Do you need a break from skyrocketing health care costs? Maybe you should take something called a "medical vacation." More and more people faced with expensive medical procedures are doing just that.

An estimated half a million Americans are going to take a "medical vacation" this year because they either can't afford to undergo the treatment they need in this country or prefer to save money this way and use the money they save in other ways.

It's a rapidly growing trend and it's primarily due to a combination of rising healthcare costs, an increasing number of people with little or no medical insurance, and the appealing idea of combining two things at once: travel (often exotic) and necessary or elective surgery.

The travel industry refers to this phenomenon as "medical tourism" and it's one of the fastest growing businesses in the multi-billion dollar travel industry.

A cottage industry of specialized travel agencies not only book hotels and air travel, but they also find doctors and arrange surgeries. Some will even provide concierges who pick up patients at the airport, offer them cell phones, and wait with them at the hospital.

So these "medical tourists" are traveling half-way around the world, often to Third World countries, to undergo a complex operation that can cost as little as a third of the "retail" price back home.

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There's even one medical tourism agency called PlanetHospital that offers a special service that arranges for American doctors to travel with patients overseas to perform surgeries and then handle follow-up care back home.

PlanetHospital claims that, even with its top-tier service, you can still save a ton of money.

For example, a heart valve replacement in India with an American doctor will cost you about $11,000. That includes the doctor's malpractice insurance as well as airfare and hotel for both you and your doctor. In the U.S., that same surgery would cost about $55,000 and you wouldn't get a trip out of it. Or if you did, it would be to Baltimore, Rochester, Minn., or some other less than exciting locale.

Good Idea?

Should you or your loved ones become one of these medical tourists?

While the idea of saving money is always attractive, there's often a price attached and this is no exception.

Consider the downside. Going to your local doctor, or a renowned specialist at a big medical center, for an operation is risky enough. Just look at all the release forms you have to sign before a surgeon will touch you. They do this because they know things sometimes go wrong in the operating room.

But what if something goes wrong in a foreign land, thousands of miles from home, in an operating room where no one speaks English, in a country that wouldn't know a lawsuit from a pantsuit?

Yes, it's scary but there is an upside. A medical vacation may be worth the potential risks, especially if you would not have been able to have the treatment because you either didn't have health insurance or the insurance you do have wouldn't cover it.

Let's say you need stomach surgery that would cost $30,000 in a typical U.S. hospital. That same procedure, including airfare and a hotel room for ten days where you would stay during your recovery period will cost you less than $5,000 in India.

Dental work for one medical tourist would have cost $7,000 here. But he spent just over $3,000 in the Philippines, and that included two round-trip airline tickets for him and his companion.

Safety First

If you're thinking about this option, there are a number of things to consider. After cost, the most important aspect of traveling to a foreign country for a medical procedure is safety.

You want to find a hospital or medical facility that has a highly trained staff and the equipment to handle any of those things that could go wrong during or after a medical procedure. One way to do that is to determine that the facility has been certified by the Joint Commission International (JCI), a wing of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

A list of accredited facilities is available on the group's website -- www.jointcommissioninternational.com -- or call 630-268-2900.

Also learn where your doctor was trained, and whether he or she is board-certified in whatever specialty covers your procedure. Experts recommend doctors trained in the U.S., U.K., Canada or Australia. Also, ask about out how many times your doctor has performed the treatment or surgery you are going for.

Insist that your overseas doctor reviews all of your medical records, and talk with him or her before you leave home.

While it might seem that a medical evacuation program membership might be a good idea, read the fine print. These plans may not cover you if you're a "medical tourist."

One of the larger medevac services is MedjetAssist -- www.medjetassist.com. Its terms of service rule out transportation for medical tourists who develop complications: "A member traveling outside the United States for the sole purpose of seeking medical treatment, whether inpatient or outpatient, experimental or otherwise, will not be eligible for air medical transport benefits for that specific trip."

Bangkok's Bumrungrad International Hospital is a JCI-certified facility. It services more than 200,000 foreigners a year, including 55,000 Americans. That's just one hospital. There are over 100 JCI-certified hospitals in 25 countries and more are being built everyday in places like Costa Rica, India, and Malaysia.

Different destinations seem to specialize in different treatments. Costa Rica is known for dentistry while Brazil is popular for plastic surgery.

India has a number of large hospitals including Apollo in Delhi and Wockhardt in Mumbai that cater to international patients. A liver transplant in the United States costs around $450,000. In Bangalor, India it costs $40,000.

India performs an estimated $700 million worth of "medical tourism" procedures a year. Experts say this is due to a combination of cost-savings and confidence in Indian doctors. They point to the statistic showing that one out of every six doctors in the U.S. is an Indian. A third consideration has to do with language. English is spoken in Indian hospitals.

To further attract medical tourism to Malaysia from neighboring Thailand and Singapore, the Malaysian government has been cracking down on so-called "fake hospitals." Recently six healthcare centers allegedly run by phony doctors have been closed down.

On the Bookshelf

There are a number of books on the subject of medical tourism including "The Complete Medical Tourist" by David Hancock and the forthcoming "Patients Beyond Borders: Everybody's Guide to Affordable, World-class Medical Tourism" by Josef Woodman (due out in March, 2007).

Woodman spent three years researching medical tourism to determine the most cost-effective places to have dental work, orthopedics, neurosurgery, LASIK eye surgery, heart surgery, cancer treatment and a number of other procedures.

Woodman says "the primary thing to consider is that the trip is more about your health and well-being than it is about travel." He prefers the term "International Medical Travel because "if you're going for more invasive surgery you won't have vacation on your mind."

His book points out that an infrastructure has been built that didn't exist ten years ago to deal with international medical travel and that there is inexpensive but high-quality medical treatment available for those who do the research. The book lists 50-60 health travel planning agencies such as Medretreat, Medical Tours International and Planet Hospital along with other helpful tips, such as what questions you should be asking of the doctor who will be performing the treatment.

Woodman warns that not all hospitals and medical facilities are equal, so you should do your own research before undertaking what could be a life-altering journey. Of course, that's true in the United States as well. Survival rates for various procedures differ widely from one hospital to the next.

Other experts recommend not traveling alone. You You should bring a companion who can help get prescriptions filled and can consult with the doctor. Also, inform your bank that you are traveling overseas to make sure your credit card isn't rejected when you try to pay for something in a foreign country.

A few insurance companies say they cover some overseas care.

For example, Blue Shield of California and Health Net of California offer low-cost policies allowing members to seek care in Mexico. United Group Programs (UGP), based in Florida, offers a plan that will cover patients who get care in Bumrungrad Hospital in Thailand.

So if you ever find yourself wanting to mix travel and surgery, a "medical vacation" may be the solution.