Delta chat is an app that turns email inbox into chat like interface on android phone... potentially obviating the need for any separate business chat service.
Me? Id like to think I'm a 6, I don't cut family ties over their political opinions but I'm very likely to shut that down with a "I don't want to speak politics with you".
I'd say that's 3 or low 4. I think you need to define the middle stages of this scale more clearly.
Have you considered the possibility of medical tourism, to say India? Any particular treatment/procedure that really requires you costly American doctors, and can't be done elsewhere?
because India acceded, changing american strategy drastically