We are all familiar with the notion of a vacation on the Mexican Riviera or an Indonesian jungle adventure. But what about dental implants in Chihuahua or a hip replacement in Bangkok? Or open heart surgery in Mumbai? Welcome to the world of “medical tourism.” As health care costs approached the stratosphere, “western” medical training and technology reached the developing world. So there is no mystery as to why enterprising practitioners and cost-savvy healthcare consumers found one another.

The biggest driver of this phenomenon – it’s far beyond a fad or trend at this point – is the virtually uncontrolled rate of medical spending in the United States. This, combined with the ever-increasing ranks of uninsured or very high deductible patients have created a ripe opportunity for international medical clinics and hospitals. Paradoxically, so too have the wait-lists and access limitations in many government-run western health care systems. “Let's see – I can wait 18 months for the hip replacement, or get 'er done in 3 weeks in India, for about the price of a motorcycle.”

These facilities are not grimy ramshackle huts crawling with rodents and dispensing snake-oil. Rather, these are very much modern and western hospitals; many of them are hotel-like, catering to western tastes, treating in a conventional/allopathic fashion. They are staffed by providers with traditional training – many of them coming from highly regarded teaching programs in the U.S and U.K. Some foreign hospitals even have formal collaborative arrangements with respected U.S. hospitals.

So why fly to Singapore for that valve replacement surgery? How about the $13,500 vs. $170,000 bill for total treatment costs? How about that new knee? Fifty grand in the good ol' U.S.A. vs. $11,500 in Costa Rica . Granted, travel is not included. However, you can fly first class – maybe on the Concorde - and still pocket a tidy sum. You'll want to fly first class and fast, too, because you may be eager to recover elsewhere but in a foreign hotel.

Flippancy aside, the cost differences are staggering – on the order of 70% of U.S. costs, generally. So there must be a catch, right? Terrible quality, unsanctioned work? Not necessarily. In fact, the Joint Commission on the accreditation of hospitals, the U.S hospital credentialing agency, has an international branch, and has certified hospitals in many countries. It's admittedly hard to make quality comparisons between, say, Hungary and the U.S., but then again, it’s often difficult to compare quality between Utah and Florida. Many overseas hospitals stack up quite favorably on typical quality indicators, with U.S. facilities.

Some insurance carriers have caught on to the potential here, and now offer significant inducements to clients who get their care in other countries. Depending upon the direction that U.S. Health care follows, and particularly if a market-driven option is facilitated, we may see a huge increase in the breadth and depth of foreign competition for American health care dollars.

There are significant issues that one must contend with if contemplating overseas health care. Travel and its costs and complications, recovery issues, post-operative follow-up and malpractice differentials are substantial. Nonetheless, international health care is just one more example of, as Thomas Freidman aptly named it, our globe’s 'flattening'. Tummy tuck in Timbuktu, anyone?