Holding the edge in healthcare
IN MAY, 20,000 biotech industry leaders will converge in Boston for the BIO 2007 International Convention , reflecting Massachusetts' leadership and the extraordinary concentration of human resources in healthcare and the life sciences. The choice of Boston for the conference confirms what thousands of people who come here for treatment already know: Massachusetts is the global leader in medical care and life sciences research.
Greater Boston's outstanding teaching and research hospitals make up the core of the healthcare and life sciences sector. A recent report by the Conference of Boston Teaching Hospitals documents that Greater Boston's teaching hospitals are the largest driver of the regional economy, outpacing other vital economic sectors.
But history teaches that leadership is fleeting. As difficult as it is to get to the top, it can be more difficult to stay there. National and global competitors want what we have and are determined to get it. As gratifying as the numbers are, complacency is dangerous.
Each year the 14 Greater Boston teaching hospitals and their affiliated medical schools generate $24.3 billion in total economic activity, attract more than $1.38 billion in federal research funding, and contribute $839 million to local and state coffers. In Massachusetts, the hospitals employ nearly 100,000 workers and support almost one additional job for every worker directly employed, for a total employment impact of 175,000 jobs.
The state is now home to more than 300 biotechnology firms and more than 200 medical device manufacturers. Knowledge-based firms follow the talent and Greater Boston's teaching hospitals lead the way in the conduct of scientific research, with more than 4,000 clinical trials underway and approximately 100 patents issued annually.
Teaching hospitals in Boston collectively provide more than $200 million in nonreimbursed care to those who cannot afford it, and partner with and support more than 300 local agencies providing direct care and promoting public health.
That we provide the best care by the best doctors at the best hospitals in the world is ingrained in our psyche. It is so deep a part of our regional identification and legacy that we run the risk of taking it for granted.
The sky is not darkening yet, but the clouds are gathering. Other cities and states are determined to replicate in a matter of years and decades what Boston has developed organically over more than a century. Reputable medical centers in Philadelphia, Pittsburgh, Baltimore, Cleveland and St. Louis, and emerging life sciences markets like San Diego, Phoenix and Charlotte, North Carolina, are poised to make a "great leap forward" by adopting highly aggressive public strategies, involving mixes of public-private partnerships, tax incentives, expedited permitting, incubators for start-up companies and other subsidies to lure talent and businesses.
If we don't respond, we run the risk of losing our edge. We don't necessarily need to match our competitors dollar for dollar, but we do need to take action to create conditions that sustain our leadership, not just in healthcare and the life sciences, but in other critical sectors as well.
The state needs to invest in affordable housing and facilitate the construction of new housing. The high cost of housing is driving up labor costs and driving away skilled workers. From internationally acclaimed researchers we want to recruit to those less visible staff who keep the hospitals running, living in and around Boston has become prohibitive.
The Commonwealth must commit to investment in science, technology, engineering, and math education at all levels and in public colleges and university to address the shortage of skilled workers that threatens current healthcare and research activities.
It needs to foster a favorable regulatory environment for the conduct of medical research and education, which will fuel growth and private investment.
It needs to advocate collectively and in concert with other New England states for a renewed federal commitment to medical research with real and predictable growth in National Institutes of Health funding and resist pressures for cutting Medicaid and Medicare funding that are the lifeblood of health care and research advances.
Greater Boston's teaching hospitals are firmly rooted in their communities. But many of the thousands of doctors, nurses, and scientists who provide the most advanced care and conduct the leading research, and hundreds of biotech, pharmaceutical and medical device companies that invest the capital and create the jobs will rightly go where opportunities take them. Massachusetts must make sure that the best opportunities remain here.
Dr. James Mandel is chairman of the Conference of Boston Teaching Hospitals and president and CEO of Children's Hospital Boston. 
