Dismayed by high surgical costs in the U.S., increasing numbers of American patients are packing their bags to have necessary surgery performed in countries such as India, Thailand, and Singapore.

"This is not what is sometimes snootily referred to as 'medical tourism,' in which people go abroad for elective plastic surgery," says Mark D. Smith, MD, MBA, president and chief executive officer of the California HealthCare Foundation in Oakland.

Today's "medical refugees," the term Smith uses in an article published in the Oct. 19 issue of The New England Journal of Medicine, are going to foreign countries for lifesaving procedures such as coronary bypass surgery and heart valve replacement, and also life-enhancing procedures such as hip and knee replacementknee replacement.

"People are desperate," Smith tells WebMD. "This illustrates the growing unaffordability of the U.S. health care system, even to people who are by no means indigent."

It's no suprise the right is always focused on problems overseas and is afraid to look in the mirror, the reflection is just too ugly...

Why does it disintegrate? Presumably, if you believe that, it is because you have some numbers handy that show the percentage of Americans doing this is lower. Care to share?

"Why are offshore healthcare services to be any different, or for that matter why would it alone be viewed as a negative?'

Huh? If citizens of a country with socialized medicine do it, then it is a negative mark against their health care system, but if Americans do it, it says nothing about ours?

Ezra Klein has some numbers on Americans traveling abroad to get cheaper care, noting that “there are more Americans — 100,000 — traveling abroad for cosmetic surgery alone than there are Britons seeking any type of services in foreign lands.”

Forgive me, I remain unimpressed as ever with Klein.

First, there are more Americans overall than Brits anymore.So that there are more Americans looking outside for healthcare is a matter of raw numbers. If he were to suggest that a higher PERCENTAGE sought services outside the system.... Of course at that point his entire argument disintegrates.

Secondly, we are a country that imports far more than it sends out... we as a matter of routine look offshore for cheaper everything. Why are offshore healthcare services to be any different, or for that matter why would it alone be viewed as a negative?

Americans have been heading to Mexico for at least a decade (that I personally know of).

Here is a European medical tourism site. Apparently it is a growth industry in some EU countries.

There’s a vicious cycle at work here: Highly trained doctors and nurses can command premium salaries elsewhere, so the NIH is forced to pay higher wages to compete. Given that there’s a limited sum of tax dollars they can collect, though, that means cuts have to be made elsewhere.

The “elsewhere” is mostly the United States and another way of looking at this phenomenon is that the U. S. system is driving up healthcare costs worldwide.