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Presumptive Republican nominee John McCain on Monday repeated his pledge to provide veterans with the option of seeking medical care outside the Veterans Affairs health system if they do not have convenient access to a VA facility.

In a speech before the National Convention of Veterans of Foreign Wars in Orlando, Fla., the Arizona senator said a veterans' care access card is necessary for low-income vets and those with injuries or illnesses incurred during military service.

"This card will provide those without timely access to VA facilities the option of using high-quality health care providers near their homes," McCain said. "For many veterans, the closest VA facility isn't close enough."

He said while many of veterans' local health care providers are familiar already with their patients' needs, the absence of an information-sharing system among the federal government, civilian hospitals and doctors, is an obstacle.

McCain responded to the proposal's critics by insisting that the card is not intended to replace VA or privatize veterans' health care. VA should be there always to provide care for veterans, including specialized care in areas like spinal injuries, prosthetics and blindness, where VA "sets the standard," he said.

"My reforms would not force anyone to go to a non-VA facility," McCain said. "They will not signal privatization of the VA, and they will not replace any scheduled expansion of the VA network -- including those facilities designed to serve veterans living in rural and remote areas."

The Veterans of Foreign Wars does not support the access card. Dennis Cullinan, VFW's national legislative director, said the card would take funding and patients away from VA, "undermining the entire system over time."

Cullinan said the agency already has the ability to provide contract care in areas where a VA facility is not available or does not have the capability to address a certain medical need. But if one group of veterans were given a card to go outside the VA system, he said, others likely would demand the same option.

Rep. Bob Filner, D-Calif., and chairman of the House Committee on Veterans Affairs, said it is unclear in McCain's speech who exactly would receive the access cards and that giving the cards to everyone is "absolutely privatization."

"If you determine on a case-by-case basis or based on geographical area that there is a need to do this for better access, that's one thing; giving it to everyone is another thing," Filner said. "That's the end of the VA."

He also noted that McCain has not detailed any cost control measures that would be attached to the access card.

McCain said an access card would help the agency bridge the existing gap in care for women. As the number of women in uniform has grown dramatically, VA has lagged behind in the services it provides, he said.

"Here the veterans care access card will prove especially valuable, affording women medical options while the VA improves capacity and expands services," McCain said.

McCain said he would build on existing legislation to improve screening and treatment for post-traumatic stress disorder and traumatic brain injury. He also stressed the importance of finding the right leader for the department.

"My VA secretary must be a forceful advocate for veterans and forthright adviser to me, so we can make the right choices about budgeting, health care and other veterans' benefit issues," McCain said. "He or she will also need to be a high-energy leader, too, because we'll have a lot of work to do in improving service to veterans."