In January, the U.S. supermarket chain Hannaford Bros. Co. began offering its employees hip and knee replacements at a hospital in Singapore.  Such "medical tourism" is attractive because it offers an upfront price, a package price and a low price.  A hip replacement, for example, costs $9,000 in Singapore compared with $43,000 in the United States.

Less well known is reverse medical tourism, where U.S. hospitals offer upfront, package prices to foreigners who come to this country for medical care.  Hospitals who compete in this market often offer foreigners prices and packages they will not offer to American patients!

Now, however, a new phenomenon is emerging: medical tourism within U.S. borders.  Turns out, you too can have price transparency - if you're willing to travel.

For example, soon after Hannaford, which is headquartered in Scarborough, Maine, negotiated its deal in Singapore, several U.S. hospitals offered to match the Singapore prices.  Currently, the company has a contract with a Boston hospital for hip, knee and spine surgery, according to a Victoria Knight article in the Wall Street Journal. 

Moreover, a new company, Healthplace America, has been formed to facilitate within-country medical tourism.  It offers price and quality transparency for a network of 15 hospitals.  Savings are typically 30% to 50% off of what patients and their insurer/employer would otherwise pay.

Note: all this is happening without any HHS coaxing, cajoling, prodding, pleading, moaning, groaning or begging.  Just markets at work.