Medicine is not a speciality I am familiar with, but reading this thread and mindful of the history that supplying medical care in COIN is often described as a "win, win" option two thoughts came to mind:

a) traditionally IIRC medical care was given on an individual basis, with the host community being aware of what that meant and with very rarely was care given beyond the "village" or local community

b) today there is an emphasis on public health, e.g. clean water and on somewhat sophisticated medical care, way beyond local comprehension, local affordability and out of community sight, e.g. helicopter evacuation to Camp bastion's hospital for an IED injured child

It seems to me that in 'stability operations' we have adapted the traditional approach, which was kept small and in view, added the far more effective public health option - which may not be locally seen as benign and offered medical care that is simply too much.

This issue also appears in civil / NGO provision in medical emergencies, notably after disasters and natural failures, drought comes to mind.

Now back to my "armchair".