You get an international driving permit from your home country:
http://en.wikipedia.org/wiki/International_Driving_Permit
No problem at all to rent cars with that. While the convention says that you should have your original driving license available I never have done that (could be lost) and I have never been asked for that.
And seriously: If you are not in an English-speaking country, could you tell if someone is showing you your original, home-country license and not your health insurance card ? (No, the German license does not show anything in English)