LAS VEGAS — I just spent half the week talking to more doctors than brokers.

We always close out the year with a trip to the combined World Medical Tourism & Global Health Congress and Employer Healthcare & Benefits Conference. Over the last five years, the show's grown exponentially — this coming from a quasi-competitor. According to their official count, there were more than 2,200 attendees.

But as I took a look around on the last day, a couple of things dawned on me:

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For an industry on the brink, there were an awful lot of people in a pretty big exhibit hall. Sure, there were a lot more HR professionals, providers and tourism types than actual brokers or carriers, but it's clear this business is far from over.

A lot of the growth driving the success of this particular event is clearly on the medical tourism front. And that's not necessarily a bad thing. The show's obviously tapped a vein.

Finally, those Cirque du Soleil characters creep me out more than clowns.

All of this, of course, still has me wondering what kind of legs this medical tourism business really has. Now, I know I'm gonna get in trouble here, but we've been talking about how this is going to be the next big thing for at least as long as I've been covering this business. We're still waiting. 

And as I sit at our booth in the corner, I stumble across a story from Medical News Today questioning the very same thing.

"Debunking the 'myths' of global medical tourism" basically charges that it's a market only for the affluent, boasts an uneven playing field, with markets not quite as open as it appears. And, perhaps, most damningly, all the numbers we see reported come from the stakeholders themselves. As the story suggests, there really isn't much in the way of independent research in this field. 

Don't get me wrong. I think there's a future here — and a boatload of potential evidenced by the exhibit hall crowd I rubbed elbows with this week. But I can't help but wonder why we're still waiting for this to take off. I could a see a complete transformation to defined contribution health market moving us in that direction, so maybe it's not as far off as I think.

A quick follow-up to my last blog: Reports say that Blockbuster is finally pulling the plug on its U.S. operations, shutting down their final 300 or so locations. Fewer than 10 years ago, the movie rental chain was a retail icon, the weekend destination for more than a few of us. And now, because they couldn't (or wouldn't) see a trend (or in this case, a couple of them) — and adapt to a new way of doing business — now they're roadkill. 

As I learned pretty early in my career, no one's irreplaceable. That includes each of us.

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