The trade journal for our industry, Modern Healthcare, had a recent article entitled, "Staff Cuts - Industry claims that fed's debt reduction plans will lead to massive layoffs" and it certainly hit home. After what was announced yesterday at WMHS that we would be separating around 20 employees from the system, but all tolled eliminating 95.1 positions of our 2200 positions, the article was very timely. For 2013, the job loss numbers are projected to range anywhere from 250,000 to 766,000 with hospitals suffering the greatest loss. The article noted that hospitals across the US are streamlining operations in preparation for spending cuts in Medicare. My blog of September 14th, the State of the System, laid out the challenges that we have been experiencing as well as what is on the horizon for WMHS. The State of the System report served as a backdrop for the actions being taken this week. These are not easy times, but certainly we have an obligation to our community to ensure that we are providing health care in a way that we enhance quality, reduce cost and improve the overall health status of the community.