In mid-2004, a carpenter from Durham, North Carolina, found out that his potentially fatal heart condition required surgery that would cost $200,000. As one of the 45 million uninsured American citizens, he could not a?ord it. So he outsourced the job to India, ?y- ing to Delhi for a heart valve replacement that would cost only $10,000, including air- fare and a side trip to the Taj Mahal! Approximately 150,000 so called "medical tourists" traveled to India for similar reasons in 2004, a growing number from the United States. They are taking advantage of lower costs and quality services-everything from airport pickups to private hospital rooms to treatments that include yoga and other traditional forms of healing. Overall, India's health care system is poor, but there is an increasing number of private medical facilities there that provide services as good as or better than those in the developed world. For example, while the death rate for heart bypass at Es- corts Heart Institute and Research Centre in Delhi was just 0.8 percent, the 1999 death rate for the same procedure at the New York hospital where former president Bill Clinton had bypass surgery was 2.35 percent.27

Internet Assignment: What can you ?nd out about the trend to outsource high-end ser- vices like these? Is it on the up tick? Is it expanding to include other services which re- quire advanced professional training?