U.S. health insurers that really want to save money should consider encouraging policyholders to seek medical care in other countries.

Aaditya Mattoo and Randeep Rathindran make that argument in an article published in the latest issue of Health Affairs, a health finance journal.

Today, the quality of medical care in many countries, including developing countries, is comparable to the quality of care in the United States, and the typical cost is so low that patients would come out ahead even after taking the cost of airfare into account, the researchers write in their article.

“It is puzzling that insurers in countries with expensive health care deny coverage for nonemergency treatment obtained abroad,” the researchers write.

The average U.S. outpatient cost for knee surgery is $4,142 and the average U.S. inpatient cost is $10,335, while the average foreign cost, including air travel, is $1,321, the researchers write.

If 10%, or 6,000, of the 60,000 U.S. residents who need knee surgery each year sought care abroad, patients, private insurers and public health plans could save a total of about $377 million, the researchers estimate.

Sending 10% of outpatient hysterectomy patients overseas for care could save $243 million, and exporting 10% of outpatient tubal ligations could save $169 million, the researchers estimate.

The researchers’ results do not include the cost of hotel stays or travel costs for patients’ companions.