Bradley Thayer, a retired apple farmer from Okanogan, Wash., traveled 7,500 miles to get his torn knee ligament fixed, and says he paid a third of what it would have cost him in a U.S. hospital. And that included air fare to Bombay.

Thayer, 60, had no health insurance when he fell and injured himself while summering in British Columbia. He says his U.S. doctors told him he would have to wait six months for surgery and pay bills totaling $35,000. So he joined a rising tide of American and European patients heading to India, Thailand and Singapore for top-class orthopedic surgery, plastic surgery, infertility treatment and cardiology that come much cheaper than in the West.

It's the latest in outsourcing Asian doctors study in the United States or Britain, acquire their skills and reputations in hospitals there, then take them back to their home countries and wait for the business to come to them.

"Flying halfway around the world is cheaper," said Thayer, beaming from his Bombay hospital bed. "I came straight to India. It's a long way to come without tests, but I feel great."