Defense Health Care

The American military presence in Europe has declined dramatically since 1989. The active duty population has been cut by 57 percent- -from 332,000 to 138,000. At the same time, the military health services systems has also been substantially reduced. Many beneficiaries have expressed concern about their reduced access to health care from military medical facilities overseas and are dissatisfied with the care they receive from host nation providers. This report discusses (1) the availability of health care in military facilities, (2) any obstacles to providing that care, (3) the experiences of beneficiaries who have used host nation providers as an alternative to military health care, and (4) whether the Defense Department is addressing service delivery problems and beneficiary concerns. To develop this information, GAO visited 15 military communities in Germany and norther Italy, where many of the beneficiary complaints about medical and dental care originated.

GAO found that: (1) since the downsizing of U.S. military personnel in Europe, beneficiaries have found it difficult to obtain health services at overseas military facilities; (2) although beneficiaries have access to primary health care services, their access to specialty and dental care services is limited; (3) the reduced military health care system has resulted in DOD relying on the German and Italian medical systems to provide health services to beneficiaries; and (4) beneficiaries must contend with language barriers, cultural differences, unfamiliar doctors, and the general lack of information about how to obtain host nation health care. In addition, GAO found that DOD: (1) is developing an interservice health care plan for all beneficiaries in Europe; (2) has hired liason personnel to help beneficiaries obtain health care from German and Italian health care providers; and (3) plans to contract for services to monitor the care that beneficiaries receive from host nation providers, an education program that explains beneficiary health care options in Europe, and the translation of host nation medical records.