Laws crucial to new hospital

| 11/11/2010

(CNS): The creation of new legislation and law reform are essential to the development of Dr Devi Shetty’s proposed health city, his local team has confirmed. The Cayman government must change the Health Practitioner’s Law and legislate for tort reform as well as introduce a new law to facility organ and tissue donation before the project goes ahead. The acclaimed surgeon told an audience from the Chamber of Commerce that he was intent on changing the rules when it came to the delivery of health care for all and that he was convinced the Cayman Islands was the best location for his first project outside of India.

With his eye on the more than $2.2 trillion industry in the United States, Dr Shetty said he believed American patients would come to this jurisdiction. He said Cayman was the right location for the project for a number of reasons, including the government’s willingness to change the laws to accept medical qualifications from India — a country which produces the most doctors in the world, with the most experience.

Dr Shetty pointed out that one of the reasons why health care was so expensive was because of the artificial shortage of trained manpower. He blamed medical councils for deliberately maintaining that shortage in order to keep the price of senior medical personnel services high.

He said the main reason why his new health city would be able to succeed in the Cayman Islands is because it was willing to accept Indian doctors and their qualifications. He said his model would attract patients from the US because it would provide health care at 50-60% of the cost there in a place that Americans would feel comfortable.

Shetty explained that Cayman is an attractive destination for quality medical staff, not just from India but from the US, where the heads of departments at his hospital would come from. As a result of the government’s willingness to change the necessary legislation, together with no infectious diseases, a stable government and a respected banking system, Cayman provided an attractive option.

Dr Shetty said that Cayman, which already had the infrastructure related to existing tourism, could more easily become a significant medical tourist destination. With its proximity to the States and the fact that the destination was considered safe, patients would feel comfortable coming here to be treated and the necessary medical experts would also want to live here, offering a winning combination.

Cayman would benefit extensively, the doctor said. Not only would the country get access to affordable high quality health care, unlimited employment opportunities, but medical tourists also spend a lot of money.

“We are confident Cayman will be a success because America will move to a social form of medicine where waiting lists will be introduced,” Shetty said. “Waiting lists will drive medical tourism because patients, especially elderly ones, don’t want to wait.” He pointed to the aging population in Florida that would increasingly need access to affordable and immediate health care, as well as assisted living.

Answering criticisms that his model had been referred to as a production line, where quantity was placed over quality, Dr Shetty said that it was about volume in India, which is what made health care there affordable. But any hospital doing the largest number of operations has the best results. “If you keep doing it you become technicians and get good at it,” he said. The surgeon explained that his hospital in Bangalore, India, was compared with nine New York state facilities and it had better outcomes.

“Everything we are doing is about affordable health care” he said, adding that he wanted the idea of accessing medicine to be disassociated from affluence.

Acknowledging that the concessions he was asking for were about significant change, he said someone had to start to say that the way things are currently done in the world when it comes to access to health care were unacceptable. “Our goal is to make it affordable,” Shetty said.

Gene Thompson from Shetty’s local team told the Chamber audience that he hoped to break ground sometime in the second quarter of 2011. He would not reveal which locations were being considered but said the start of the project was heavily dependent on the legislative changes.

“We can’t move forward until the regulatory issues are resolved,” Thompson said. “We are committed to moving forward and are pushing the process. Things are moving forward, not as fast as we would like, but things are moving.” Thompson said.

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  1. Anonymous says:

    the lack of detail in the proposals at this stage is alarming……

    where is it going to be built?

    where is the cost plan?

    how can cayman offer lower price medical services when everything in cayman costs 100% more than the states?

    cayman is one of the most expensive places in the world but is somehow is going to deliver indian cost medical services?

    i’m sure once shetty looks at all figures including operational and construction costs he will back out….


  2. Anonymous says:

    come on fellow Caymanians, let us wake up and support this hospital venture.

    Most countries are having serious budgetary crisis because of rising health care costs. Even in the USA, there is concern about the bankruptsy of medicare / medcaid because of the high costs.

    With no direct taxation and no viable network to take care of the elderly, who by the way are living longer, the Government will have no money to take care of the high health care costs assosciated saside.

    Let us put politics aside and work together as Caymanians to bringf in affordable and quality health care.

    Forget about some of the protectionist doctors and in particular the Lawyers about tort reform. They are only doing so to protect their special interests. The 1992 "swamp hospital ‘ was stopped by a few doctors for their own interests and it costed the money in millions of wasted dollars. Some of the same group are trying it again.

    As far as the Lawyers, with the financial services industyry shrinking and their pocket books hurting, they are probably thinking of an alternate income source– Contingency Cases.

    We end up with frivoulous suits like what is happening in the USA. This has caused Physicians to practice defensive medicine resulting in unnecessary diagnostic tests which is a major player in high health care costs. Who pays– the consumer of course!

    Let the very same lawyers who offose any reform, worl like normal people and not hope to retire by the mid-forties with millions in the bank.

    For the doctors who are opposing it in the name of quality ( basically for protectionism ),get the registeration process be regularised to let quality doctors come in and not the 6-7 countries on the list.

    By the way , the University Hospital of WI is not automatically granted registerationin the UK. Does it mean they are bad and hence we restrict them?

    ThE UK extends reciprocal registeration to countries in the European Union– and that is nearly 27 countries. This goes all the way up to Turkey. Physicians from these countries could easily get registered here. Why single pout India alone, in the name of protectionism.

    You go to any hospital in the USA and UK and you will find nearly 15-20 % of the doctors from  there . We do not complain if they take care of us ?

    Let us grow up and get to think of the future of this countries health care costs. It will surley bankcrupt us if niothing is done now !


    • Anonymous says:

      could not ask for more reasons.

      the trickle down effects from this hospital will benefit us all

  3. CLiberty says:

    Narayana Hospital meaning Hospital of the Lord is a light to the world!

    Any PPM supporter who attacks this Hospital’ initiative,

    I am afraid, has no light in them!

    How long will you be blinded by a 2-party system?!

    We are ONE Cayman Islands, and Shetty’s Hospital will be a light to the world!  Why are you all resisting what can save people’s lives???  You are no more worse than the UDP supporter who opposed the funding for Schools that the country needed in order to house its children!

    Caymanians, let us stand up against these reckless, foolish, and partisan comments on CNS!

    The People should be first!

    The Economy should be first!

    Forget Parties… we have always been in the same boat!  This Hospital will for the first time introduce medical tourism into the Cayman Islands, and IT WILL HELP OUR ECONOMY!

    To the naive, is not our ECONOMY #1 importance???

  4. Anonymous says:

    UDP GOT DOCTOR SHETTY HERE.  I hope some of you will try to know things before you start to post  your openion here. when doctor shetty first came to cayman ,and got the cayman pardner it was the PPM goverment that was in power. and maybe if he had know then what he now know he might not come after what the present goverment wanted to do. what i am talking about is facts not my no belief

  5. Anonymous says:

    Some of us still seem to think the sun rises and sets in the US only! Come on, other countries can produce doctors that are just as well if not better qualified than the ones being procuded out of the US. Stop looking for the US being the answer to everything. How many people go to Cuba for medical treatment and that is despite the fact that many have language barrier issues. If Cayman doesn’t get the foot in the door regarding medical tourism now, don’t bother to try once Cuba has opened up to the US.

  6. Marek says:

    Medical tourism is already a big business in the United States with hundreds of thousands of patients leaving the US to have their operations done in other countries (including India)…

    Here is how this works, a US consumer (who has health care coverage) is faced with an operation that might cost $200,000 and has a 20% deductible, so despite having coverage that person will have to go out of pocket for $40,000… money they most likely don’t have.

    The number one cause of bankruptcy in the US is health care bills and about 55 million (the true number) don’t even have health care… but that’s another story…

    What the health care provider does is go to their patient and say if you agree to go to India to have this operation, we will waive any deductible and we will also pay for the trip for you and your closest relative.

    Bottom line, in the US the health care provider is faced with $160,000 bill after collecting the deductible… if they send the patient to India (or elsewhere) and the total bill is $85,000 plus $15,000 in travel and hotel… they save $60,000…

    It’s all about the health care providers saving money, it is the health care providers who are pushing their customers to consider having their operations outside the United States.

    The business model is already in place and yes, if we build it … they will come …  again, it’s all about savings.

    A flight to Cayman is cheaper than India…

    Remove the emotion… this is all about math… and the math is good.


    • Anonymous says:

      Marek….this still does not speak to how the cost of the medical procedure will be lowered here. -thus making the destination attractive!

      In India and elsewhere it was based on patient volumes (which has just be admitted) so the model that is being proposed here is speculative and the figures would not calculate based a 200 bed hospital and the type of medical procedures being contemplated. The procedures I believe will in some cases may have a long inpatient recovery time thus restricting the ability to gain huge turn over volumes given the limited inpatient be facility.

      Calculations on how the lower cost will be achieved would be helpful.

      • Dred says:

        I don’t know why you actually don’t get it. It’s the same exact concept as in India. There will be a build up in clients and rooms and staff to match.

        Let’s say it another way. The staff level, equipment and other cost will scale up as the hospital rooms grow so whether it’s 200 rooms or 2,000 the concept stays the same. The main focus is that each doctor will be performing multiple operations daily creating a volume situation.

        Client’s wise they are already there, they just need redirecting. Keep in mind he already has the system in place so his hospital in India is already well known and they can do referrals until his Cayman one becomes known also.

        The greatest fundamental difference between Cayman and India is cost. Cost of utilities, staffing, equipment, etc. This is why instead of doing a heart operation for US$7,000 (India) it might run US$40,000(Cayman). This is why they are only saying 50% of US cost because in India it’s actually much less.

        In truth the example given by Marek is not really close to the numbers I am hearing. The operation is about US$160,000 in the US would probably be around US$15,000 to US$20,000 in India not US$85,000. You can Gooogle it yourself to see the comparative cost and most of what you find isn’t even under the volume system.

        In this article it states open heart surgery from US$1,800 and they are trying to bring it down to US$800. The US would be 20-30 times that.

      • Marek says:

         As Shetty said in the above article, the healthcare costs in the US are kept high by government mismanagement and regulation.

        In July I was in Miami and had to fill a prescription, the cost was four times the price I pay at Fosters.

        The US healthcare providers state that this is to pay for research and development of new drugs and that buying drugs outside the United States is dangerous.

        The only problem with that is this.

        Most of the drug companies are NOT located inside the US and their research and development costs are spread across dozens of markets.

        Secondly, most of the drugs in the United States are not produced there and in fact come from … those countries that the US warns … are dangerous.

        Here’s some simple math. In UK/France/Canada drugs cost 75-90% less than they do in the United States.

        In the US average deductibles are between 10-20% and the sale price of the same drugs in … three to five times times higher. 

        All the drug manufacturers have done in the US is raise their prices by a factor of whatever the healthcare provider is picking up.

        This is the same as when they do rebates. I watched this several years ago… FLP in Florida offered a rebate of 20% … all the A/C companies immediately raised their prices by… you guessed it… 20%. "The end cost to the consumer remains the same".

        The US has gone out of it’s way to STOP the American consumer from having access to affordable prescriptions. Individual states have entered into direct agreements with Canada that would have resulted in savings of 80% and the federal government blocked it.

        They have passed laws stopping Americans from going to Mexico and getting their prescriptions filled there…  But there are 50,000 square foot pharmacy stores in every border town.

        Why… Bayer makes all their headache tablets in the same place and ships them all over the world, as to most of the other manufacturers.

        They don’t make their drugs to different specifications for different markets.

        The only thing the US government is doing (at the cost of providing affordable healthcare to their citizens) is protecting the drug companies profits.

        The drug manufacturers are one of (if not the) largest contributors to Senators and Congressmen in the United States.

        Sorry, the short answer is. This reasoning also applies to medical equipment sold to hospitals. Manufacturers sell for market rates (what the consumer can bear) US hospitals pay ten fold what international hospitals do for equipment. 

        CNN did a story on this and showed some of the massive excess costs that hospitals in the US pay for the simplest things in operating rooms. 


  7. the Insurance guy says:

     Contrary to popular belief, the costs for procedures done through medical tourism arrangements  are often paid by the insurance companies in the USA.  In fact most large  insurance providers look to medical tourism as a cost saving benefit to themselves, and  have entire divisions solely devoted to steering patients to offshore medical facilities.

     These insurers have a strict criteria for facilities they will refer their patients to including an underlying requisite that the doctors are Board Certified, and the support staff hold appropriate and intenationally accepted credentials.   They would not under any circumstances send their insureds to a facility not meeting their requirements, as the insurer may well become liable in the event of a probelm, as the insurerer would be held to the standard of " but for the fact that the insurer/ or referring physician  sent me to this facility this problem never would have happened.  The isurer  or referring physician will send patients to this hospital beacuse they would put themselves in a  situation  such that they "should have known" the physicians at the facility did not have certifications and tort reform was enacted as a pre requisite for the facility to  open. 


    Now if you all believe something to the contrary, i have a nice brdge to sell you in Brooklyn


  8. Anonymous says:

    I agree that if medical tourism is such a good thing, why not try to bring in some good reputable medical establishment from the US or Canada?

  9. Anonymous says:

    On the whole Americans still have a thorough grasp of responsibility and "answerability" – by which I mean one answers to the consequences of one’s actions.  They have not yet been lulled into the hypnosis of  socialist mediocrity.  An American who believes his service provider (professional or otherwise) has failed to live up to his bargain, will sue the service provider. He will be disappointed to find damage awards are made in Cayman by judges who are guided by precedents largely awarded in the UK courts (the socialist mediocrity model).  He – the potential patient – may think long and hard before submitting himself to Dr. Shetty knowing that, at best, his claim is capped at $0.5m.


    • Anonymous says:

      Caps on damages for future pain and suffering and punitive damages are commonplace in the US. "Hard" damages, such as past and future medcal bills, lost earnings, etc. are not usually capped and don’t appear to be capped in this proposal either.

  10. Anonymous says:

    I agree fully with 11/10/2010 – 21:59.  Furthermore, the fact that this country would have to lower its required medical standards to allow Indian doctors who are not now allowed to practice here is a valid concern!!! Shetty said it well, in that with practice doctors perfect their craft.  The question for the Caymanian people is whether or not they should be allowing their medical standards to be lowered to accommodate Indian doctors to come and practice on Caymanians and their guests who will be invited to come to this jurisdiction for medical tourism. If these doctors are as good as they claim then they should have not problem in sitting and passing the required medical testing to meet the qualifications we require.

    • Anonymous says:

      Not a good argument, since Shetty’s hospital in India operating under this same model has a higher patient recovery and operational success rate than hospitals in the UK and the US…Even the British Prime Minister met with him to find out how the British Health care system could learn from Dr Shetty…

      Do some research before taking a position, otherwise your position is based on fear instead of knowledge…

    • Anonymous says:

      Exuse my ignorance, but would a graducat for St. Matthews be allowed to practice in the US? Are some of the Jamaican doctors that come here allowed to practice in the US?

      Why does it mean allowing an Indian doctor to practice here is equal to lowering the medical standard?

    • Anonymous says:

      Look around bro… how many Indian Doctors are in Cayman and a lot of us are useing their services….. Wake up and smell the coffee….

      • Anonymous says:

        Idiot, the difference is that the Indian doctors here now, and in fact those from Jamaica and other jurisdictions, have had to meet certain standards before they are licenced to practice here. Don’t you fools realise that it is human life, perhaps even your own, that you are talking about? If the doctors that Dr. Shetty wants to bring here are so great they will have no difficulty sitting the exams to show that they meet our standards, if they do not then they should not be allowed to work here. Simple!

    • Dred says:

      Some of the best doctors in the world come from third world countries. Take Cuba for instance. Some of the best doctors in the world come from Cuba.

      The problem is several fold to be honest.

      1) Controls over education – Can the country control the fact that some people might claim their credentials but not have it. Is a strict enough system in place in these countries so that their credentials are verifiable. This is often a #1 concern.

      2) Education sylabus and training level – Is their training up to the level of the US and other leading countries?

      So basically after both of those are thrown out the concensus is that they do not accept 3rd world countries. But while the above are in many ways valid concerns they also prejudice good doctors also.

      I don’t believe that we are lowering anything but just saying that MAYBE their reputation for success should be recognised. Their success rates in India are highr than the US in most cases.

  11. Halmark says:

    Excellent work UDP, if everything goes well as plan, you will be making history. I am proud of you of all. You still baffle your opponents

    • Oh Snap says:

      It’s their supporters that they baffle.

    • Rorschach says:

      Yep, I couldn’t agree with you the old saying goes…."If you can’t dazzle ’em with brilliance….Baffle ’em with BULLSHIT!!"

  12. rick says:

    That is why it is crucial for the UDP to continue with their negotiations with Dr. Shetty. You can’t expect business to thrive here and have laws against business!  The UDP has done a good job in getting him here, now they must keep him here for the betterment of our tourism industry.

    I pray for our leader and hope he and the UDP crew continue making the right decisions for this country.


    • Anonymous says:

      "You can’t expect business to thrive here and have laws against business!"


      Correct me if I am wrong, but has businesses not been thriving in Cayman for at least the past 30 years with the current laws?

  13. Anonymous says:

    " The main reason why this new health facility would be able to succeed in the the Cayman Islands is because it was willing to accept the qualifications of Indian Doctors."…."but from the US where the heads of departments at his hospitals would come from".  So the operating surgeons would be ones whose medical qualifications are not recognized outside of India, but the front men would be Us Doctors whose qualifications are accepted?


  14. Anonymous says:

    Dr Shetty  states that he believes that Americans will come to Cayman for treatment.Does he have something more than his belief to back this up such as a copy of any survey carried out.He also states that America will move to a social form of medicine,.How does he know?Is he also a psychic (like MIss Cleo) or did he not see the results of the latest US elections.There are a number of Indian doctors practicing in the US so why doesn’t he locate his hospital here.Florida has no state income tax and a very large elderly population so that would seem to be the ideal location.I believe the reason he is coming to Cayman is because your Govt. is  stupid enough to change malpractice laws to accommodate him.Why does he want this change ,is he anticipating a high number of malpractice cases?If so, why?Could it be that he will be using doctors who are not properly trained? XXXX

    • American Girl says:

      For the life of me I can’t understand why Dr. Shetty believes that Americans would come to Cayman for surgery.  The only scenario that could possibly work would be if American medicine were socialized which it is not at this time and won’t be in the forseable future.  And for those who value life they will choose the best physicians available.  Case in point, Ted Kennedy.  He was pro Obamacare but as soon as he was diagnosed with brain cancer he assembled the top neurologists and neorosurgeons in the country.  Now we can see incompetent doctors any time we wish- we just prefer not to.  It’s usually safer to forego the surgery.

      • Anonymous says:

        Probably the same reason they go to Mexico, India and elsewhere – treatment by experts at a fraction of the cost of the same in the U.S. You do understand that Americans do this already, don’t you? You do understand that Dr. Shetty has very successfully done this before (In India), don’t you? 

  15. THINK BIG says:

    I think to bring in Medical Tourism is one of the best things to happen to Cayman. I cannot see how some in the PPM ranks can oppose this Hospital that will be saving lives. I am 100% behind Mckeeva on this one, and do believe it will be a great booster stimulus to the Cayman economy.


  16. Anonymous says:

     I actually started to like the idea of Dr. Shetty coming in and I thought what would be better is if he could take over the GT & Faith Hospital and get some more pleasant looking nurses in there.  I don’t mean good-looking, I mean don’t look like they just swallowed a lemon.  If you don’t like your job, please get another one because I feel like I am asking for a favor to be taken care of when I go to the hospital.  

    A lot of people are concerned about Caymanians having jobs.  How many Caymanians are working at these hospitals?  They are taken over by another nationality. At least all the Indians that I have seen act very pleasant and don’t act like they are there just to collect the big pay check.

    But I think if we are going to bring in outside investment, let’s get a rich country like Switzerland, Germany, Sweden, Norway, etc.  India is a third world country.  We should be choosing from top notch countries that are leaders in the field of medicine.

    That new law governing the limits of malpractice suits makes me go hmmmm..

  17. BoddenT says:

    I think even Barak Obama sees how India has something great to offer the world. The British Prime minister was there as well.  It is interesting how our leader, Mckeeva Bush had the vision to travel there before these giants did… very interesting and makes me proud to be a Caymanian, knowing that we have here great thinkers and opportunist. More interesting, is how the Premier and his team were able to catch the attention of this renown Indian doctor who was Mother Theresa’s doctor to come here and build a hospital that will compete with the United State’s Health Care system! 

    I must say that despite their shortfalls, the UDP has really done an outstanding job with their negotiations with Shetty. I am sure it will pay off all the expenses his trips have accrued, and even more the deficit which they inherited from the previous party.

    • Anonymous says:

      Oh please! Bush and the UDP didn’t find Dr Shetty. This whole thing is being driven by Dr Shetty and the UDP just happens to be the party in power. If the PPM had won the elections we’d be in exactly the same place. All the UDP have to do is not screw things up.

      However, I am really impressed with the way that Mac makes the sun rise every morning. I bet Kurt or whoever replaces him couldn’t do that. No way! That takes real political skill.

      You are either extremely gullible or a propaganda tool.

      • chalice says:

        Actually Bush travelled that is why PPM made all headlines about it. When they were in, they did no traveling. How you know the same circumstances would have occurred when they were in?  Please you sound ignorant yourself! 

      • Anonymous says:

        But they could have said No to the Hospital. No to the port, no to the dump, no to casino’s, no to expats with needed skills, no to new liquor stores ….. yes is a refreshing change !

  18. A Torney says:

    But if the "tort reform" he is looking for is to cap non-compensatory damages at $500,000 does he not need to get someone to tell him that this is not America and we only award compensatory damages?  A simple exclusive jurisdiction clause in his contracts would be more effective than new legislation.

    • dynamite says:


    • uslawyer says:

      US federal courts have automatic jurisdiction if a case involves a US resident.  US patients will always sue in the US as US courts will disregard clauses in contracts and foreign law which are against US public policy.  So it does not matter what Cayman law says.

      • Mmmm . . . says:

        But a) if that is true (which it isn’t), the proposed Cayman law change would be a waste of time because itwould have no impact and b) it is the jurisdiction over the defendant which is the issue – and if the defendant is a Cayman company, providing Cayman services, under a contract governed by Cayman law with a Cayman exclusive jurisdiction clause then there would be no personal jurisdiction in the US (even the "chain of commerce" nonsense cases don’t go that far).