Remember that one defining slogan from Bill Clinton's 1992 presidential campaign — "It's the economy, stupid"?

Clearly we are experiencing a bit of dèjà vu. Debates raging in Washington, in statehouses, on Main Street and on Wall Street all center on an uncertain economic climate. The slogan, however, should probably be altered slightly this time around to "It's jobs, stupid." As you surely know by now, President Obama is slated to deliver a major speech next week to a joint session of Congress on jobs and there's a lot of pressure on him to deliver some innovative ideas. After all, the economy added just 117,000 jobs last month, according to the Bureau of Labor Statistics, which did little to alter the 9.1 percent unemployment rate.

Health care has been one of the lone bright spots in an otherwise dismal jobs market. BLS reports that health care employment grew by 31,000 in July. Hospital and ambulatory services combined for 28,000 of those jobs. Health care has added 299,000 jobs during the past 12 months.

BLS predicts that health care will create 3.2 million new jobs by 2018, "more than any other industry, largely in response to rapid growth in the elderly population." Ten of the 20 fastest growing occupations are health care-related. BLS goes on to suggest, however, that hospitals will experience some of the slowest growth at 10 percent, compared to outpatient centers at 38 percent and home health services at 46 percent.

As the New York Times reported a couple of weeks ago though, there's a growing pool of skeptics who wonder if health care can remain immune to the same economic forces that's plaguing other industries. Daniel Sisto, president of the Healthcare Association of New York is quoted in the article saying, "It's not realistic to believe that we're going to continue to generate job growth when you're speaking about Medicare and Medicaid reductions in the hundreds of billions of dollars over the next few years."

To take Sisto's point one step further, we know from our own reporting and elsewhere, that hospital executives are looking for ways to trim their costs by upwards of 20 percent just to maintain current operations. Staffing and workforce issues will obviously be in the crosshairs. So a big question for hospitals is: how can they continue to be economic and jobs engines all the while needing to hold the line on costs? Oh, and let's not forget about that migration of services (and jobs) to outpatient services.

We hope to tackle some of these challenging questions in an upcoming series on cost containment, which will run in both H&HN Daily and H&HN. We are very interested in hearing your stories and experiences in controlling costs. Feel free to email me at

Matthew Weinstock is the Senior Editor of Hospitals & Health Networks magazine.