Cast in stone on the Department of Veterans Affairs building in Washington, D.C., is the promise, "To Care For Him Who Bore the Battle."

Steve Robinson, executive director of the National Gulf War Resource Center and an advocate for Persian Gulf veterans, wants to make sure that pledge is kept.

The motto "means that those people fought for the freedom of this country and should be first in line for treatment," said Robinson. "If you are going to send a soldier into war, that's the person you have to care for first."

But that's not always how it works at the 1,300 Veterans Affairs (search) health care facilities across the country.

The system has approximately 6.2 million veterans enrolled, about a quarter of the more than 25 million veterans from recent wars still living in the United States.

Of the number enrolled, 4.3 million veterans received some sort of services in 2002, up dramatically from 2.6 million in 1996.

VA officials expect to serve at least 300,000 additional veterans in 2003, not including new Operation Iraqi Freedom (search) servicemen and women returning from battle. More than 250,000 American troops deployed to that theater. As of April 23, 495 wounded in the war had received some kind of medical treatment from the military.

But those numbers don't reveal a second story. According to the VA, more than 200,000 veterans are on a six-month waiting list to see a doctor for the first time.

VA spokesman Jim Benson said the VA health care system has been strained by expanding eligibility and the addition of more services required by the Veterans Health Care Reform Act of 1996. The bill broadened eligibility requirements to include many veterans suffering from non-service related injuries and illnesses.

The VA has struggled to keep up, offering expanded services, including broader outreach and the establishment of outpatient clinics and labs to reach more veterans.

"It's been a tremendous challenge," Benson said.

So much so that VA Secretary Anthony Principi (search) was forced recently to suspend temporarily health care privileges to approximately 165,000 vets who did not have service-connected illnesses and who could afford private health care.

Benson said the suspension of benefits was done in part to ensure that new veterans with service-connected injuries would get the best care possible. It also has helped to clear the waiting lists for the most needy.

While the VA has applied a number of strategies to work down the backlog, Benson said getting the money to fund the medical services has also been challenging.

A potentially painful budget cut was averted in the recent budget negotiations, according to Peter Dickinson, a spokesman for the House Veterans Affairs Committee (search). Instead, lawmakers allocated $30 billion for VA health care for 2004, a 12 percent increase over the previous year's health care budget.

"There has certainly been a tremendous influx of people seeking care to the facilities," said Dickinson, adding that House VA committee chairman Christopher Smith, R-N.J., (search) was instrumental in pushing for the increases. "And there was certainly an understanding already of the needs increasing before Afghanistan and Iraq, and there have been efforts on our part to increase the resources."

Robinson acknowledged that many improvements have occurred in the VA system, which for decades has been debilitated by under-funding, a stifling bureaucracy and lack of interest by the powers that be. He said that whoever on Capitol Hill supported budget cuts must have "never served a day in uniform."

Robinson credited Principi with doing "a fantastic job" of trying to reform a system that "is in perpetual crisis."

But he said an appointee can do only so much to overhaul an entire system.

"They are doing the best they can, but there are significant problems," he said. "I am concerned that if we have a new generation of veterans returning for services, we will be further strained."