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At a contentious city council meeting this past March, Rochester approved a plan to build the DMC. Lisa Clarke, the DMC’s executive director, speaks bluntly about what the DMC would offer.
In exchange for the tax increases, Destination Medical Center authorities are promising city residents that their quality of life will vastly increase. In an interesting, contemporary twist, foreign companies are funding much of the construction. With its monumental architecture dominating downtown Rochester and a nearby secondary campus, the Mayo Clinic looks very much the part of a stately hub of global medical care. Although most visits by celebrities and royals to Rochester are discreet, they sometimes make the news. If the Destination Medical Center project is implemented as planned, it will drastically transform the town. Kruesel says that a concern among many residents is the fact that although affordable housing was promised as part of the DMC project, most of the housing developments announced so far have market-based pricing.
Some residents have been angered by what they consider vague plans, and a lack of clarity over how their tax dollars are being spent. When I spoke with the DMC's Clarke, she made sure to note that the plans would be adjusted every five years in response to market conditions.
Writing in the New Republic, Ilan Greenberg astutely noticed that the first discussions of the Destination Medical Center took place in 2009, when the Affordable Care Act was making the rounds.
It remains to be seen how happy and healthy all those new residents of Rochester turn out to be.
Correction: An earlier version of this article misidentified the purchaser of the Chateau Theatre building. The project, a public-private partnership between Rochester, the Mayo Clinic, the state of Minnesota, county governments, and the private sector, would effectively remake all of Rochester in the Mayo Clinic’s image. As of this writing, the project is expected to be paid through a combination of a $6 billion of investment from the private sector and $585 million from state and local government. Promotional materials sent to Rochester residents extol the creation of at least 35,000 new jobs and a long-term boost to tax revenue. A recent count of foreign real estate investment in Rochester found the sale of a seven-story office building for $4 million to a United Arab Emirates-based firm that is expected to tear it down for replacement by a luxury hotel. Royals from the United Arab Emirates routinely arrive at Mayo for treatment (see below), and others want to invest in American biotech.
The city is used to dealing with global markets thanks to the Mayo Clinic, and the fact that overseas purchasers are interested in local properties is seen more as a sign of a healthy economy than anything else.
Over 1 million patients from all corners of the United States and the world visit Mayo for care each year, bringing massive amounts of cash into the local economy, generating $1.5 billion annually in tax revenue. In 2012, three women sued Saudi prince Abdul-Rahman bin Abdul Aziz when he reportedly told a local limousine company to only give him male chauffeurs on a visit to the small Minnesota city.
Educated, well-paid professionals who otherwise would live in the nearest big cities of Minneapolis or Madison, Wisconsin, instead make their homes in Rochester. Rybak, the former mayor of Minneapolis and a member of the Destination Medical Center Corporation’s oversight board, feels the project is essential for attracting jobs to the city.
John Kruesel, who runs an antique shop in downtown Rochester, told Fast Company that there are big concerns about how all these new residents will be housed and provided with services.
In an effort to quell such concerns, Rochester City Council President Randy Staver recently told the Rochester Post-Bulletin, "I think it would be very difficult to really envision in high detail all of the projects that might happen over the next 20 years.

A 2009 Deloitte & Touche report estimates the global medical tourism market at $100 billion. While Obamacare doesn’t affect wealthy medical tourists, it does cut into the meat-and-potatoes treatment Mayo offers ordinary Americans. Blueprints are being made, politicians are cutting deals, and, if plans hold, a small city will double its population in just 20 years. And it is, right this minute, competing fiercely for a small-but-extremely-lucrative slice of the global medical tourism industry. Downtown would be rejuvenated and made more cold-weather friendly, while the Mayo Clinic would welcome gleaming new facilities. And that’s before the seven new neighborhoods they plan to construct around the city. The $585 million cost is expected to be shouldered by taxpayers through sales tax increases approved in 2012 and diversion from other portions of the state and local budgets. Another Emirates-based firm has bought more than $15 million of commercial real estate in Rochester over the past four years.
The Hong Kong investment firm behind a new Rochester office building, for instance, is led by an executive who has organized conferences in mainland China to promote regenerative medicine and stem cell research. Longtime Rochester residents can tell stories of seeing entourages of influential foreigners coming into local boutiques and spending tens of thousands of dollars in a single visit—something southern Minnesota citizens rarely see. The plans include the construction of a new performing arts center, a series of multistory parking garages, and the aggressive building of street and sewer infrastructure for developers to construct commercial, academic, and residential buildings across the city.
The city of Rochester (in close communication with the DMC board) purchased an iconic downtown theater at the end of April, and then there's that public library, which faces possible demolition. If Mayo outflanks the Cleveland Clinic, Johns Hopkins, and other medical hubs in the United States, and offers well-heeled foreign patients a better alternative than Asian megahospitals, much of that money would be reinvested in the local economy. Because of changes to insurance structure and Medicare, the number of middle-class American patients from the Midwest getting treatment at Mayo is expected to go down over the next decade. Vast plots of land would be used for fresh office space for biotech and pharmaceutical firms, local schools would get a cash injection, and development of amenities like hip restaurants and upscale shops would be subsidized by local and state government to attract out-of-town talent and medical tourists. Rochester’s population would nearly double in size, and a small city would be transformed into a bigger player.
The Dalai Lama has stopped by the Mayo Clinic for checkups, Middle Eastern royalty come to the Mayo Clinic for long-term treatment, and politicians and wealthy captains of industry are not unusual sights in Rochester.
IBM is in the middle of a corporate pivot that emphasizes data products, and the company’s long-term economic state is at the mercy of forces largely outside its control. We don’t want people to lose sight of the work being put behind the plan and its comprehensive nature. There are even plans for a rail link to the city of Minneapolis, approximately 90 miles away. This past January, 975 employees were reportedly laid off from the IBM plant as part of a much larger workforce reduction worldwide. Construction around the Destination Medical Center has already begun, with a hotel boom occurring in downtown and near Mayo’s secondary St.
The first hotel to open was a Hilton Homewood Suites this past summer; all the openings are for high-end or middle-range hotel rooms.

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