CHENNAI, India -- As startling numbers of Americans go without health insurance, more of them see their only hope in fleeing to far-flung nations like India for life-saving medial treatments.

The dearth of affordable health insurance has engendered a new breed of what the New England Journal of Medicine classifies as "medical refugees" -- patients traveling abroad for heart surgery and other crucial procedures -- that has grown sharply in the past two years.

In 2005, 46 million Americans -- or about 15 percent of the total population -- lacked health insurance, according to a Census Bureau study. For families who don't qualify for Medicare but can't afford private coverage, a sudden accident or illness could lead to financial disaster.

The situation in the United States and other countries where health care is expensive will contribute to tourists spending $2 billion on medical procedures in India by 2012, according to a study by McKinsey and the Confederation of Indian Industry.

The phenomenon of "medical tourists" -- people who casually travel to foreign lands for face lifts or breast implants -- has been well documented. But the new exodus of patients are looking for more essential care. Indian hospitals welcome these sick travelers with open arms, often lavishing them with more attention than they could expect in their home country.

"The current wave of medical treatment will mature over the next five years," said Vishal Bali, CEO of Wockhardt Hospitals in Bangalore. "Patients will crisscross the globe for affordable health care. It won't be strange, it will be a global reality."

Just in the last year, Bali said the number of medical refugees treated by Wockhardt has increased by 35 percent.

Kathleen Schneiderwind is one patient who was desperate to get rid of the lightning bolts of pain shooting through her spinal cord. But she and her husband lost their health insurance when they retired, and the hip-resurfacing surgery doctors promised would help cost $30,000 in the United States.

Schneiderwind and her husband, both in their late 50s, didn't have that kind of money, and the thought of so much debt was scary. So they began searching for alternatives. "We began to look at places outside the United States and traded e-mails with doctors in Turkey and India. It turns out that the doctors in Bombay were both more experienced in this particular surgery and would only charge a fraction of what we were going to have to pay at home," said Barry Schneiderwind by phone as he sat with his wife who was recovering at Wockhardt Hospital in Mumbai.

Not only has the treatment been first-rate, they say, they have been able to pay for their plane tickets and even get some dental work and a vacation in Goa for $10,000. Treatment in India isn't for everyone. The interminably long plane ride deters some, while other people fear that Third World hospitals won't have the same standards as their Western counterparts. But many foreign hospitals are comparable to U.S. facilities, according to a report in the New England Journal of Medicine by Arnold Milstein, an associate clinical professor at the University of California at San Francisco Medical Center.

"We doubt ... that the average U.S. hospital can offer better outcomes for common complex operations such as coronary-artery bypass grafting, for which several ... offshore hospitals report gross mortality rates of less than 1 percent," Milstein wrote. Many of the doctors practicing in these hospitals received their medical training in the United States or Europe, and the care is sometimes superior to that in U.S. hospitals. "We've had a dozen nurses waiting on us hand and foot," said Barry Schneiderwind. "Not only are they letting me stay next to my wife for the whole recovery, but a hospital in the States would probably have kicked us out to free up bed space several days ago."