"ContractBeast did not address the problem of providing a significant, consistent and immediate benefit"
Neither does insurance but its pretty much a no brainer for most companies.
Contact management isnt suppose to give instant gratification. Its supposed to provide peace of mind knowing you will not miss important dates in the FUTURE.
Hate to say it but Mr Romero seems to have given up way too early.
All the smart people on HN someone will pickup the baton and run with this idea.
Cant really speak about orthopedic issues but have had some experience when my partner had cosmetic surgery abroad. Cosmetic surgery makes up a significant chunk of treatments and is much more of art than science. There is no way I would ever risk having surgery anywhere before i knowing all the facts.
My partner had a face and neck lift from a "reputable" doctor in Los angeles and honestly looks worse afterward than he did before. About 5 years he became painfully aware that he needed it done again so he went to a well-regarded surgeon in Bangkok that really improved his appearance and cost about half as much. http://www.thaimedicalvacation.com
One interesting thing about her experience was that he was told by the doctor in Thailand that he would not be able to offer a surgical facelift since he already had one 5 years earlier. It was very interesting to see doctors saying no rather than risking poor results with multiple surgeries. A person like Joan Rivers is a good example of what can happen when you have way too many surgeries.
Overall though my opinion is that for rare or esoteric conditions, there is no place on earth better than the US. However for common elective or nonelective surgeries, going abroad may not be a bad idea.