Medical tourism. Ten years ago the phrase was almost unheard-of, but today it is the catchphrase of a growing segment of patients who, disillusioned, ignored, or simply unable to afford vital care, are choosing to travel outside their home countries for medical procedures.

Panama is one of the latest countries to emerge on the health tourism scene, offering US-trained doctors, state-of-the-art infrastructure and equipment, plus a distinct advantage --- proximity to North America. With as many as 45 million Americans uninsured, and Canadians waiting up to two years for critical procedures, many are looking south for alternatives.

Recent political campaigning in the US has turned the spotlight on health care, exposing the largely crippled medical systems of first-world countries and the impact on their residents. The Congressional budget office estimates Medicare and Medicaid costs will triple by 2050 and baby boomers have been clearly told: Medicare will not be able to foot your future bills.

In Canada, endless waiting lists and a dire shortage of specialists have left patients out in the cold. While public health care in Canada is paid for through taxes, long wait times for complex, specialized surgeries are sending Canadians south in search of more rapid solutions. In Ontario, for example, hip replacement surgery wait times average six months, and knee replacements eight months. Even simple diagnostic scans such as MRIs have an average wait time of more than three months.

Little wonder, then, that medical tourism is garnering so much attention. With countries such as Panama and Costa Rica -- just a stone's throw away -- joining the roster, more and more North Americans are opting to bypass their countries' health care systems altogether in favor of becoming 'health tourists'. In fact, an estimated half a million Americans per year are traveling abroad for health care.

For them, the cost of travel is more than made up for by the savings in medical costs, with the added bonus of recovery in a beautiful, tropical setting.

According to Pana-Health, a group of more than 100 Panamanian specialists working with the Ministry of Tourism to meet the needs of health tourists in Panama, some of the most popular procedures being sought out in Panama are in-vitro fertilization, dentistry, plastic surgery and laser eye surgery.

Dr Richard Ford, the medical coordinator for Pana-Health, believes Panama is poised to become the 'Mecca of health tourism of the Americas' in the next ten years.

Lower prices - 50-70% less than in the US - are just the tip of the iceberg, he says, with highly personalized care by English-speaking doctors and nurses, rapid access to critical procedures and great places to visit while recovering creating a high-quality, comfortable experience for patients.

According to one example, one patient's in-vitro fertilization treatment cost a grand total of $5250, compared to up to $18000 in the US. Another patient's cataract surgery cost $2500 per eye, compared to $5000-$6000 per eye in the US.

Nor are all the procedures elective. Panama's hospitals offer care in cardiology, pneumology, oncology, orthopedics, urology, endocrinology, cochlear implants, cardiovascular and thoracic surgery, and much more.

A knee or hip replacement, normally about $20,000 in the United States, costs about $12,000 at one of Panama's private clinics. Demand for orthopedic surgeries is skyrocketing at private facilities like Panama City's Punta Pacifica Hospital. And there is no corresponding drop in quality; this John Hopkins affiliate boasts state of the art facilities, intelligent operating rooms, English-speaking, US-trained staff and a level of care that is almost Elysian compared to the cramped conditions of the average US hospital.

Consider their nurse to patient ratio: one nurse for every two patients in general wards, and three nurses for every two patients in intensive care. In comparison, patient to nurse ratios in California average four to one. Punta Pacifica also offers digital diagnostics such as virtual MRIs, CT scans, and X-rays.

Panama City also boasts two other world-class private health care centers, the San Fernando Hospital and Paitilla Medical Center. The San Fernando Hospital, Panama's first private hospital, opened its doors in 19449, and has affiliations with prestigious institutions such as the Tulane University Medical Center of New Orleans, Baptist Hospital South Florida and Miami Children's Hospital, among others. The Paitilla Medical center, long favored by wealthy Panamanians, is best known for its excellent oncology unit.

These facilities, and Panama's position as the 'Hub of the Americas' mean more and more health tourism agencies are choosing Panama as the preferred destination for their clients.

“The demand is very strong, and we haven’t even begun to scratch the surface,” says Rudy Rupak, president of Planet Hospital, a medical tourism agency researching qualified doctors and hospitals in countries around the world to perform procedures for clients who cannot afford, or wait, in their home countries.

His company added Panama to its roster of qualified countries in 2006

“We look for doctors who are educated in the USA, or other excellent institutions abroad such as in Canada, the UK or Europe,” explains Mr Rupak, “as well as peer review, publications over the years in their area of specialization, and patient interviews.”

“I see Panama as a strategic place, with a good location, just a five or six hour flight from the US. But the main factors are quality of doctors and the presence of a US hospital,” he says.

While the push for Medicare to outsource health care has yet to bear any fruit, more and more companies in the US are covering out-of-country procedures for their employees. For them, lower costs and rapid access means a better bottom line and a quicker turnaround for their employees.

More than just North Americans are looking to Panama for health care.

"Most patients come from the USA, Canada, Spain, England and France," agrees Dr Ford, "but there is a growing number of people from South America who are coming to Panama."

Tougher visa laws in the US mean many Latin American patients who would have previously gone to the US for procedures not available in their home countries, are now turning to Panama.