Mexico is closer, and some physicians are already setting up surgical practices there. Both their patients and the surgeon normally live in the US, but both travel to Mexico for the surgery.
Mexico has a large number of competent, English speaking medical support people, again vetted by the American surgeon. Added up, a major surgery for cash costs as little as 1/4th the price of getting it in the US. There is the added advantage that the surgery will not be in the patient’s HIPAA medical file, so cannot be accessed by government agencies.
The doctor does not have to pay egregious malpractice insurance prices, nor worry about litigation. It is all very cheap, cheerful, and capitalist.
The wife of a good friend of mine traveled to Mexico for surgery. Her trip was uneventful enough until she died.