Nearly 200 institutions outside the U.S. have been certified by the Joint Commission International, an affiliate of the organization that accredits U.S. hospitals. Medical travel companies are springing up to link American patients with foreign providers eager to boost their profits.
Add a rapidly aging U.S. population and a shrinking medical safety net, and the notion of Americans looking elsewhere for treatment no longer seems such a stretch.
"This is going to be one of those things that starts slow and becomes pretty routine 15 years out," said Arnold Milstein, chief physician for Mercer Human Resource Consulting.
The fact that 1 in 6 U.S. residents, nearly 46 million people, lack health insurance is well known. But soaring deductibles and increasing restrictions on coverage are driving even insured consumers to seek alternatives.
Mark Sawko's insurer balked at paying to replace a bum knee the 50-year-old Arizonan injured back in high school. So he called a Tempe, Ariz.-based medical travel company called MedToGo. The firm arranged for him to have surgery last year in Puerto Vallarta, Mexico, where he spent $13,500 instead of the $50,000 quoted by a local orthopedic surgeon.
The owner of a company that makes industrial parts, Sawko competes every day with foreign manufacturers. He sees the same thing happening in medical care.
"I think we're going to lose a lot of business to these other countries," said Sawko, who has returned to playing golf without pain. "I'm American, so I'd like to keep things here. But no one was going to make it affordable for me."
At present, the vast majority of U.S. medical travelers are cash-paying patients such as Sawko. But analysts say that's changing fast as insurance companies and employers add foreign providers to their networks to slow runaway costs.
In Southern California, insurers Aetna, Blue Shield of California, HealthNet and PacifiCare have developed cross-border programs that allow members to seek treatment in Mexico. That means cheaper premiums for employers and smaller co-pays and other out-of-pocket expenses for members.
"A lot of small employers have been priced out of traditional coverage," said Jim Arriola, president of Sekure Healthcare Inc., a Chula Vista, Calif.-based company whose plans cap services at a fixed dollar amount. "That same $1,000 benefit goes a lot further south of the border than it would in the U.S."
