. >> joe coopersmith. i just recently, the director of medical research program of the va. one thing that everybody agrees upon is that costs have to come down. no matter how that's done, whether it's redistribution or deficiencies or whatnot, it's going to be there's less money in a system for hospitals and other aspects, less people employed an absurd amount of economic change for both the institutions and the community because hospitals are among the highest earners, or highest employers in many, many communities in the country. i wonder how you see that aspect of it? >> do you want to go first? you're absolutely right. the change that's gone on in the american economy is such, and the growth of the american health care system is such, and communities around the country, hospitals are the major employer or one of the major employers. cedars-sinai is the sixth largest employer in los angeles county, just as an example. but at the same time all of us have to recognize that as organizations will have to be more efficient, have to figure out how to deliver care. there are te

, right >> joe coopersmith. recently the director of the --earch program in the v.a. one thing that everyone agrees upon is that costs have to come down and no matter how that is done, distribution, efficiencies, what not, it means money in the system for hospitals and other aspects, less people employed, with a certain amount of economic change for the institutions in the community, because hospitals are among the highest earners in many, many communities in the country. i wonder how you see that aspect of it. you are absolutely right. the change that has gone on in the american economy is such and the growth of the american health-care system is such that in communities run the country, hospitals are the major employer or certainly one of the major employers. cedars-sinai is the sixth largest private employer in los angeles county, just as an example. at the same time, all of us have to recognize that as organizations, we are going to have to be more efficient. we are going to have to figure out how to deliver care in ways we have not thought of until now. technolog

, right >> joe coopersmith. recently the director of the --earch program in the v.a. one thing that everyone agrees upon is that costs have to come down and no matter how that is done, distribution, efficiencies, what not, it means money in the system for hospitals and other aspects, less people employed, with a certain amount of economic change for the institutions in the community, because hospitals are among the highest earners in many, many communities in the country. i wonder how you see that aspect of it. you are absolutely right.