Choosing the United States

Michael E. Porter; Jan W. Rivkin

Article | Harvard Business Review | March 2012

Choosing the United States

Abstract

The U.S. is not winning its appropriate share of location decisions, even those involving the high-value-adding activities that the country has long been able to attract. In part, this is because U.S. policy makers are not addressing weaknesses in the national business environment and are doing little to fight economic distortions that disfavor location in the United States. In addition, executives are prone to leave or overlook U.S. locations because they ignore many hidden costs associated with offshoring and do not consider how to enhance the economic potential of U.S. locations. Although both government and business must urgently address some unnecessary weaknesses in the U.S. business environment, there are hopeful signs that sophisticated management teams are reevaluating their rush offshore and, in some instances, are moving high-end mobile activities back to the United States.

Keywords: Decision Choices and Conditions; United States;

Format: Print

12 pages

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Citation:

Porter, Michael E., and Jan W. Rivkin. "Choosing the United States." Harvard Business Review 90, no. 3 (March 2012): 80–91.

Since its establishment in 2005, Hamburg's Martini Klinik had single-mindedly focused on prostate cancer care with a commitment to measure long-term health outcomes for every patient. A wholly owned subsidiary of the Hamburg University Hospital, Martini was a "hospital in a hospital" in close proximity to other hospital departments and services. By 2013, Martini Klinik had become the largest prostate cancer treatment program in the world with 5,000 outpatient cases and more than 2,200 surgical cases annually, with patients coming from all over Germany and from other countries. However, German private insurers were cutting reimbursement for prostate cancer by 15 percent, and denying extra payment for some new procedures, while reimbursement by public health plans was not covering costs. Dr. Hartwig Huland, Martini's founder and Medical Director, was considering how to respond.

Case | HBS Case Collection | February 2009 (Revised June 2019)

Cleveland Clinic: Transformation and Growth 2015

Michael E. Porter and Elizabeth O. Teisberg

The Cleveland Clinic's health care services are internationally renowned for quality. In 2008, The Clinic began to restructure the organization into teams defined around patient needs, rather than traditional medical specialties. "Patients First!" takes shape as the teams measure and report outcomes, coordinate care, and develop to support improving value for patients. In addition to restructuring care delivery in the hospitals and throughout northeastern Ohio, The Clinic has investments, facilities, and staff in several other states in the U.S. as well as in Canada and Abu Dhabi. Now in 2015, as the Clinic's domestic and international footprint continues to expand, its leadership is also focused in maintaining the Cleveland Clinic brand and providing optimal clinical care. Students can explore strategy transformation, geographic expansion, the process of introducing new measurement approaches, alignment of activities with strategic goals, and issues in leading change both within a company and across an economic sector.

Keywords: health; health care operations; health care quality; health care; strategy and leadership; strategy development; Health Care and Treatment; Leading Change; Goals and Objectives; Growth and Development Strategy; Measurement and Metrics; Service Delivery; Organizational Change and Adaptation; Outcome or Result; Health Industry; Cleveland;

Citation:

Porter, Michael E., and Elizabeth O. Teisberg. "Cleveland Clinic: Transformation and Growth 2015." Harvard Business School Case 709-473, February 2009. (Revised June 2019.) View Details

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Amazon’s initial request for proposals for a second headquarters (HQ2), released in September 2017, attracted great attention and, ultimately, proposals from 238 cities and regions in North America. This case discusses the company's decision to split its HQ2 between two locations, and the ensuing response from local politicians and the public.

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Choosing the United States

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