In addition, the MHSS provides health care to dependents of active duty members, retirees and their dependents, and survivors of service members. Beneficiaries Have Access to Primary Care but Specialty and Dental Care Are Limited

Beneficiaries have access to primary care at military facilities, including outlying clinics. Beneficiaries in all categories expressed general satisfaction with their access to primary care in military facilities. However, the military medical leadership, military physicians, and beneficiaries all commented that there has been a significant reduction in the amount and location of U.S. military specialty care available in Europe since the downsizing began. These actions often resulted in immediate personnel shortages for the medical units in Europe and further hindered the delivery of health care to beneficiaries there. Health care providers at one clinic estimated that it took between 2 and 4 weeks to obtain the results for such tests. When admitted, beneficiaries explained that they must contend with language barriers, cultural differences, and quality of care concerns such as differences in treatment. To address beneficiaries’ overall concern, DOD is developing an interservice health care plan for all beneficiaries in Europe that seeks to maximize the use of military medical facilities. To better inform beneficiaries and thereby reduce their anxieties about health care—military and host nation—available in their communities in Europe, DOD is creating an education program. For example, it has (1) prepared a new detailed handbook to inform patients about host nation obstetrical services; (2) developed a questionnaire to obtain beneficiary feedback about host nation medical care; (3) held meetings with beneficiaries to educate them on the changes; (4) hired a host nation physician to perform oversight and liaison services among the host nation facility, the patient, and the military medical providers; and (5) made arrangements for translators to assist when Italian ambulance service is needed. A recorded menu will provide information on how to obtain these lists.
Why GAO Did This Study

Pursuant to a congressional request, GAO reviewed beneficiary access to military health care in Europe, focusing on the: (1) availability of health care in military facilities; (2) obstacles in providing military health care; (3) experiences of beneficiaries that have used host nation providers instead of military health care providers; and (4) Department of Defense's (DOD) handling of service delivery problems and beneficiary concerns.

What GAO Found

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.