Uncertainty and skepticism are a cause of sickness in the tried-and-true health care sector, which has been the worst performer in the S&P 500 in 2019–up a paltry 3.8 percent compared to the broader index’s 16 percent. Can the typically-reliable health care eventually cure itself?

Putting the sector under the microscope reveals two trends–middling performance for conventional health care, but astounding gains for biotechnology. The biotech space has been fueled by a spate of mergers as of late, including Bristol-Myers Squibb offering $74 billion to take over Celgene–a deal that could allow Bristol to become a top five pharmaceutical giant. In addition, Eli Lilly offered $8 billion to purchase Loxo Oncology.

“It’s kind of been a tale of two cities–biotech and conventional health care,” said ETF Trends CEO Tom Lydon. “Conventional health care year-to-date–mid single digits. Biotech–some up almost 20 percent year-to-date still after the big correction last year.”

While health care has been relatively unloved by investors as of late, the sector doesn’t reveal weakness in terms of hiring. The Labor Department recently reported better-than-expected payrolls to bring the three-month average to a strong 180,000 jobs created per month–that number is lower than the 223,000 jobs created in 2018, but falls in line with a robust labor market.

Of the 196,000 jobs created, over 35 percent came from the education and health services sector. Specifically, strong hiring came from ambulatory care, hospitals, and nursing and residential care facilities.

For more market trends, visit ETF Trends.