As the economy continues its downward spiral and more people are losing their jobs and their health insurance, the reasonably young field of medical tourism is seeing some interesting changes. While optional procedures such as tummy tucks, weight loss surgeries, and nose jobs are seeing a decline, other more serious procedures such as knee replacements, spine fusions, and hip replacement surgeries are seeing an increase in numbers. For many of these people, there was no other option but to go overseas for treatment, as they have lost their employer provided insurance, were declined for a private plan, or could not afford the high cost of such a plan, or COBRA insurance. Information shows that 90% of these things would have been covered under a good employer provided group plan, but without such coverage, people are forced to look elsewhere. Is this further proof that a health care system tied to employment is a fundamentally flawed one?