Detroit: Motor City to Medical Mecca?

http://prescriptions.blogs.nytimes.c...er=rss&emc=rss

http://www.nihcr.org/Detroit-Community-Report.html

...as the Detroit area develops an overall strategy for economic renewal going forward, some envision the health care system as playing a major redevelopment role, to the point that “Medicine could possibly replace motors as the engine of Detroit,” according to a May 2010 National Public Radio broadcast. While this view may be overly optimistic, there is evidence of considerable vitality in Detroit’s traditionally strong health care system.

-Will significant investments in health care infrastructure help make the Detroit area a major center for medical care and research that can help drive revitalization of the metropolitan area or will it simply drive health care costs higher and discourage employment growth by making coverage more expensive?

-Will hospital/physician integration accelerate, and, if so, what impact will this have on quality of care, efficiency and costs to purchasers of care?

-Will Detroit be able to attract and retain sufficient numbers of physicians to meet community needs?

-How will the Detroit safety net be affected by the sale of Detroit Medical Center to Vanguard?

-How will the safety net handle Medicaid enrollment growth resulting from coverage expansions enacted through health reform?

-Will the UAW Retiree Medical Benefits Trust, now the largest single health care purchaser in metropolitan Detroit, initiate innovative purchasing strategies, either on its own or in collaboration with other purchasers?

-How will Trust activities shape the Detroit health care market going forward?

Using eds and meds to revitalize a city seems to be a dead end. I'm betting Vanguard, or the people they flip it to, will leave the Medical Center broke and largely empty eventually.

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Originally Posted by Detroitnerd

Using eds and meds to revitalize a city seems to be a dead end. I'm betting Vanguard, or the people they flip it to, will leave the Medical Center broke and largely empty eventually.

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The demand far outweighs the supply, and will for the foreseeable future. I'm not aware of an eds and meds strategy being considered a dead end anywhere, but it certainly adds muscle to much-needed diversity in our regional economy, big bad corporation relying on big bad government health care for business aside.

Agreed bartock!

Here's an interesting discussion of for-profit [[Vanguard) and non-profit [[DMC)....

http://www.usatoday.com/money/indust...ers13_CV_N.htm

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Originally Posted by Detroitnerd

Using eds and meds to revitalize a city seems to be a dead end. I'm betting Vanguard, or the people they flip it to, will leave the Medical Center broke and largely empty eventually.

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It worked in Pittsburg and has sustained it. I am mostly concerned about the amount of Debt encumbured by ALL of the hospitals over the last several years. The following non-DMC hospitals have made huge investments and created new campuses throughout the region: Providance [[Novi), Henry Ford [[W Bloomfield), Oakwood [[Downriver), U of M and St Joes in Ypsi-Arbor, Beaumont in Troy and RO and Genesys [[N Oakland Genessee). Each of these were built with the assumption that we will have a much larger population and need more beds and surgical facilities. This has not happened, in fact we are shrinking. This will leave us with high costs and empty facilities throughout the region. Every bed built in a wealthier part of town impacts the ability to fill a bed in a more modest income area.

Detroit Public Schools and other public schools need to have Medical-Industry charter academies, where students are trained with the medical fields in mind, given college credits before graduation, etc. Have these hospitals be active partners with schools..

Detroit used to be a place with factories that turned raw materials into finished goods to sell overseas. Thanks to organized labor, much of the profits went to the workers, who then spent their money at cafes, car dealerships, restaurants, bowling alleys, bars, barbershops, etc. It was difficult to even find skilled help or -- often -- housing during that expansion.

We will replace that with production economy with service-based businesses that take uneducated and sick people and turn them into educated and healthy people. Except that these uneducated and sick people will increasingly have less and less money and fewer jobs. None of this has any export value, or adds any value. Oh, and many of the businesses doing all this will not pay taxes. They say it's working in Pittsburgh ...

Yes, sounds like a bang-up strategy for building a city ... just sayin'.

After using DMC over the last 8 years, I gave up 2 years ago and transferred out...the quality of care was OK, but the short staffing that exists in all the clinics I dealt with led to botched appointment scheduling, misplaced referrals, computer systems that did not share resources from one department to another, the complete loss of the Orthopedic surgeons to Oakwood, the famous Wayne State Physicians group freeze out...so Duggan has achieved the goals the Board apparently directed him to meet...Vanguard has to run DMC better than he did...sad.

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Originally Posted by DetroitPlanner

It worked in Pittsburg and has sustained it. I am mostly concerned about the amount of Debt encumbured by ALL of the hospitals over the last several years. The following non-DMC hospitals have made huge investments and created new campuses throughout the region: Providance [[Novi), Henry Ford [[W Bloomfield), Oakwood [[Downriver), U of M and St Joes in Ypsi-Arbor, Beaumont in Troy and RO. Each of these were built with the assumption that we will have a much larger population and need more beds and surgical facilities. This has not happened, in fact we are shrinking. This will leave us with high costs and empty facilities throughout the region. Every bed built in a wealthier part of town impacts the ability to fill a bed in a more modest income area.

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im sure more beds were added, however the majority of these projects involved creating private patient rooms which consumer demand/competition has driven. as a healthcare designer, i can say that healthcare systems are very keen to the number of beds they operate as they are licensed by the state. new spaces help, but many hospitals differentiate by specialities to gain market share. the majority of expansions happen because older infrastructure can not support required building systems due to ceiling heights/existing capacities. currently, lean thinking and evidence-based design are very much a part of practice and many new facilities may showcase larger patient/visitor areas, but in a smaller building footprint overall due to departmental and operational effiencies. my fears are what happens to all this healthcare infrastructure once all the baby boomers are gone? we have to get through all the gen xers before the echo boomers will again require such a drastic need/change in the market.

Pittsburgh and Seattle are both good examples of medical economics at work. I've spent too much time recently on Seattle's "Pill Hill", which has 4 major hospitals within a 15 block area, and what they add to the economic landscape of the city huge. And what they bring to the "quality of life" rating for the area is also large.

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Originally Posted by Detroitnerd

Detroit used to be a place with factories that turned raw materials into finished goods to sell overseas. Thanks to organized labor, much of the profits went to the workers, who then spent their money at cafes, car dealerships, restaurants, bowling alleys, bars, barbershops, etc. It was difficult to even find skilled help or -- often -- housing during that expansion.

We will replace that with production economy with service-based businesses that take uneducated and sick people and turn them into educated and healthy people. Except that these uneducated and sick people will increasingly have less and less money and fewer jobs. None of this has any export value, or adds any value. Oh, and many of the businesses doing all this will not pay taxes. They say it's working in Pittsburgh ...

Yes, sounds like a bang-up strategy for building a city ... just sayin'.

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This is a huge problem with our national economy. We are not producing or creating anything of value. Healthcare is no more an economy than patching the roads, digging ditches, libraries, or cops. We need it, but it is a service, not the economy.

For God's sake though, bring on the health care jobs in Detroit. I still go to DMC when I get my shit ruined. They are a bit rough around the edges, but I am still amazed at how they brought me back from rather debilitated situations.

Something like 80% of the economy is services; the idea that services are not the economy is a bit misleading--they are the bulk of the economy. While it is true that a region does need to be able to sell something to the rest of the world, most people are going to be employed doing things for the other people of the region, not people elsewhere. Also, medical care is largely paid for by the federal government, and will probably be increasingly so in the future, so in fact a medical center does attract money from outside.

^ Economics is totally not my lane, but I'm really worried about the service-based economy. It is predicated on the false assumption that cheap, easy fuel will last forever, and that we will always be able to import manufactured goods from overseas more cheaply than we can make them here.

I think that the local and sustainable movements aren't just fads. I think they're pointing the way to the rest of this century in the same way that the first automobiles and airplanes 100 years ago today were pointing towards the 20th.

Yes, we will need eds and meds, but we will also need jobs, opportunities and life chances for the many people who are talented artisans, skilled tradesmen, laborers, and farmers. Not everyone is willing to sit in a classroom for nearly 3 decades in order to make a living. Nor should they have to.

great idea detroit! grand rapids is at least a half a decade ahead of you on this one...

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Originally Posted by mwilbert

Something like 80% of the economy is services; the idea that services are not the economy is a bit misleading--they are the bulk of the economy. While it is true that a region does need to be able to sell something to the rest of the world, most people are going to be employed doing things for the other people of the region, not people elsewhere. Also, medical care is largely paid for by the federal government, and will probably be increasingly so in the future, so in fact a medical center does attract money from outside.

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Right, because if nobody worked manufacturing or production jobs, nobody would be able to afford services. Just arguing that the majority of jobs in any national economy are service jobs isn't enough. You must take into account that the people who make the money to PAY those service businesses are largely involved in production. Unless somebody's just printing money somehwere [[i.e. the Feds). We have lived on 40 years of junk economics and it's starting to finally take its toll. Don't extend this period of delusion, OK? We need to take raw materials, fabricate things people want, and then sell them, make a profit, pay our production workers, so that 20 percent of the work force can then sustain the other 80 percent.

The ed & med strategy is an excellent one for Detroit and other older cities. DMC and Hnery Ford this year announced plans for 1.3 billion in investments in their campuses in the next decade. Wayne State is the largest med school in the country and Oakland University will open a new med school in fall 2011. The population age 60 and over in Michigan will double in size in the next 20 years. This society will be spending many more dollars on health care because of the aging of the population. Hospitals and med schools are among the last institutions to move from central cities to suburbs. The University of Michigan spends about 800 million a year on research with almost all of those funds coming from the federal government and external sources. One can imagine a substantial increase in medical sector research in Detroit. In the Minneapolis metro there are probably more than 35,000 manufacturing sector employees making medical devices. That employment can increase in metro Detroit. Commuter rail could easily connect the larger medical faciltiies in Detroit with the large three hospital complex in Ann Arbor.

Birmingham, AL has a thriving health care district that is keeping their economy moving despite a similar loss of industrial jobs that has been Detroit's fate.

The University of Alabama complex which includes highly ranked UAB Hospital and research facilities is the main single employer in that area.

The expansion of Detroit's main hospitals in the Midtown area will improve the local economy and help diversify the economy as manufacturing shrinks further in the future.

The days of high-paying factory jobs are ending. Manufacturing will continue to employ people in MI and the US but it will no longer sustain the economies of most Midwest and Northeast metro areas. They will need to replace the industrial jobs that are gone with jobs in health care, IT, technology, tourism, finance, etc.

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Originally Posted by kryptonite

Birmingham, AL has a thriving health care district that is keeping their economy moving despite a similar loss of industrial jobs that has been Detroit's fate.

The University of Alabama complex which includes highly ranked UAB Hospital and research facilities is the main single employer in that area.

The expansion of Detroit's main hospitals in the Midtown area will improve the local economy and help diversify the economy as manufacturing shrinks further in the future.

The days of high-paying factory jobs are ending. Manufacturing will continue to employ people in MI and the US but it will no longer sustain the economies of most Midwest and Northeast metro areas. They will need to replace the industrial jobs that are gone with jobs in health care, IT, technology, tourism, finance, etc.

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You guys are willfully living in a fantasy land. Of course, by the time you find out all this stuff doesn't really work, it will be too late.

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Originally Posted by Detroitnerd

You guys are willfully living in a fantasy land. Of course, by the time you find out all this stuff doesn't really work, it will be too late.

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Well your plan of continuing to base our local economy on high wage factory jobs does not exactly appear to be such a great economic model for about 40 years now. Here it is 2010 and oh my, unemployment in MI is over 13% and people are begging for any kind of job and leaving the state by the hundreds of thousands. Why? Because the types of jobs you propose don't exactly exist these days.

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Originally Posted by kryptonite

Well your plan of continuing to base our local economy on high wage factory jobs does not exactly appear to be such a great economic model for about 40 years now. Here it is 2010 and oh my, unemployment in MI is over 13% and people are begging for any kind of job and leaving the state by the hundreds of thousands. Why? Because the types of jobs you propose don't exactly exist these days.

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Sure they do. The jobs Detroiters used to have are still in existence: In China, in Thailand, in Malaysia. Thanks to Reaganomics, NAFTA, GATT and a concerted effort to offshore American manufacturing, the economy in former manufacturing areas is screaming. And that's the way it's supposed to be. If they can eviscerate the American middle class [[all while telling us how it's OK, we're all going to be performing services for each other in the new, exciting knowledge-based economy) then we'll work hard with a gun in our back for a bowl of rice a day. They will finally invest in American manufacturing when the last tax is scrapped, the final environmental law is struck down, and the sole remaining labor organizer dies. Ever wonder why two of the main manufacturing enterprises still going in our area are foreign-owned [[Severstal, ThyssenKrupp). We owe it all to our leaders; they want it that way. Thank you, American business leadership!

As far as I can tell, people still get sick. People still get older, and people are maintained longer before they die. Slowing down death is big, big, big business.

Developing expertise in special fields of treatment also brings people in from various parts of the country and world. If you want heart expertise you go to say Mayo, for burns you go to UAB Birmingham, for some cancers you go to Houston, etc.

The hospital expansions are great for our future. They are great for Midtown in particular.

Similarly, the Tank plant tech jobs expansion is bringing in around 1,500 new jobs to metro Detroit. I have met a family already that relocated here from out of state for three years to work there. Locals are also being hired for that expansion.

So much economic ignorance in this thread. This lunch-bucket leftism idiocy may play with the Virg Bernaro crowd but it does nothing but cast this state in the retro era light that most of the country still thinks of when they hear "Detroit". Overpaid underskilled workers and their enablers who at best are economically ignorant and at worst, hostile to economic activity.

Yup. People keep dying, too. Why don't we base our economy entirely on the service of embalming and burying people? That way we can create lots of service jobs too, lifting us up out of this slump. ...

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Originally Posted by Detroitnerd

Yup. People keep dying, too. Why don't we base our economy entirely on the service of embalming and burying people? That way we can create lots of service jobs too, lifting us up out of this slump. ...

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That's just argumentative and obtuse.

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Originally Posted by bartock

That's just argumentative and obtuse.

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Yes, bartock. It's also known as SATIRE or HUMOR. :p

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Originally Posted by Detroitnerd

Yes, bartock. It's also known as SATIRE or HUMOR. :p

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Point taken. Have a good weekend.

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Originally Posted by bartock

Point taken. Have a good weekend.

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Hey, you too! :)

The report that prompted that blog post is issued by a group that was founded and is funded by the UAW and the Big 3. That might explain why [[metro) Detroit, specifically, is suggested as a possible future medical Mecca. So maybe it's suspect.

That said, I can only imagine the Mayo Clinic is not a drag on the Minnesota economy. This is as reasonable an idea for bringing in some outside bucks as anything else. It would have to be something like the Mayo Clinic, though, something that draws medical tourism, in order to really have a big impact, I should think.

A case could be made that the existing infrastructure for that kind of thing is pretty good [[little traffic on the Interstate from DTW to Detroit, etc). That, and the land is cheap. You could build a whole campus.

It certainly couldn't hurt to bring a bunch of Doctors into the city/region.

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Originally Posted by fryar

The report that prompted that blog post is issued by a group that was founded and is funded by the UAW and the Big 3. That might explain why [[metro) Detroit, specifically, is suggested as a possible future medical Mecca. So maybe it's suspect.

That said, I can only imagine the Mayo Clinic is not a drag on the Minnesota economy. This is as reasonable an idea for bringing in some outside bucks as anything else. It would have to be something like the Mayo Clinic, though, something that draws medical tourism, in order to really have a big impact, I should think.

A case could be made that the existing infrastructure for that kind of thing is pretty good [[little traffic on the Interstate from DTW to Detroit, etc). That, and the land is cheap. You could build a whole campus.

It certainly couldn't hurt to ring a bunch of Doctors into the city/region.

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Much of what you say makes sense [[and is amusing), but my criticism isn't of Mayo Clinic or even hospitals in general. It is this "Eds and Meds" idea, that we are going to rebuild and reinvigorate our cities by building massive university and medical campuses. I tend to overstate things [[fire for effect, you know?) but I think it's a fair criticism that we can't hospitalize or matriculate our way out of the problems we have. We need jobs for normal people, and they won't come from servicing the service economy alone. Somebody needs to make something for all this to work.

As for big campuses, sigh ... it all just sounds like more retrograde 1960s thinking of megacampuses and monorails, and none of those pesky neighborhoods or small businesses ... :rolleyes:

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Originally Posted by Detroitnerd

Much of what you say makes sense [[and is amusing), but my criticism isn't of Mayo Clinic or even hospitals in general. It is this "Eds and Meds" idea, that we are going to rebuild and reinvigorate our cities by building massive university and medical campuses. I tend to overstate things [[fire for effect, you know?) but I think it's a fair criticism that we can't hospitalize or matriculate our way out of the problems we have. We need jobs for normal people, and they won't come from servicing the service economy alone. Somebody needs to make something for all this to work.

As for big campuses, sigh ... it all just sounds like more retrograde 1960s thinking of megacampuses and monorails, and none of those pesky neighborhoods or small businesses ... :rolleyes:

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I hear you. But some of the Detroit geography is hardly vibrant. Maybe you take a couple of those blocks and create a park-like setting for people to rehab, or whatever it is medical tourism does. It doesn't have to be exclusive, people can pass through or go for a walk there or whatever. Just make it something where folks won't have to confront social ills on their way to buy some coffee or get a newspaper in the place they're staying while they're miserable.

I also hear you about the Eds and Meds approach, at least the Meds bit. I heard, for example, that MI paid to retrain a bunch of laid-off auto workers as nurses. Lulz all around! But besides that, it's like my dad's joke about the West's ageing population, where pretty soon there's no one left but pensioners and pension administrators. Pretty soon, all Michiganders will be sick or taking care of the sick.

Thanks for finding me amusing. I aim to please. :D

This is a map of Mayo Clinic's largest center in downtown Rochester, MN. Note how all the patient facilities are linked together with underground or skyway walks which is really nice in a Minnesota winter. All the patient buildings are walking distance of each other with hotels and restaurants and hotels in between for patients who do not need bed care, relatives, and other visitors. The airport is nearby. This is what medical tourism could look like if you want to adopt it for Detroit. It is a nice place for doctors and everyone else to raise their families.

Mayo Clinic map

Some of you believe that a project that could help produce jobs in the city, manufacturing is necessary...
Well, maybe you guys don't know that through medical reseach this is possible.
I remember one of the doctors working at DMC invented a brand new valve for people with heart problems. Maybe this is not the kind of stuff people usually talk about and that's why few people know about the great achievements done through medical research at DMC.
Next step would be to set up the facilities to manufacture the stuff invented through research. Maybe they exist already? If they don't, there's plenty of space available to do that...
I remember I read some decades ago that DMC was also one of the top 5 cancer research centers in the nation.