“GRAND CAYMAN — Last spring, a 6-foot-4, 250-pound Texan sorely in need of new knees became one of the first medical tourists to this Caribbean island, better known for its tax-dodging opportunities than its healthcare.

Encouraged by his self-insured employer to explore alternatives to a local hospital, Wayne Wright, now 68, spent hours on the phone with an expatriate American nurse at Health City hospital, a joint venture between Ascension and India’s Narayana Health. She carefully explained how it would work.”

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