International telemedicine services have existed virtually outside the U.S. regulatory matrix for over a decade. This lack of regulation has opened the door for dangerous and possibly lifethreatening situations to arise, leaving little to no available recourse for injured consumers. Regulation is often cast as an antonym of liberalization and a dirty word under the current political and economic zeitgeist. Despite this common misconception, regulation can be imposed without threatening liberalized trade or breaching current free-trade agreements. All current trade agreements, by nature, seek to increase liberalization and globalization by reducing barriers to trade. However, lack of commitment, provisions allowing for domestic regulation of services, and specific exceptions within the agreements leave the door open for the U.S. to impose a regulatory matrix governing telemedicine without breaching the obligations of our current free-trade agreements. Telemedicine’s value cannot be denied. Nonetheless, trading healthcare services, and thereby the health and safety of Americans, cannot continue unchecked. If executed properly, regulations can both serve U.S. free-trade interests and protect patient-consumers.

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