After spending much of the last few weeks with my eye on projects from outside of the United States, I have been trying to place what I've seen into context with the U.S. healthcare situation. In many ways, comparisons are difficult to make--the United States is just one country, after all. However, because the U.S. healthcare system incorporates at least four major models of healthcare delivery used around the world, there are some insights to be applied for sure.

But what about the actual design of healthcare facilities overseas? How does it compare to the trends we've seen in the U.S. over the last few years? In some areas, such as the Middle East, the hospitality-influenced model so prevalent in the United States (but now on the decline) is alive and well; in other areas such as Europe, healing environments are thriving.

In reviewing submissions for the International portion of our annual Architectural and Interior Design Showcase issue every year, I am often struck by how many elaborate, huge-budget conceptual plans are submitted (and often nominated for Citiations of Merit). The percentage of conceptual drawings versus actual completed or in-progress bulidings is generally much higher for these projects. But year after year, the jury asks, "Will they ever actually be built?"

That question crystalizes exactly why we continue to present this International highlights issue every year; we want to know if these projects, and others we haven't seen or even dreamed of yet, will see the light of day, if they will show a marked U.S. influence or move in a totally different direction. To quote Oscar Wilde, "talent borrows; genius steals"; there cetainly are a great many ideas out there to be borrowed (or, ahem, stolen) by domestic firms. At the very least, however, an even exchange of ideas and concepts will benefit the entire global design community.