Well, one reason people don't become medical tourists are concerns about quality. Americans in particular are still convinced, despite ample evidence to the contrary, that our medical system is the highest quality in the world - and that this justifies the costs.

I believe this is false. Healthcare quality is basically the same in all first-world countries, the only difference is cost structure. (My wife had a c-section in Germany and our total cost was about 100 euros for an optional private room.)