Hospitals look for international business
Rather, Cleveland Clinic executives were surrounded by sheiks and a prince as they signed a 15-year agreement to operate a medical facility in Abu Dhabi. It is part of the oil-rich United Arab Emirates, home of a booming economy and a steady supply of wealthy patients.
In the Middle East and other parts of the world, international medicine is big business for U.S. hospitals, clinics and medical schools.
The overseas ventures are seen as lucrative opportunities for new revenue as the global economy expands. There is also growing pressure from insurance companies to keep healthcare costs down inside the United States - but that's not a factor overseas, where many of the patients can pay full price for medical care.
Sioux Falls, S.D.-based Sanford Health also is planning a network of children's clinics around the world, part of an expansion plan fueled by retired banker T. Denny Sanford's $400 million gift to the hospital.
Sanford will be in for some fierce competition outside the U.S., said Dr. George Dover, director of the Johns Hopkins Children's Center in Baltimore.
"They're not the first ones to think of this," Dover said. "Every major academic institution in the country is trying to leverage its reputation and resources to get international patients now."
Dover was recently in the United Arab Emirates, where Johns Hopkins, the Mayo Clinic, the Cleveland Clinic, Harvard and other U.S. medical institutions are racing to develop lucrative research and business opportunities in the oil-rich region.
Dubai leaders have declared Dubai Healthcare City - a $1.8 billion project - a "free zone" where companies and health systems that operate there are exempt from paying taxes.
In nearby Abu Dhabi, the new Cleveland Clinic Abu Dhabi will feature the clinic's systems, procedures, guidelines and standards, Hospital Business Week reported.
At Johns Hopkins, a 12-story building now under construction in Baltimore will be named the Sheikh Zayed bin Sultan Al Nahyan Cardiovascular and Critical Care Tower after a "transformational" gift from the UAE president, Sheikh Khalifa bin Zayed Al Nahyan.
Sheikh Khalifa is ranked No. 2 on Forbes' list of world's richest royals, with an estimated net worth of $21 billion. That's well ahead of T. Denny Sanford, whose estimated net worth is $2.8 billion on the Forbes lists.
Early discussions about Sanford's international expansion focused on Canada and Mexico, Sanford CEO Kelby Krabbenhoft said, with more recent planning aimed at Europe.
"Mexico is complicated," said Carole Campbell of the Dallas-based search firm Stanton Chase International. She has extensive experience recruiting hospital executives for international operations. Even with the North American Free Trade Agreement, "it's still very difficult to get past the rules, regulations, permitting and legalities in Mexico."
The nations Krabbenhoft has mentioned as possible sites for expansion - Ireland, Germany and Norway - have seen economic gains in recent years. Sanford wouldn't be the first U.S. health system to expand to Ireland, where the economy has been so strong in recent years that it has its own nickname, the Celtic Tiger.
St. Jude Children's Research Hospital in Memphis already has a partnership involving cancer research with one of the largest Irish children's hospitals, Our Lady's Hospital for Sick Children in Dublin. Rhode Island banker John Murphy, a first-generation Irish-American, and other St. Jude philanthropists donated money to establish the Memphis-Dublin partnership.
Regardless of where Sanford expands, Dover and others say the potential for new treatments that benefit children is greater than ever before. Because of the rapid pace of scientific discovery, he said, "I couldn't imagine a more exciting time to be in pediatric research."
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