Hospital ships. Turn on the operating room when you’re 3 or 12 miles offshore. It’s got to happen.
They may have to be foreign flagged, but they will be nearby.
There’s a history for tolerating things in boats that aren’t tolerated on land, like gambling barges in states that don’t allow casinos on land. Of course, that’s state run, and the problem here is Federal, but you get the idea.
Indian reservations, too, perhaps, for major procedures.