Washington ? President Barack Obama has said he wants to focus laser-like on the public’s top concern: jobs. But the ongoing effort to remake the nation’s health care system keeps getting in the way.

The White House held a ceremony Thursday in the sunny Rose Garden where Obama signed into law a $38 billion jobs bill containing a modest mix of tax breaks and spending designed to encourage the private sector to start hiring again.

There is debate about how much the jobs package, which includes $18 billion in tax breaks and $20 billion for highway and transit programs, will actually encourage hiring. Optimistic estimates are that the tax breaks could generate 250,000 jobs by year’s end, a tiny portion of the 8.4 million jobs the economy has shed since the recession began in December 2007.