One perennial defense of the United States' health care system is the fact that wealthy foreigners regularly come here to receive medical care.

But medical tourism goes both ways. Among those for whom cost is a concern, the U.S. health care system is not an ideal vacation destination. 

A new report by Visa Oxford Economics projected that the number of Americans traveling abroad for medical care will increase 25 percent annually over the next decade. That means an estimated 1.4 million will leave the United States for treatment this year. 

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