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Slide 1: In December 2007, I spoke at the International Medical Tourism Conference in Washington DC and posed a question: Is medical tourism simply version 1.0 of healthcare globalization? Despite all the hype over medical tourism as the next “big” thing, it is still a grass roots movement, in its infancy, operating within a B to C model serving primarily the underinsured and uninsured with enough cash or credit to pay out-of-pocket for medical services and international travel. But these early adopters are exposing the tip of the iceberg in healthcare reform led by the convergence of three forces: globalization, consumerism and the internet. The promise of global care is that buyers can use the web to search for doctors, hospitals and medical services from around the world; compare services and prices; select the provider, place and product right for them and transact on-line. This happens every day, a million times a day in other industries, like travel, so why not healthcare? Why can’t healthcare look and feel more like Travelocity? Globalization in healthcare is all about delivering more options and choices for healthcare consumers. 30 years ago, when you bought a car your options were Ford, GM and Chrysler. Today, they include Toyota, Nissan and Honda. Globalization drives transparency, competition and efficiency…just ask Ford, GM and Chrysler. But this is medicine, the argument goes, and can consumers really be trusted with managing their own healthcare? Sure they can. To borrow the old adage, you just have to teach them how to fish again. Throw away the paternalistic notions that people cannot manage their healthcare and empower them to do it and the healthcare revolution will drive itself. Over simplistic? Maybe, but in the seven years I worked at Bumrungrad International I met thousands of patients who did just that. These were people from all walks of life who literally traveled halfway across the world for medical treatment using the internet as their primary tool of information and communication. Medical tourism has shown that consumers can and do make informed choices about their healthcare treatment, and when empowered with the right information, tools and incentives make appropriate choices based on what’s right for them. The promise of global care will be realized when insurers expand their networks and build products around them; international providers substantiate their claims of quality using standardized reporting systems; stop gap liability coverage for patients traveling overseas is available; and patients payors and providers can connect seamlessly on the web. The good news is that commercial solutions exist for each of these, and that they are readily available. The bad news is that it will take another 12-18 months of gestation time to deliver a new and improved global care model. In the meantime, we’ll just keep pushing Ruben Toral Bangkok, Thailand