Globalization is a key challenge facing health policy-makers. A significant aspect of this is trade in health services. However, little is currently known about how trade in health services will affect the health of populations and national economies. A key determinant of the impact of trade in health services will be the general economic and trade context of the country concerned. One specific aspect of this is the openness of a country s health sector to trade; yet there is little, if anything, currently known about the most appropriate methods to assess openness of the health sector.