Operating across parts of western Wisconsin, northeastern Iowa, and southeastern Minnesota, Gundersen Lutheran Health System employs more than 6,000 people and has revenues in excess of $1.3 billion. Anchoring the system is its 325-bed hospital and multi-specialty clinic in La Crosse, Wisconsin. I n 2008, Gundersen established an aggressive program called Envision to achieve environmental leadership in the areas of energy conservation and renewable energy, waste management, recycling, and sustainable design. In order to accomplish its goals, Gundersen has set local food-purchasing goals, developed local alternative energy sources, established a multi-stakeholder food cooperative, rehabilitated old buildings into affordable housing and other facilities, built environmentally friendly infrastructure improvements, and offered financial incentives for local homeownership.
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University Hospitals System comprises the 1032-bed, former academic medical center of Case Western Reserve University, and six community hospitals across Northeast Ohio. The system employs more than 24,000 people and generates revenues in excess of $2 billion annually. A key initiative has been University Hospital’s Vision 2010 project, a $1.2 billion, five-year strategic growth plan that started in 2006. As part of Vision 2010, University Hospitals set separate goals to procure from local, minority- and women- owned businesses, and actively aimed to create new supplier capacity within the city. It also hired a third party to hold it accountable, voluntarily entered into a unique Project Labor Agreement, and has now started to apply this vision to its entire supply chain purchasing. Further still, University Hospitals is involved in other job creation and wealth building initiatives in the community.
The Pluralist Commonwealth is a systemic model, developed and refined over the last forty years by political economist and historian Gar Alperovitz, which attempts to resolve theoretical and practical problems associated with both traditional corporate capitalism and traditional state socialism. A central emphasis is the reconstruction of communities—and the nation as a community—from the ground up. Hence, it might also be called a Community-Sustaining System. The term “Pluralist Commonwealth,” however, is offered to stress the inevitability—for functional as well as scale reasons—of different (plural) institutional forms of wealth democratization.
Despite Cleveland Clinic’s global presence, the vast majority of the system’s operations are based in Ohio, where the system is the largest employer in the northeast part of the state and second largest in the state. Cleveland Clinic’s main campus alone employs more than 26,000 people, has revenues of nearly $4 billion, and procures more than $1.5 billion in goods and services annually. In recent years, it has adopted a variety of anchor strategies, including shifting a percentage of procurement locally and to minority-owned businesses, participating as an anchor partner in a comprehensive neighborhood revitalization effort, implementing childhood wellness programming in local school districts, and positioning itself as a leader in sustainability.