The fall of the iron curtain led to the rise of a curious industry in Hungary. In 1992, the dentist Béla Bátorfi began treating a certain Viktor Orbán, who—as luck would have it for the savvy dentist—would go on to have a highly successful career as a conservative politician. Bátorfi would soon become a pioneer in Hungary’s “medical tourism” industry, drawing patients from Western Europe for dental procedures at a good price. However, his fortunes further improved after Orbán’s party won the 2010 elections, returning him to power as prime minister. Shortly thereafter, Bátorfi’s company won a slew of government contracts to direct the development of the country’s growing medical tourism industry. Over the years, this perpetually well-tanned dentist has become something of a national superstar: he now heads a sports club named after himself, directs the Budapest Ironman as head of the Hungarian Triathlon Union, and is reportedly moving into the entertainment industry, among other potential ventures.

The above story is told by journalist Sasha Issenberg in his revealing and timely new book, Outpatients: The Astonishing New World of Medical Tourism. A consultant hired by Bátorfi, in an interview with Issenberg, describes their aspirations aptly: “In Switzerland you get chocolates and watches. For Hungary you get dentistry.” Except, of course, that health care is neither a confectionary nor a luxury chronometer. The story of Hungary’s dental trade is but one small glimpse into a growing, profitable, and highly problematic industry—one that is now spreading throughout the globe.

Why do people travel for health care? For many (perhaps most), the issue of cost is paramount: in the United States, for instance, with out-of-pocket expenses rising even among the insured, the price of medical care continues to matter. Some travel for the types of treatments available outside their home, and perhaps others for the novelty of the experience itself. However, one stereotype of the medical tourist—that of an individual seeking a luxurious medical experience ensconced in a sumptuous setting enhanced by cultural amenities—probably does little justice to the typical experience for most.

The phenomenon of medical tourism has been in the spotlight for some years: A 2006 story in Time headlined “Outsourcing Your Heart” told the story of some unfortunate Americans who were pushed into “the swelling ranks of medical tourists,” going abroad for back and heart surgeries to save money. An article that same year in the New England Journal of Medicine described medical tourists as “middle-income Americans evading impoverishment by expensive, medically necessary operations,” and around the same time a report in the Lancet described medical tourism as a $60 billion industry. A sometimes cited but old figure puts the number of American medical tourists at an estimated 750,000 annually; today the number could be higher. Rising copayments and deductibles in the United States may provide further fodder for the thirsty industry in the years to come.

Issenberg approaches the issue from a unique perspective: he is mainly exploring the world of medical tourism in Eastern Europe, taking us along with him to two countries—Hungary and Bulgaria—where the industry began flourishing in the post-Communist era. What we see are people traveling less out of choice than out of some form of compulsion: “[T]he bulk of medical tourism today,” Issenberg justly contends, “at least beyond frivolous cosmetic procedures, is not undertaken as an act of privilege.”