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Tribal sovereignty 101: Skating Obamacare

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By William Sellers

The Economic Times of India this week reports that Dr. Devi Shetty, the “Indian cardiac surgeon renown for making cutting-edge medical care affordable to the masses,” is creating a new $70 million startup, deliberately designed by its nearby location, to skate the United States regulatory nightmare, while delivering reduced cost, and advanced healthcare to American citizens.
Located in the Cayman Islands in a British protectorate, “Health City Cayman” just became operational with a 104-bed, multi-specialty hospital and a team of some 70 Indian doctors, technicians and nurses. Shetty said the facility will begin with costs some 30 percent-plus, lower than U.S. rates on healthcare services, while shooting for a 2000-bed facility, a 50 percent cost reduction, and an additional $2 billion invested within 10 years. A web search shows dozens of U.S. flights daily to the Caymans, many from originating airports, as well as the 90 minute puddle-jumpers from Miami.
Shetty’s corporate global enterprise, Narayana Health, already controls some 6,300 beds in several countries, including a state-of-the-art facility I used when we lived in Abu Dhabi.
All of this begs the local New Mexico question posed to me a while back by consultant Bill Haltom, president of SDW Worldwide, a San Diego-based tribal enterprises firm…as to why New Mexico tribes don’t engage in more creative uses of their tribal sovereignty.
Methinks the good Shetty is laying out a business model for New Mexico tribal enterprises to copy, except instead of flying to the Caribbean, people can come to New Mexico for the same kind of quality care.
After all, global medical tourism is no flash-in-the-pan; just ask the sheiks backing Abu Dhabi’s new Cleveland and Mayo Clinics. It’s already a multi-billion dollar industry.
Tribal sources now looking for a replacement to the saturated tribal gaming business should step up their games, and there’s no better place to begin than the kind of legal umbrella their tribal sovereignty affords them. Who’s to say they cannot do a deal with the likes of Shetty and his proven business model? You’d better believe insurance companies are already designing healthcare policies for what’s called “concierge medicine,” that while it doesn’t completely skate the Obamacare takeover, it does compensate and allow individuals who want quality healthcare immediately to get it.
Native American councils using the proven legal doctrine of tribal sovereignty are asleep not to consider this avenue as a new source of investment and revenue, and under certain conditions, employment and education for their members.
Moreover, the state of New Mexico, long perplexed by healthcare concerns, should also see the possibilities as a way to cut their own costs, while delivering a superior product as well as economic development.
Make no mistake however, the U.S. healthcare complex, just like the previous gaming industry, won’t simply lie down for such a new and unique form of disruptive competition.

William T. Sellers is a local venture coach and can best be reached via email at readbill19@usa.net.