Ramstein/Landstuhl are key support/transit points for US units in the Middle East as well as in Eastern Europe. The US Army Hospital at Landstuhl has treated hundreds of US casualties from Iraq and Afghanistan, providing the troops with a level of care equal to state side military hospitals, but many life saving hours closer than flying the injured troops to the East Coast. And Ramstein is the primary air base where those injured troops are flown into from the combat zone for treatment and then evacuated back to the States.
Thus, I don’t consider Ramstein/Landstuhl being only “symbolic” to the Germans. Also, Rhine-Main AFB is gone as a US facility, it is part of the greater Frankfurt airport.
LANDSTUHL