International Trade in Online Medical Services

The hard-working Cato interns pointed me to this article discussing a constitutional challenge to restrictions on the online provision of veterinary services:

A retired Texas veterinarian has filed a federal lawsuit challenging state regulations that bar him from evaluating animals and giving veterinary advice over the Internet.

Since 2002, Ronald Hines, 69, of Brownsville, Tex., has used his website to provide veterinary advice—sometimes for free and sometimes for a flat $58 fee. Sometimes his clients are overseas with limited access to veterinary services. He gets lots of questions from people who find wounded birds and want to nurse them to health. Over the course of his career, he developed an expertise with monkeys, and said he still gets a lot of monkey questions.

Last month, the Texas veterinary board suspended Hines’ license for a year after finding that his Internet practice violates state laws. Texas regulations require a vet to establish a “veterinarian-client-patient relationship,” and they explicitly state that such a relationship cannot be established solely through the telephone or Internet.

Hines’ lawyers at the Arlington, Va.-based Institute for Justice say the rule infringes on their client’s free-speech rights and is an unreasonable restriction on the profession.

Jeff Rowes, an attorney with the institute, said the case could set a precedent in fields that extend well beyond veterinary medicine. He noted that telemedicine continues to be an emerging field and that regulations restricting Internet speech could affect a number of professions, including law, psychology and investment advice.

More details here, here and here.

I’ll leave the U.S. constitutional issues to the smart folks at the Institute for Justice. I just wanted to say a few words about international trade in veterinary and other medical services. (Note that the vet in question offered services to clients abroad, so international trade is already happening.)

The restrictions faced by the vet in this case make clear that there are plenty of domestic impediments to this trade. Hopefully this lawsuit can help get rid of those.  

But if that happens, we may still have to deal with restrictions on international trade in these services. What will governments think of their citizens getting online medical advice from foreign doctors/nurses? What will they think of their doctors/nurses giving online advice to foreign patients?

I know what I think: this has great potential for increased competition and benefits to consumers.

But I worry that some governments will impose restrictions and undermine these developments. I don’t mean to imply that no oversight or regulation of international trade in these services is required. But any such regulation should be reasonable, and should not prevent this trade from occurring.

Right now, the United States and other countries are engaged in efforts to liberalize trade in services in a number of multilateral and regional trade negotiations. It would be of great value if they addressed online trade in medical services as part of these talks, with the goal of ensuring that international trade in these services is as free as possible.