Recently, I wrote about the growing trend of medical tourism, in which patients, mostly the uninsured or under-insured, travel out of the country for discounted surgeries. For those who find such an alternative unappealing, North American Surgery Inc. offers an intriguing option: pre-negotiated, reduced-rate surgery in a U.S. hospital.

The company claims its customers pay "a small fraction of the standard prices charged by U.S. hospitals" for common surgeries, and that these discounted rates are competitive with overseas hospitals when all costs are considered. North American Surgery typically works with hospitals in more rural areas where price flexibility is easier to negotiate. At present, participating hospitals are found in New York, Michigan, Washington state, and Oklahoma. The company collects its fee from the hospital, with the hospital billing the patient at the special, reduced North American Surgery rate.

Surgeries included are orthopedic (joint replacements, rotator cuff repair and the like), neurological (spinal fusion, for example), cardiac (bypass surgery, etc), lap band, hernia, gallbladder and carpal tunnel. It also offers GYN and urological procedures as well as biopsies and headache relief management. According to the U.S. News and World Report, NAS offers hip replacements and heart bypasses each for as little as $14,000, and weight loss surgery for $10,000-$15,000.

The uninsured typically pay much more for such procedures than members of large health plans. If you lack insurance and you are willing to trust the staff of a hospital out of your area when you need one of these operations, this seems like an option worth considering. I'd certainly research the hospital and surgeon before making a decision, though. A good place to start would be the U.S. Department of Health and Human Services Hospital Compare site.