Lots of Americans continue to travel overseas for dental and cosmetic surgeries, as well as knee or hip replacements, but at least one research firm expects the recession to temporarily slow the astronomical growth rates that the medical tourism industry had enjoyed.

About 648,000 patients are projected to travel abroad this year, up 20 percent from 2008 but less than the doubling in patient volumes once forecast by the Deloitte Center for Health Solutions, a think tank.

Last month, Deloitte adjusted its previous projections downward, saying more consumers may now delay elective procedures to save money. Still, it expects economic recovery to spur annual growth of more than 35 percent starting next year, due in part to consumers getting more comfortable with the quality of overseas health care facilities.

One gray area is what a public option for health insurance or other reforms being debated in Congress could mean to this segment. There are differing opinions among top health care experts about whether there'll be much impact at all.

. . . In the workplace, the recession has made some employers eager to explore cost-cutting ideas, but others have feared the possibility of negative publicity if complications developed after someone had surgery in another country under their health plan.

We need a few examples of highly visible employers who actually promote this," said Joseph Marlowe of Aon. "Once that happens, we'll see more (activity) in the marketplace."

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