Even as the U.S. dollar sags, many Americans are still heading overseas for bargains on elective cosmetic procedures and other surgical care they could not afford otherwise.

In some cases, they are also seeking experimental therapy unavailable in the U.S., such as last-ditch stem-cell-infusion therapy for myocardial ischemia. They may also be trying to jump to the head of the line for an organ transplant.

The scope of so-called medical tourism depends on how it is defined. It could be as mundane as simply crossing the border by car for simple dental work. It could mean elaborate highly planned excursions to Malaysia, Thailand, Singapore, India, Argentina, Brazil, Costa Rica, El Salvador, Turkey, and other destinations.

Some observers estimate that as many as 150,000 Americans head across the border or overseas every year for therapy they can't afford or can't get here. Others view that number as greatly inflated.

Some say that cosmetic and other therapy at established centers overseas is little riskier than it is here. Others invoke caveat emptor.

The economic case can be compelling, though: at the age of 53, Howard Staab, a self-employed carpenter from Durham, N.C., needed surgery to repair a leaking mitral valve.

Staab was told by Durham Regional Hospital that the procedure, with associated fees, hospital charges, and aftercare, could cost upwards of $200,000.