OPINION:
As the U.S. nears a peace deal with Iran, Congress must take care of those who fought in the war.
Thirteen service members have been killed in the conflict. Roughly 400 more have been wounded. The Military Health System has absorbed casualties at this scale by evacuating the wounded, treating them across the region and in Germany, and returning many to duty.
The system has performed.
That performance should not be confused with readiness for a larger fight, however. A wider conflict in the Middle East or a contingency in the Pacific involving China would not result in hundreds of casualties. It would produce them in the thousands.
Military medical leaders have said plainly that the system is not prepared. The pending defense budget is the moment to address it.
President Trump has proposed a $1.5 trillion defense budget for fiscal 2027, a 42% increase and the largest military budget request in modern American history.
The proposal funds new battleships, the Golden Dome missile shield and accelerated munitions production. These programs are important, but nothing is more important than taking care of the people who wear the uniform.
Congress now faces a choice about how to allocate that money. The equipment and medical care to keep service members alive in combat must come first.
That gap is not new. During my service, I purchased my own boots because the Army-issued footwear was inadequate and moisture-wicking undershirts were better suited to the demands of infantry work.
Soldiers across the force routinely supplemented their gear out of pocket because the Army’s provision fell short.
The Universal Camouflage Pattern, fielded in 2005, is a more consequential example. Soldiers reported that it failed to conceal them in Afghanistan. Army testing confirmed it. Congress authorized MultiCam in 2009, but the Army kept the Universal Camouflage Pattern as its standard until 2015.
By 2019, the program had cost an estimated $5 billion. The Army has described it as a major mistake. My soldiers and I knew it the first time we wore it.
The same pattern extends to military medicine. While stationed in South Korea during heightened tensions with North Korea, I injured my back and sought care at the troop medical clinic. The provider offered pain medication. When I asked about chiropractic care, I was told it was not authorized.
I paid to get treatment in Seoul. It worked, and I returned to full duty.
The U.S. Army has since acknowledged that treating pain with medication alone hurts readiness. Research shows that soldiers who receive non-drug care are far less likely to become opioid-dependent. That fix came years too late.
These experiences point to a structural problem. In March 2025, military medical experts told the Senate Armed Services Committee that the Military Health System could not handle a major war. They cited budget cuts, delayed reforms and a shortage of trauma-trained providers.
A 2017 reorganization pushed patients into the private sector, eroding the medical workforce’s wartime skills. The former deputy secretary of defense has called the system “chronically understaffed.”
Keith Bass, assistant secretary of defense for health affairs, is guiding an agency that now lists “preparing for war daily” as its first priority. Mr. Bass told lawmakers that delayed private-sector payments, workforce turnover and Defense Health Agency consolidation had created “significant structural uncertainty” that masked true cost growth and framed the new budget around “stabilization and baseline validation,” not more reorganization.
The White House budget proposes dividing the Defense Health Program into two accounts — one for combat medicine and one for private sector care — to protect readiness funding from cost swings. Mr. Bass, who is leading the change, has called the Military Health System “the bedrock of a ready force.”
The reform is sound. Its value depends on what Congress funds within it.
The same institution that asks young Americans to deploy into harm’s way has, for too long, asked them to do so in inadequate uniforms with substandard gear and uncertain medical care in a serious contingency.
A historic increase in defense spending is an opportunity to correct that.
Mr. Bass has called this “the solemn obligation we have to all who are entrusted to our care.” Congress should treat it as one.
The 13 Americans killed in the Iran war are a reminder of who this budget exists to support. Ships and missiles have no value without trained, equipped, well-cared-for service members to operate them.
• Mark Lucas is president of Veteran Action and a U.S. Army veteran of the war in Afghanistan.
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