Under the knife overseas

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Growing numbers of Americans are traveling abroad to undergo medical and dental procedures that are much less expensive than they are in this country -- and sometimes not available in the United States at all.

These so-called "medical tourists" have a vacation in an exotic place where they can soak up the sun, visit a few golden temples or other landmarks and end up with a new hip or knee, a healthy heart -- or a robot-controlled joint replacement, a procedure that has not yet been approved in this country.

In addition, "they return with a lot more money left in their pockets -- sometimes 70 [percent] to 80 percent more than if they'd been treated in the United States," said Diana M. Ernst, a public-policy fellow in Health Care Studies for the Pacific Research Institute (PRI).

No organization tracks the number of Americans who travel abroad for surgery, according to Consumer Reports. But PlanetHospital, which arranges medical trips to eight foreign countries, said it receives more than 4,000 inquiries a month.

"In a recent month, we arranged 81 surgeries, and 47 patients were from the United States," said Rudy Rupak, founder and president of the Calabasas, Calif.-based company.

Uwe Reinhardt, a health economist at Princeton University, said he has not heard "one horror story" involving a medical tourist.

"If there had been, you could be sure the medical establishment would have amplified it," Mr. Reinhardt said.

But Consumer Reports warns that people "should know the risks" involved in having surgery in a foreign country, such as "uncertain regulation, lack of background information on surgeons, lack of follow-up care and difficulty suing" a foreign physician or hospital.

However, it does acknowledge that going abroad might be the only way to afford surgery or dental work for those without health insurance or for those whose policies do not cover the procedures they need.

"The health care situation in the United States today is causing people to go bankrupt and is forcing companies to decide if they will have to lay off people in order to provide health care benefits," said Tom Kesling, president of Raleigh, N.C.-based IndUShealth, which sends Americans to India for various medical procedures.