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Layoffs and employment cutbacks have become an unwanted but common occurrence since the economic downtown began about four years ago. Nobody likes them, and they have caused untold grief for millions of American families. But in some cases, they have been necessary for companies and governmental entities to survive, and that’s the sad fact that appears to be true about the recent layoffs at KershawHealth.

The county-owned medical complex laid off 24 employees earlier this week, and that came on top of 36 jobs that had been eliminated through attrition. It was the first round of job cuts since 2006 and means that KershawHealth has, during the past five years, eliminated nearly 10 percent of its job force. But CEO Donnie Weeks made a good point with a succinct explanation: “We must run the hospital like a business.” Of course, he also stressed high-quality patient care, so it wasn’t as if the mission were simply a slash-and-burn operation.

Health care is a tough go these days for hospitals. KershawHealth must not only compete with larger institutions in the Midlands but also faces the same situation that other hospitals do: caring for indigent patients who receive wonderful and skilful care but don’t pay anything. That’s one reason “paying patients” are often shocked when they see their bills.

The hospital’s board of trustees has indicated on several occasions that being bought or merged into a larger institution is not something that’s palatable. We imagine that most county residents agree with that. In order to stave off being swallowed up, the hospital must produce good operating results rather than red ink. The latest cutback schedule is one way to pare costs and improve the bottom line. It’s not popular, of course, but it’s necessary.