Costa Rica used to be considered an exotic vacation hot spot for beach bums and thrill seekers alike. Now it's becoming an increasingly popular destination for those seeking medical procedures - everything from cosmetic surgery to a heart transplant, and especially for many Americans looking for quality and affordable treatment.

Jonathan Edelheit told Biomedical Business & Technology that about 500,000 Americans traveled abroad last year for medical care, and in the next couple of years it is anticipated that millions more will be going overseas.

"I think the biggest thing that's driving the trend is the cost of healthcare in the U.S.," said Edelheit, the first president of a new non-profit group called the Medical Tourism Association (MTA; West Palm Beach, Florida) and VP of OptiMed Health/United Group Programs.

Edelheit pointed to both increasing healthcare costs in the U.S. and the growing number of the uninsured. and the that the number of uninsured, reaching 47 million in 2006.

Continually rising are the costs of hospital care and prescription drugs, and "it's only going to get worse," Edelheit said. "And," he added, "you look overseas and see the cost of healthcare almost 80% less."

Not only is overseas healthcare cheaper, Edelheit said, but in some cases the quality of care is better. And he even [compared] some international hospitals to the swank of a Ritz Carlton and that a lot of times you find a higher nurse-to-patient ratio. "It's experiences you don't get here, and because the cost of healthcare keeps going up there's no way to control it . . . the liability in other countries is not like it is here," Edelheit said.

Edelheit recently took a trip to Costa Rica for a medical procedure and to have some dental work done - acknowledging the need to support a concept that he espouses. He said he was surprised to find that he didn't feel that the doctor, who was a specialist, was in a race to get him in and out, spending much more time than the eight-minutes cited as the average doctor/patient contact in the HMO environment.

"I actually got to spend 45 minutes with the doctor. The doctors you see over there still speak English, it's a different experience and the cost of the specialist was the same as paying with my co-pay through Blue Cross/Blue Shield in the U.S. And I picked up some prescription drugs that cost less than my prescription drug co-pay here," he said.

Costa Rica, India, Singapore and Thailand are four main countries that are seeing a lot of American medical patients, Edelheit said. Medical travel to Costa Rica is really on the rise he said, especially from the southeastern U.S., because it's a relatively fast and inexpensive trip. For example, he was able to hop on a plane from Miami and touch down in Costa Rica in two-and-a-half hours, the plane ticket costing just $200.

Although some U.S. insurance companies will pay for overseas treatment, Edelheit said most won't. And he said that the majority of Americans traveling abroad for medical purposes are uninsured, suggesting again that they must finid touring for treatment cost-effective.

Catching this rising wave, MTA was formed as a U.S.-based international organization which it says is comprised of top international hospitals and clinics, leading medical tourism companies, employers and benefits payers, as well as "key influencers worldwide."

Beside promoting the growth of medical tourism and attempting to increase the awareness and use of overseas hospitals by Americans, MTA says that a large part of its mission is an attempt to support quality, by setting credentialing standards for hospitals and medical tourism companies.

In what is expected to be a $100 billion industry, Edelheit said a lot of medical tourism companies - which are similar to travel agencies - have popped up to send American customers to overseas hospitals. While some are sending people to quality hospitals, he acknowledged that some companies are not completely credible.

"The whole purpose of the association is that there's no rules and regulations in the industry at all," Edelheit said, and to correct that situation. Some in the industry realized, he said, that there needed to be not only a forum people could use to discuss the issues surrounding medical tourism, but also a non-profit organization to help regulate the laws and promote quality healthcare. "And to make sure that the hospitals we recommend are the ones that have equal to or better healthcare than we have in the U.S."

The organization said it also will create an internal network to increase the flow of information between hospital members regarding fraudulent practices or other important issues impacting medical tourism.

"We are establishing a comprehensive, credible resource for American citizens to access information on medical tourism, identify hospitals and providers, and learn about their outcomes," Edelheit said.

He said that the organization is developing minimum U.S.-based credentialing standards for participating hospital members. Based upon these criteria, Americans will be able to make informed choices regarding the most appropriate venues for their individual medical needs.

To further enhance connectivity and communications between international hospitals and U.S.-based insurers and claims payers, the MTA said it is also promoting a single gateway for electronic data interchange (EDI), healthcare transactions and claims. And the group plans to publish a magazine focused on medical tourism and is already working on a television documentary.

"Together, we can generate awareness of the quality and economic value of going abroad for quality healthcare and build credibility for foreign hospitals. As a unified, combined voice, we expect this industry to flourish and meet the needs of citizens who want to take advantage of services outside the U.S. borders," Edelheit said.