The gap that drives most US medical tourism: cost
Rising deductibles, an average bronze ACA plan deductible around $7,186 (KFF), and 2026's insurance-market disruption following the ACA enhanced-subsidy expiration all widen the specific gap between what US patients can afford domestically and what elective procedures actually cost.
The gap that drives significant UK and Canadian medical tourism: access speed
Documented wait-time pressure in tax-funded universal systems creates a different gap — patients with the means to pay privately increasingly look abroad specifically to bypass domestic wait times, not primarily for cost reasons.
The gap that drives coverage-limited populations: exclusion
Cosmetic, certain fertility, and other procedures frequently excluded from both public and private domestic coverage create a population for whom self-pay abroad isn't a workaround — it's effectively the only realistic path to the procedure at all.
Why this framework matters
Understanding which specific gap applies to your situation clarifies your actual decision calculus — a cost-gap patient and an access-gap patient are solving genuinely different problems, even if both end up considering the same destination via colombiamedical.co.
The Takeaway
Identify your specific gap — cost, access, or coverage exclusion — and it clarifies which factors should weigh most heavily in your destination and provider decision.