Well it happened today. It didn't take long. A patient requiring a replacement of his implantable cardioverter-defibrillator due to its battery running low, called me to inquire if he could have this procedure performed in India. "I can get the same device for a whole lot less money there."
Worldwide cost differentials of the same expensive medical devices will need to be addressed by device manufacturers if we're to maintain our livelihood here in the US.