Host nation health care

Host nation health care

by Kristy Reilly
Stripes Europe

Living overseas brings changes from the comfortable norms of American society. One such difference that may present a challenge to an American living in Europe is host nation healthcare. Although this can be a dissimilar experience to what Americans are used to, it does not have to be one in which you go it alone. You do not have to be intimidated if you  go to a medical facility on the local economy. There are things that can be done to help ease the worry when facing a visit to a host nation treatment center.

Patient Liasions
The most important thing to remember is that you are not alone. Throughout Europe, patient liaisons assist Americans in their healthcare needs. These customer service experts work directly with patients utilizing local medical facilities, acting as an intermediary between patients and doctors in order to help facilitate the best care possible. From the language barrier, to insurance forms, to providing comfort to the client, patient liaisons allow American patients to feel comfortable in their surroundings. These liaisons work with all ID card holders and can be contacted 24 hours of the day.

If you make an appointment with a host nation clinic that is already on file with the local military treatment facility, the clinic should contact a patient liaison directly. If you need emergency care, ask the hospital to contact a patient liaison or call your local military treatment facility or TRICARE service center (TSC) to arrange a meeting. Once you have made contact, your patient liaison will be there with you to help with any questions or needs you may have.

Dr. Evan Steil, the head of the Europe Regional Medical Command (ERMC) patient liaison program, says that the program “is there to help our beneficiaries feel more comfortable in accessing a host nation medical provider. The liaisons give an extra sense of reassurance that the military treatment facility is not ‘abandoning’ the patient when it is necessary to leave the base for further care.” This reassurance is one that can help facilitate an easy and comfortable visit to a host nation medical provider.

The patient liaison program is available through both TRICARE and the Army’s ERMC and is open to all ID card holders, including non-TRICARE members. “In fact, TRICARE service center staff will provide information and assist as much as possible to anyone reporting to the TSC,” says Maj. Angel Blackwell of USAFE.

In addition to the TRICARE provided liaisons, USAFE also has at least one Beneficiary Counseling and Assistance Officer and Debt Collection Assistance Officer in every Air Force military treatment facility (MTF) that can provide additional assistance. Patient liaisons are located at all of the MTFs throughout Europe and are ready to assist in your healthcare needs.

To find your local TRICARE Service Center and patient liaison, go online to To contact your ERMC liaison, go to to find a link to your local MTF. Once there, you will have access to information on how to contact your local liaison and can even find your local “Guide to Host Nation Healthcare”.

Treatment differences
Some Americans may be wary of receiving medical treatment on the economy. The local healthcare experience is neither better nor worse, it is simply different. The best way to handle these disparities is to be aware that they exist. Whether it is in medicine, language, or customs, there are differences between American (military) and host nation healthcare. Understanding this will help to provide a smoother experience and an overall better state of care for the patient and those involved in the treatment.

Medication is an area in which you may notice divergence from the American medical system. Typically, the U.S. uses stronger medications than the providers in Europe. This is not because European physicians don’t have access to these high powered drugs, but because many doctors here try more homeopathic remedies to medicate their patients. If you are in pain or are not responding to these treatments well, stronger prescriptions are available. Talk with your doctor about your needs and concerns. “The most important thing is open communication”, says ERMC Patient Liaison consultant Leslie Lehwald-Verron. “Use your patient liaison to speak with your doctor about medicine. You must be really open.”

You will need to specify what prescriptions you are currently using so that the medical team is aware of what they can and cannot give you. Communication is key while in the care of host nation physicians. If you do not ask questions, the doctor may not explain everything. If you have questions, write them down to ask your physician during rounds. The patient liaison can assist if a language barrier exists. Language can provide an intimidating difference for the American patient. Though most doctors will speak English, many of their staff may not. When you check in, bring a bilingual dictionary.

Privacy provides another difference between MTFs and host nation facilities. Don’t be surprised to find yourself in a hospital room with more than one other person. (If you have been to almost any beach in Europe, you are aware that Americans are more modest than the average European.) Moreover, there are generally no privacy screens between beds in these rooms. To help ease discomfort, do not wear transparent garments and take appropriate clothing that allows you to remain semi-dressed during an exam. Additionally, host nation doctors may not always have a chaperone when examining a patient of the opposite sex. If you feel uncomfortable, it is appropriate to ask for an additional person. Remember, you can say no. If you want to leave your room, make sure to get dressed. Most European patients will not stay in their gown all day. Also, if you anticipate leaving the ward, let the nursing staff know.

While these differences are important to know, do not let them deter you from entering a local medical facility. One thing that is not dissimilar to U.S. hospitals is the standard of care. You will find that your treatment will be one of professionalism and precision. In fact, in 2000, the World Health Organization ranked European health care higher than the treatment found in the United States. If you have any concerns about the care you are receiving, contact your patient liaison.

Be prepared
In addition to being aware of the differences, being prepared can help you have a smooth transition into host nation care. One of the most important things you can do is to learn the location of your local clinics and hospitals. Try to find ones not only in proximity to where you live but in the general area so that you will know where to go in the event of an emergency. Having a bag packed of things you will need in a crisis situation can save you some headaches. Some key things to bring with you are a list of medications, local currency and toiletries. Host national hospitals do not provide personal effects or toiletries so it is important to make sure you bring these items with you. If you forget or are unable to bring these things, the hospital will generally have a store where you can purchase them. You will also need money to purchase a hospital telephone card and to use internet if it is available. For a complete list of what to bring, see the suggestions at the end of this article.

Despite the differences between host nation and American healthcare, treatment standards are the same. If you are a patient at one of these facilities, you will be treated fairly and with a great deal of respect. As one patient of a German hospital put it, “The staff makes you feel like it’s a pleasure to assist you.” Plan ahead and use the resources available and you will have no problems using a host nation medical facility.

What to bring for your hospital stay:
· Your ID card

· A list of medications you are currently taking

· Towels/washcloths

· Pajamas, slippers, and robe

· Personal hygiene items

· Local currency

· Notebook and pen

· Books, magazines, & Stars and Stripes newspaper

· Snacks

· Bottled water

· Bilingual Dictionary

· Set of clothes for going home after discharge

· DVD/earphones

· Tissues

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