Global competition is emerging in the health care industry.  Wealthy patients from developing countries have long traveled to developed countries for high quality medical care.  Now, growing numbers of patients from developed countries are traveling for medical reasons to regions once characterized as “third world.”  Many of these “medical tourists” are not wealthy, but are seeking high quality medical care at affordable prices.  To meet the demand, entrepreneurs are building technologically advanced facilities outside the United States, using foreign and domestic capital.  They are hiring physicians, technicians and nurses trained to American and European standards, and where qualified personnel are not available locally, they are recruiting expatriates.