Ben Levi,
You are incorrect regarding the cost of malpractice insurance. In four of the five boroughs of NYC an “occurence” policy for an Ob/Gyn costs $163,269/year. In Manhattan the cost is $137,642/year. It took me less than five minutes of internet searching to get those quotes online, from Medical Liability Mutual Insurance Company. That is still high, but it isn’t a million a year or even close to it. I’ve much prefer a system like Canada where (1) it is almost impossible to win a malpractice case against a physician, and (2) there is no need to go to court for medical treatments because it is all covered by the provinicial health insurance!
You are correct about medical tourism, however; the example I gave of El Paso/Juarez is precisely the effect you mention: Texas has more uninsured citizens than any other state so they go to Mexico for care they can afford. (That also shows that tort reform is inadequate to fix the system; Texas has some of the most draconian limits on medical malpractice cases in the US but it continues to have the most dysfunctional health care system.)