Image: Surgery © Corbis

Medical tourism has been promoted as an inexpensive and even enjoyable way to see the world while getting high-quality cosmetic and elective surgeries for pennies on the dollar, compared with U.S. health care costs.

Yet despite that rosy prospect, most Americans are not interested in leaving the country for their health care needs.

The underlying conditions needed to support medical tourism are largely being met, experts say. The quality and depth of foreign medical facilities has continued to improve. Costs are still a bargain for many procedures, and medical tourism travel brokers have become better at putting together the packages needed for a successful experience.

Forecasts for attractive growth rates for medical tourism ran head-on into the recession, notes Paul H. Keckley, the executive director of the Deloitte Center for Health Solutions, a unit of the consulting firm that closely follows medical tourism trends. If that wasn't enough, the expected support of employers and health insurers has failed to materialize.

"We had estimated that employers would drive the medical tourism market," Keckley says. "We thought they would approach the medical insurance companies and tell them that they needed to add (medical tourism) benefits.

"But the major employers are not clamoring for medical tourism right now," he continues. Health care inflation has been under 4% each of the past two years, he notes, so employers are under less pressure to trim health care expenses. And while such savings are still a major priority, "medical tourism doesn't show up as a top-tier issue."

It's also not a top-tier priority for consumers. Deloitte conducts an annual survey of U.S. and global health care trends. Among consumers from a dozen countries, Americans are the least likely to go outside their home country for health care.

Only 3% of Americans would definitely consider traveling outside the United States for either necessary or elective care, Deloitte reported in its 2011 survey. And only 1% actually did so in the past year.

Uninsured consumers are more likely to practice medical tourism, Deloitte reported. And the willingness to travel varies with age. More than 30% of younger consumers say they would at least consider travel outside the United States for health care. The percentages decline for progressively older age groups and are only 21% for baby boomers and 17% for seniors.

While the total market for medical tourism may be flat, that's not true for all markets and providers, says Geoff Moss, a vice president at Planet Hospital. Based in Los Angeles, it specializes in medical tourism and has developed its own network of recommended physicians and hospitals. Moss estimates that company business has been growing at a 30% annual clip for several years.

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