Deal killer right there. You can get murdered, mugged and raped - and have your car stolen - at any of our many local Injun casinos, and you're shit outta luck; word flies quickly.
The tribes don't even bother responding to complaints. You're on your own when you enter their little world.
If they don’t respond to complaints about medical care, they won’t get many customers. People are pretty rational about health care shopping — going to a casino is irrational in the first place, and the Indians know full well people who want to throw their money away will just keep coming.