Insurers looking at surgeries overseas

NEW DELHI, India — She's a rodeo barrel-racing champion who runs a 180-acre ranch in Oklahoma. Dodie Gilmore is a spry 60-year-old who loves the outdoors, but when she could no longer straddle her faithful horse, River, she knew it was time for a new hip.

But how could she afford it? As an independent contractor for a small Coldwell Banker real estate franchise in Durant, Okla., she knew her privately purchased health plan would never pay up to $40,000 for the operation.

So she asked her boss about traveling to India where hip resurfacing alone would cost just $7,000. He not only gave her his blessing but offered to foot the bill, minus travel and hotels — making Gilmore one of the very first Americans sent overseas for surgery by an employer.

"The doctors were wonderful," Gilmore said days after being discharged, sipping coffee at a New Delhi roadside cafe with her sister, Carol, who was along for whole trip. "The overall care was pretty darn good."

With an estimated 45 million uninsured Americans, some 500,000 trekked overseas last year for medical treatment, according to the National Coalition on Health Care. Asian hospitals in Thailand, India and Singapore have long been swarmed by medical tourists looking for tummy tucks and face lifts, but many glitzy, marble-floored facilities are now gaining reputations for big-ticket procedures including heart surgery, knee and back operations.

More and more patients like Gilmore — who had never held a passport or even tasted Indian food before her trip — are returning home and spreading the word about an alternative to America's ailing health system. Businesses, insurance companies and even a state lawmaker are now also starting to eye the potential savings of outsourcing health from the world's richest country to the developing world.

"It's just one of the many ways in which our world is flattening," said Arnold Milstein, chief physician at New York-based Mercer Health & Benefits, who's researching the feasibility of outsourcing medical care for three Fortune 500 corporations. "Many companies see it as a natural extension of the competition they've faced in other aspects of their business."

Some American hospitals already rely on places like India for X-ray readings and other diagnostics, while also importing foreign doctors and nurses. But the U.S. health care industry has been largely immune to overseas competition — just one reason behind soaring costs.