You can outsource medical care quite easily. If you don't have dental insurance, for major procedures like crowns, it's cheaper to fly to Thailand, get them done, and fly home, then to do them in the states. Same for cosmetic surgery and a number of other elective procedures.
Some people like having a direct relationship with the producer of the goods they are consuming - whether it be the food they eat, the jacket they wear or the surfboard they ride.