With health care costs rising in the United States, Americans are increasingly going out of the country for surgeries.

Known as “American medical tourists,” these people tend to have no health insurance or insurance that doesn’t adequately cover the procedure they need.

As recently as five years ago, most Americans traveling for healthcare reasons went to countries like India, Thailand and Mexico. But now, many are going to Europe, where care at top hospitals frequently costs a fraction of what is charged in the U.S.

There are even private facilitators who will help arrange the trips, taking care of not only travel plans but also pairing patients with doctors and hospitals.

“In the past few years, Americans are definitely more willing to go overseas and now appreciate that there is quality there, whereas seven years ago they didn’t have that perception,” Jonathan Edelheit, chief executive of the Medical Tourism Association, told The New York Times.

Balazs Stumpf-Biro, executive director of the European Medical Travel Alliance, told the Times: “The idea is to make it easier for patients from overseas—whether from North America, Russia or the Middle East—to see Europe as a solution because of its high quality and reasonable prices.”

Americans on the East Coast tend to visit Europe, while those on the West Coast go to Asian countries like South Korea or Thailand. Many patients also travel to a country with which they have a cultural connection.

Stumpf-Biro said the cost of American medical care is a big reason, “but the main driving factor is quality and a common background.”

Michael Shopenn went to Belgium in 2007 for hip replacement surgery. If he elected to have the surgery in the U.S., the cost would have approached $100,000. But in Belgium he paid only $13,660, which included all medicine, doctors’ fees and round-trip airfare.

-Noel Brinkerhoff

To Learn More:

The Growing Popularity of Having Surgery Overseas (by Elisabeth Rosenthal, New York Times)

Independent Surgical Centers Accused of Bleeding Millions from Insurance Companies (by Ken Broder, AllGov California)