Cleveland Clinic

The Cleveland Clinic helps set Cleveland apart as a medical city.

Detroit is the latest metro area vying to become a medical destination. The hope is that its hospital systems can draw patients from outside its region, helping the local economy. In short, Detroit wants to be more like Cleveland. But Cleveland could be tough to copy.

In 1975, a young cardiologist arrived in Cleveland.

“I came here in a rented truck with a Vega on the back end because it was too sick to pull,” Toby Cosgrove said. Jump ahead 36 years and that newbie with a beater of a car is now CEO of the Cleveland Clinic. Cosgrove presides over a medical empire vastly larger than when he came to town hoping to get better at heart surgery.

“We were about 140-150 doctors. We’ve grown a bit since that time. We’re now about 3000,” he said.

Dan Bobkoff

Toby Cosgrove, the Cleveland Clinic's CEO, in his office.

The Clinic has become a centerpiece of an industry that employs roughly 70,000. That includes places like University Hospitals\ next door, and Summa Health in Akron.

Growth has been rapid. University Hospitals alone has added 4000 workers in the last few years. And, expansions have been pegged at about $3 billion in construction spending.

George Rouse is a nurse who made his own transition before the rest of the region.

“My friends were like: are you crazy? Are you nuts?” he recounts.

About 15 years ago, Rouse was working in IT for a manufacturing company.

“I had a very good living with that company but I’m like: what if this would ever end? What would I do next?” Rouse said.

His premonition was right. His former employer closed up shop a few years ago. No one thinks he’s crazy now.

“When I’m driving to work, the last two years, for all of us, you know, our houses have dwindled down to nothing, our 401ks have shrunk down,” he said. “I mean, all these pieces are crumbling.”

Dan Bobkoff

Nurse George Rouse prepares a patient for a pacemaker operation.

While it worked for Rouse, healthcare is no replacement for manufacturing. Health jobs make up about 11 percent of the workforce. In its heyday—say the 50s and 60s—manufacturing jobs employed 40 percent of Clevelanders.

“Healthcare became the big generator of jobs by accident,” said Chris Seper, founder of MedCityNews.

Cleveland’s hospitals have been growing for nearly a century. It’s only been in the last decade that healthcare has become the center of economic development.

“The healthcare system here and the life sciences industry here does as much as it possibly can. But there’s a limit to what they can do,” Seper said.

Cleveland never really set out to become a healthcare capital. Cleveland Clinic CEO Toby Cosgrove says it’s not like some politician stood at a podium many years ago.

“No, nobody raised their hand and said they’re going to push this organization to the front,” Cosgrove said.

The Clinic’s international reputation can be traced back to advances in heart care in the 50s and 60s. Now, patients arrive from around the country and world for heart procedures. Foreign patients often pay cash. Bringing patients in is the holy grail for cities like Detroit that want to be like Cleveland. But even at the Clinic, only one percent of its patients are international. Paul Ginsburg is president of the Center for Studying Health System Change.

“But when you really look at the numbers of some places that are really strong in medical tourism, it’s not that large a part,” Ginsburg said, adding that there are other reasons why healthcare may not be a good economic driver for regions.

For one, building more hospitals often means people consume more care, which means we all pay more in taxes and insurance. Whether any city can sustain this much expansion is a big question.

And, the industry is changing, shifting more to home care and so-called telemedicine. Already, smaller hospitals are outsourcing difficult diagnoses to places like the Cleveland Clinic. Chris Seper of MedCityNews says that will make it even harder for cities trying to embrace healthcare as their future.

“I think if you’re building healthcare systems and hospitals as an idea that they’re going to be your jobs growth engine, it’s a lose-lose situation,” Seper said.

Cosgrove of the Clinic says we may end up with nationwide chains, the way banks have consolidated over the years. So, if you’re trying to copy Cleveland, good luck.


Four weeks ago, a small group of demonstrators began protesting the grim state of the U.S. economy in New York City with little fanfare.

Now, a growing movement based on the Occupy Wall Street protests has spread throughout the country, including demonstrations in several Midwest cities.

Separate groups protesting the role of big banks in the U.S. foreclosure crisis marched Monday and Tuesday through Chicago, meeting at the Art Institute of Chicago, where the Mortgage Bankers Association was holding its annual conference.

“People are mad as hell at these financial organizations that wrecked the economy, that caused this whole mess,” Catherine Murrell, a spokeswoman for Stand Up Chicago, a coalition of approximately 20 Chicago community organizations, told the Chicago Sun-Times. “They broke the economy. They played with it like it was a toy.”

Protestors held training sessions on how to deal with the police, distributed press releases and chanted throughout the day Tuesday, according to our partner station WBEZ. On Monday, approximately 7,000 people participated in the protests, disrupting traffic across the city.

Elsewhere in the Midwest, protests were smaller, but sustained. In Columbus, Ohio, about 100 protestors marched in front of the Statehouse on Tuesday morning, railing against corporate greed, student-loan debt and the media. The group intended to show solidarity with the Occupy Wall Street protests in New York, according to The Columbus Dispatch.

In Madison, Wisc. protests occurred over the weekend. A crowd estimated in the dozens marched throughout downtown, settling in Reynolds Park until Sunday evening. In Milwaukee, religious leaders gave the movement traction in their Sunday sermons.

“I’m not against capitalism, but a capitalist society run amok takes care of the people at the top, and the people at the bottom are crushed,” Rev. Willie Brisco told the Milwaukee Journal Sentinel.

Protests were in the planning stages in Detroit on Sunday. The South End, the student newspaper at Wayne State University, reported that hundreds of people met at the Spirit of Hope Church on Monday night to plan protests slated to begin on Friday. Event organizers said that approximately 1,000 people attended the meeting.


Three stories making news across the Midwest today:

1. Cleveland counts on small growth. In the past, economic development approaches in Cleveland have centered around big-ticket items. A new stadium. A new arena. The Medical Mart and Convention Center. That strategy is changing. Under Cuyahoga County’s new governing structure, executive Ed FitzGerald will target small-and-medium-sized business growth rather than large-scale projects. Our partner station Ideastream examines a proposal for a $100 million economic development fund that FitzGerald calls “a major commitment to business development.”

2. Tennessee GM plans will re-open. The contract agreement between the United Auto Workers and General Motors calls for the hiring of an additional 6,400 employees. Approximately 1,700 will be located at the company’s plant in Spring Hill, Tenn. The plant was initially shuttered in June 2009, but in a move that’s considered rare among industry insiders, the plant will re-open as GM seems to gain market share from Toyota. According to an Atlanta Fed analyst, the re-opening is one such reason “Tennesee could be viewed as a leader of the pack in automotive manufacturing strength,” throughout the nation.

3. Business school applications down. As prospective students grow leery of accumulating massive amounts of student debt, applications to most Chicago-area business schools have fallen. Crain’s Chicago Business reported Monday that applications at Loyola University’s Graduate School of Business have fallen 9.5 percent this year, applications at Northwestern’s Kellogg School of Management declined 5.6 percent. Applications at the University of Chicago’s Booth School of Business dropped 3.0 percent. DePaul was the only university in the Chicagoland region to buck the trend, noting a 13 percent jump.


Three stories making news across the Midwest today:

1. Mixed Midwest real estate news. Home sale prices in Michigan increased significantly over the past three months, according to a new report from Clear Capitol. “Michigan overall is actually up even more so than the Midwest Region,” said Alex Villacorta, a Clear Capitol spokesperson. Villacorta tells Michigan Radio that prices are up 8.5 percent on a quarter-over-quarter basis, but cautions prices could decline by more than 3 percent in Michigan this winter. Elsewhere in the region, distressed sales in northeast Ohio pushed the decline in area home prices to almost double the national rate, according to Crain’s Cleveland. Prices in the Cleveland area fell 7.9 percent in August compared to a year earlier.

2. Milwaukee streetcar’s street fight continues. Two Milwaukee alderman asked Congress to kill a streetcar line in the city by giving its $54.9 million in federal funds to the cash-strapped city bus system. The alderman and opponents of the streetcar line, said Wednesday that the city could not afford to operate the streetcar. Their efforts face long odds, according to the Milwaukee Journal Sentinel. House rules may ban such a financial shift, and the city’s council has already voted to start final engineering on the $64.6 million streetcar project.

3. Closer confines in Chicago. The Chicago Sun-Times reports today the Chicago Police Department will have some company in its headquarters. The Chicago Fire Department is moving in late next month as part of cost cutting ordered by Mayor Rahm Emanuel, a source tells the newspaper. Moving boxes have already arrived, and the fire department will abandon its lease on two floors at 10 W. 35th Street. “Everyone hopes everyone will get along,” the source tells The Sun-Times.


Three stories making news across the Midwest today:

1. Porsche’s place in Cleveland economy. Is there something illogical about opening a Porsche dealership in the midst of northeast Ohio’s economic turbulence? Not really, says Mark Naymik of The Plain Dealer. Porsche buyers are faring just fine, according to U.S. Census data. Naymik attended the grand opening of a Porsche dealership in suburban Beachwood, and examines the trickle-down role of such luxury purchases and the complexities of the regional economy — while also providing details on the regal evening.

2. Standard & Poor’s upgrades GM. After reviewing the four-year contract agreement between the UAW and General Motors, Standard & Poor’s announced today that it has upgraded the automaker’s debt rating from BB- to BB+. “We believe the contract will allow for continued profitability and cash generation in North America,” S&P’s Robert Schulz said in a written statement.

3. Michigan banks receive small-business boost. The U.S. Treasury announced today that five Michigan community banks would receive a total of $28.8 million in funding as part of the Small Business Jobs Act that President Obama signed into law. The money, distributed through the Small Business Lending Fund, encourages community banks to help small businesses expand operations and create new jobs. The Treasury said in a release that small businesses account for approximately 60 percent of job creation, but that such businesses are facing “disproportionate challenges in the aftermath” of the credit crisis.


What makes a city powerful?

According to The Atlantic, cities bring together talented, ambitious people, whose ideas and

Chicago's lakefront

innovations make it a place of economic growth. And, one of the world’s most powerful is right here in the Midwest.

Chicago ranks No. 4 on The Atlantic’s list of the world’s 25 most economically powerful cities, second only to New York in the United States (it also ranks behind Tokyo and London). The list is part of The Atlantic’s new Cities page, which debuted today. It looks at issues facing urban areas around the world.

The Global Economic Power Index, developed by the Martin Prosperity Institute, reflects three key  dimensions of economic power—economic, financial, and innovative.

Economic Power is measured as economic output or gross regional product. Financial Power is based on the Global Financial Centers Index, which ranks the banking and financial power of cities across the world. Innovation is based on patent activity.

The Atlantic says Chicago’s annual economic output is $460 billion, while its global economic power score is .915, a batting average that anyone in baseball would dream of having. Its financial center ranking is 678, while its innovation score is 7.

Other American cities on the list include Boston, at No. 6 and Washington, D.C., which ranked 10th. Our neighbors in Toronto ranked No. 12.

There’s a wealth of other statistics on the new Atlantic Cities page. Did you know the median income for Chicago is nearly $60,000? But it’s under $50,000 in Detroit, while Cleveland’s median income is about $45,000.

What do you think of The Atlantic ranking? Would you put other cities on the power list?


What makes a city powerful?

According to The Atlantic, cities bring together talented, ambitious people, whose ideas and

Chicago's lakefront

innovations make it a place of economic growth. And, one of the world’s most powerful is right here in the Midwest.

Chicago ranks No. 4 on The Atlantic’s list of the world’s 25 most economically powerful cities, second only to New York in the United States (it also ranks behind Tokyo and London). The list is part of The Atlantic’s new Cities page, which debuted today. It looks at issues facing urban areas around the world.

The Global Economic Power Index, developed by the Martin Prosperity Institute, reflects three key  dimensions of economic power—economic, financial, and innovative.

Economic Power is measured as economic output or gross regional product. Financial Power is based on the Global Financial Centers Index, which ranks the banking and financial power of cities across the world. Innovation is based on patent activity.

The Atlantic says Chicago’s annual economic output is $460 billion, while its global economic power score is .915, a batting average that anyone in baseball would dream of having. Its financial center ranking is 678, while its innovation score is 7.

Other American cities on the list include Boston, at No. 6 and Washington, D.C., which ranked 10th. Our neighbors in Toronto ranked No. 12.

There’s a wealth of other statistics on the new Atlantic Cities page. Did you know the median income for Chicago is nearly $60,000? But it’s under $50,000 in Detroit, while Cleveland’s median income is about $45,000.

What do you think of The Atlantic ranking? Would you put other cities on the power list?


Three stories making news across the Midwest today:

1. Goodbye Cleveland, hello Chicago. A Cleveland-area steelmaker could receive more than $1 million in financial incentives to move its headquarters to downtown Chicago, Crain’s Chicago Business reported this morning. JMC Steel Group Inc. could bring 50 new employees in the move. Chicago’s Community Development Commission will hear a proposal to provide $1.1 million in incentives Tuesday. Crain’s writes the approval would “represent another victory for Mayor Rahm Emanuel,” who has touted several job victories since taking office.

2. Ford faces UAW strike. A Wednesday deadline looms on contract talks between United Auto Workers officials and Detroit automakers, although representatives on both sides say the discussions could be extended. UAW president Bob King tells our partner station Michigan Radio that a strike is not a “goal” of the talks, but others believe a strike could happen at Ford. Gary Walkowicz, a bargaining committeeman, says union members deserve to receive cost-of-living adjustments surrendered during the recession.

3. Obama will speak in Ohio. President Obama will continue the campaign for his $447 billion jobs bill in Columbus, Ohio, today. He’ll emphasize part of his proposal that marks $25 billion for school building and renovation while speaking at Fort Hayes Arts and Academic High School. It’s part of Obama’s plan to fight for the American Jobs Act on the turf of his Republican counterparts. The Ohio visit, in House Speaker John Boehner’s home state, comes four days after Obama visited House Majority Leader Eric Cantor’s district in Richmond, Va.


Three stories making news across the Midwest today:

1. Goodbye Cleveland, hello Chicago. A Cleveland-area steelmaker could receive more than $1 million in financial incentives to move its headquarters to downtown Chicago, Crain’s Chicago Business reported this morning. JMC Steel Group Inc. could bring 50 new employees in the move. Chicago’s Community Development Commission will hear a proposal to provide $1.1 million in incentives Tuesday. Crain’s writes the approval would “represent another victory for Mayor Rahm Emanuel,” who has touted several job victories since taking office.

2. Ford faces UAW strike. A Wednesday deadline looms on contract talks between United Auto Workers officials and Detroit automakers, although representatives on both sides say the discussions could be extended. UAW president Bob King tells our partner station Michigan Radio that a strike is not a “goal” of the talks, but others believe a strike could happen at Ford. Gary Walkowicz, a bargaining committeeman, says union members deserve to receive cost-of-living adjustments surrendered during the recession.

3. Obama will speak in Ohio. President Obama will continue the campaign for his $447 billion jobs bill in Columbus, Ohio, today. He’ll emphasize part of his proposal that marks $25 billion for school building and renovation while speaking at Fort Hayes Arts and Academic High School. It’s part of Obama’s plan to fight for the American Jobs Act on the turf of his Republican counterparts. The Ohio visit, in House Speaker John Boehner’s home state, comes four days after Obama visited House Majority Leader Eric Cantor’s district in Richmond, Va.


Three stories making news across the Midwest today:

1. Cleveland casino hiring. Today marks a milestone in the development of Cleveland’s Horseshoe Casino. After spending hundreds of millions of dollars to refurbish a downtown building, the gambling company is now seeking employees. It is filling 500 positions for dealers – no experience necessary – in positions that will pay as much as $40,000 per year, according to The Plain Dealer. A professor from nearby John Carroll University predicted the jobs would have a multiplier effect on the region. “This is the evidence that it wasn’t just hoopla or overstatement,” LeRoy Brooks told the newspaper. “They’re actually putting up the capital, the training costs.”

2. Sun power, meet sunflower. A Wisconsin energy company is building one of the largest solar projects in the state, and allowing individual investors to buy a stake in the project. The Convergence Energy Solar Farm began construction last year on 14 acres, and will be the state’s second-largest solar farm when completed. “We’re really striving to build local economies,” Steve Johnson, the company’s VP of business development told the Milwaukee Journal Sentinel. “It’s providing an opportunity for people who want to invest in solar and put a little more clean energy on the grid.”

3. Groupon may postpone IPO. Chicago-based Groupon may postpone its upcoming IPO, a delay it attributed to market volatility, according to The Wall Street Journal, which first reported the development. That may not be all. Marketwatch reported today that the company may be skirting the “quiet period” required by businesses once they file papers with the Securities and Exchange Commission, and opines that Groupon CEO Andrew Mason appears “hell-bent on becoming the poster child for business schools and budding entrepreneurs on how not to go public.”