vacation. joy is a medical tourist. she has come to costa rica for weight loss surgery. how much feels like vacation and how much feels like i m here for a surgery? yesterday was vacation and this morning when i woke up it hit me. so, like you are having surgery today. reporter: the best part of all, her company is paying the entire bill. they gave joy a choice for the surgery. a co-pay in the u.s. or outsource the procedure abroad for free. could you have afforded this back home? no. reporter: back home the gastric sleeve surgery is $30,000. here less than 18. her company, hsm, a furniture manufacturer in western north carolina, tells abc news it has saved $10 million in health care costs the past five years by sending close to 250 employees abroad for medical procedures. you are coming for a total right knee replacement.