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Renita Jablonski: More people than ever are crossing borders for cheaper health treatment. The American Medical Association has a few concerns about the trend. During the next couple days, members are voting on a set of key principles that would act as a guideline for patients, insurers, and companies. Ashley Milne-Tyte reports.

Ashley Milne-Tyte: It’s rare for a company to have an insurance plan that offers treatment abroad. New England supermarket chain Hannaford Brothers provides such a plan through Aetna. Employees can travel to a top hospital in Singapore for hip or knee replacements.

Dr. Charles Cutler is a medical director at Aetna. He says no Hannaford employee has made the journey yet. But the program’s had an unexpected side effect.

Dr. Charles Cutler: Hospitals in areas where the Hannaford employees live have now said that they want to be able to compete both on quality and cost, so that there would really be no reason for people to go abroad.

As for the American Medical Association’s concerns, Cutler says the likelihood of disaster at the Singapore hospital is low.

Cutler: The standard of care that they were able to demonstrate was comparable to or greater than the standard of care of most community hospitals in the United States.

Still, many patients don’t want to cross state lines for health care, let alone limp onto an international flight.

Dr. Arnold Milstein of Mercer Health and Benefits says employers know this, but many are looking at such plans anyway.

Dr, Arnold Milstein: We have in the last two months had clinical teams in the field reviewing on-site hospitals and surgeons in Mexico for major U.S. employers.

Unless U.S. health care costs drop, he says, more Americans will be traveling for treatment on the company dime.

I’m Ashley Milne-Tyte for Marketplace.