled and mentally scarred. As of November nearly 16,000 had already been counted as wounded in Iraq alone. What kind of care will we give them?

The key to building on the VA's improvements is a secure budget that will guarantee--not just promise--that VA healthcare is fully funded every year. Representative Lane Evans has introduced a bill to do just that: the Assured Funding for Veterans' Healthcare Act of 2005 (HR 515). Assured Funding takes into account the most important factors in determining VA funding--inflation, predictable increases in enrollment--and automatically increases the budget each year to meet those needs.

Beyond the clear benefits to veterans, there's another reason Assured Funding is important. VA healthcare is a large-scale, government-funded system that is affordable and accessible in every part of the country--a miniature version of universal healthcare. And it's more cost-efficient than other health programs, because the VA system takes advantage of "quantity buying" of prescription drugs, resulting in a lower cost of medicine for the veterans.

Maybe that's the real reason so many Republicans, despite their enthusiasm for war, don't want to give veterans the healthcare they deserve. For them, an American model for universal healthcare is dangerous. Let's adopt Assured Funding and keep it that way.

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