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tv   President Obama Discusses Health Care Law Repeal Effort  CSPAN  January 6, 2017 4:16pm-5:28pm EST

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>> they tried to assign her stories like flowers but she kept busting out and wrote stories about divorce laws and largely because of her mother's experience. she wrote about conditions about women who worked in factories and the medical treatment of the poor. >> sunday afternoon at 4:00, the nasa film "friendship 7" documenting john glen n's orbit earth. he ad at 8:00 on the presidency, constitutional law professor talks about the 22nd amendment. >> no person shall be elected to the office of president more than twice and no person who has held the office of president for
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more than two years of a term to which some other person was elected president shall be elected to the office of the president more than once. the interview took place at blair house in washington, d.c.,. t's an hour. xx >> good morning. and welcome to the blair house. speak tor and honored to
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with president obama about the affordable care act. its performance and passage and now uncertain future. we would prefer to hear from him than me. president elcoming barack obama. president obama: hello. hello. hello. [applause] >> good morning. president obama: great to be here and thank you so much for all the good reporting you guys have been doing on this important issue. >> thank you. >> we'll get started. there was an expectation that was shared among many of your staff, many congressional democrats as the aft rolls out and delivers benefits to
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millions of people that it would become more popular and safe from repeal or substantial reform and it appears that isn't quite true. what do you think you got wrong and why didn't the health care law become more popular? president obama: let's back up and say from the start there's a reason why for 100 years, no president could get expansion of health care coverage beyond the work that had been done for medicare and medicaid targeting primarily seniors. and the reason was that this is hard. the health care system is big. it is very personal. families, i think recognize the need for health insurance, but it's not something that they
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think about except when things go wrong, when you have an accident or you're sick. and so, any costs particularly at a time when families are feeling stressed, higher premiums and higher co-pays ends up having real impacts on families. and so the challenge of getting t passed was always the fact that unlike other advanced countries, we didn't start with a system in which everybody was covered. and we have a very complicated marketplace and we have third-party insurers and what that meant was even after we got he law passed, anything that dissatisfied people about the health care system could be
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attributed to quote, unquote, obamacare even if it had nothing to do with obamacare. and that was something that we recognized even when we were trying to get the law passed. the other thing is the fact that republicansgness of in congress and around the country, including some governors, to after the fight was over to say, all right, let's try to make this work, the way democrats did during the time when president bush tried to expand the prescription drug program, part b -- part d, meant that the public never heard from those who had originally been
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opposed, any concession that, you know what? this is actually doing some good. and that ends up affecting public opinion. and the third thing is that whenever you look at polls that say, well, 40-something percent are supportive of the law 40-something% are dissatisfied in the dissatisfied column are a whole bunch of bernie sanders' supporters who wanted a single-payer plan. so the problem isn't that they think obamacare is a failure, but they think it didn't go far enough and left too many people still uncovered, the subsidies that people were getting weren't as rich as they should have been and there is a way of dealing with prescription drug makers, in a way that drives down those costs.
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so all those things meant that even after the law was passed, from was still going to be a lot of tough politics. having said all that, the thing that i have been most proud of is the fact that not only have we gotten 20 million people covered, not only have we been able to reduce the pace at which health care costs have been going up ever since the law has passed, basically health care inflation is as low as it has been in 50 years, which saves the federal government hundreds of billions of dollars, extended the medicare trust fund by 11 years, but most importantly for the people who have gotten insurance through the exchanges, there has been pretty high satisfaction rates as surveys
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have shown. so rather than look at public i nion as a whole, the thing have been interested in, these are real families that have gotten real coverage. and i get letters every single day from people who say this has saved my life, who h or this has saved my bank account, or this has made sure my son who got hooked on sort of opioids was able to get treatment or i was able to get a mammogram that caught a cancer in time. and that ultimately is the measure of the success of the law. >> do you think this dynamic where you reform the health care
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system goes the other way. republicans are being with the repeal and delay situation and president-elect trump wants to cover as many people. do you think that the dynamic in which you became responsible for what people didn't like is going to hamper republican movement in their efforts to change a system that maybe they don't like but maybe has a lot of people relying on it? president obama: let me start from a very simple premise. if it works, i'm for it. if something can cover all americans, make sure that if they have a pre-existing condition, they can still get coverage, make sure that prescription drugs are affordable, encourage preventive
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measures to keep people healthy, to make sure in rural communities, people have access to substance abuse care or mental health care, that medicare and medicaid continue to function effectively, if you can do all that, cheaper than we talked about, cheaper than obamacare achieves and with better quality and it's just terrific, i'm for it. i think that part of the challenge in this whole debate -- and this is true dating back is this back to 2010 -- idea that somehow we had a fixed way of trying to fix the health care system that we were rigid and stubborn and wouldn't
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welcome republican ideas and if we only had, they had all these great solutions. in fact, if you look at how this law evolved -- and i have said this publicly before, if i was starting from scratch, i robably would have supported a single-payer system because it is easier for people to understand and manage and that's hat medicare is single payer system and people are satisfied with it and it's not that complicated to understand or to act on services. but that wasn't available. we weren't starting from scratch. what did i then do? i said where is the system that seems to be providing coverage for everybody that politically we could actually get through a congress and where we could get republican support. and lo and behold in
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massachusetts there was a plan that had been designed on a bipartisan basis including by a republican governor who ultimately became the nominee or the republican party that came close to providing universal coverage. and i would have thought, since this was an idea that had previously gotten a lot of republican support, that it would continue to get a lot of republican support. and yet, somehow, magicically, the minute we said, this is a great idea and it's working, republicans said this is terrible, and we don't want to do this. [laughter] president obama: i say all this to make something very clear. om the very start in the earliest negotiations in 2009,
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2010, i made clear to they icans that h that if had ideas that they could show could work better than the ideas we had thought of, i would be happy to incorporate them into the law. and rather than offer ideas, what we got was a big no. we just don't want to do this. after the law passed, for the last six, seven years, there has been the argument that we can provide a great replacement that will be much better for everybody than what the affordable care act is providing and yet, over the last six, seven years, there has been no actual replacement law that any policy health care experts have said would work better. in fact, many of them would
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result in millions of people losing coverage and the coverage being worse for those who kept it. and so now is the time when republicans i think have to go ahead and show their cards. if, in fact, they have a program that would genuinely work better and they want to call it whatever they want -- they can ll it trumpcare or mcconnellcare or ryancare, if it actually works, i will be the first one to say, great. you should have told me that back in 2009. i asked. [laughter] i suspect that will not happen and the reason it will not topen is because if you want
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provide coverage to people, then there are certain baseline things you have got to do. number one, health care is not cheap. and for people who can't afford health care or don't get it through their job, that means the government has to pay some money. number two, all those provisions that the republicans say they want to keep making sure that people can get health insurance even if at the they have a pre-existing condition, well, it turns out the only way to meet that guarantee is to either make sure that everybody has some modest obligation to get health care so they are not gaming the system or you've got to be willing to provide huge subsidies to insurance companies so they're taking in people who
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are already sick. and i think what you're going to see now, now that we have a republican president-elect, if republicans control both chambers in congress, is that all the promises they made about how they can do it better, cheaper, everybody's going to be satisfied, are going to be really hard to meet. nd this is why the strategy of repeal first and replace later is just a huge disservice to the american people and it's something that i think whether you are republican or a democrat, you should be opposed to. these are real lives at stake. i'm getting letters right now from people who say, i'm terrified because my son's or
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daughter's insurance, their ability to get lifesaving drugs or ability to get treatment or ability to get mental health services are dependent on us being able to get affordable health insurance. if there is going to be a assive undoing of 1/6 of our economy, the republicans need to put forward very specific ideas about how they are going to do it, people need to debate it and study it, the same way as we did passing the affordable care act and let the american people gauge is this going to result in something better than what obamacare has produced. and if they're so convinced they can do it better, they shouldn't be afraid to make that presentation. it is really interesting to try
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to figure out, why they are trying to rush the repeal so quick. what is it that they're afraid of? why wouldn't they want to say here's our plan and show side-by-side, here's why our plan is better than what obamacare has produced? because they have said absolutely, adamantly that they can do it better. i'm saying to every republican right now, if you, in fact, can put a plan together that is better than what obamacare is publicly support repealing obamacare and replacing it with your plan. but i want to see it first. i want to see it first. [applause] president obama: and i want
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third-party objective people, whether it's the congressional budget office or health care experts across the ideological spectrum or fox or -- >> be happy to. he president obama: just evaluate it. and the public will not have to take my word for it. we can designate some referees. and if they can show they can do it better, cheaper, more effective and provide better coverage, why wouldn't i be for it? why wouldn't i be for it? somehow this is about obama preserving his legacy. keep in mind, i'm not the one who named it obamacare. they named it obamacare because they wanted to personalize this and typically towards me and
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their party as an organizing tool. it's politics. but i don't have pride of authorship. if they can come up with something better, i'm for it. but you have to show and i would advise every democrat to be for it, but you have to show it is better. and that's not too much to ask. and that's the challenge. the question right now for paul why and mitch mcconnell is is it that you feel obliged to repeal it before you show what it is that it's going to replace? because the majority of americans think that is a bad idea. you have republican governors and some republican senators who think that is aren't a good idea ent -- idea. and no explanation why you would want to do this before the next
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president is even inaugurated. what exactly is this rush, particularly if you are going to delay the actual repeal. if they were making the argument that this was so disastrous that we have to repeal it completely today because it's just terrible , well, i would disagree but at least i could understand it, but you say we are going to vote for repeal but delay its effects. but why if it's so bad? if the answer is, it would be disruptive and don't want to take peoples' insurance right away, then that means you have time to show us and show the american people who need health insurance what exactly you are replacing it with. i know that was a long answer. [laughter] president obama: but in that
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sense, the answer is the republicans will own the problems with the health care repeal f they choose to something that is providing health insurance to a lot of people and providing benefits to every american, even if they are getting it through the job and they haven't shown us what they are going to do, because then they own it because that irirresponsible. even those who are opposed to me said that isn't responsible. >> president-elect trump said on twitter, quote, time for republicans and democrats to come together and come up with a health care plan that works. i remember you said that in 2009 and 2010. knowing what you know now about bipartisanship, what three
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pieces of advice would you give someone trying to attempt to pass a bipartisan health care law? president obama: well, look, i think i sort of gave the advice if, in fact, h is this is not about politics, but this is about providing the best possible health care system for my merican people, then advice would be to say what precisely is it about obamacare that you think doesn't work because you already think you said some things do work. the republicans keep on saying, well, we want to keep the things that people like and that are working well. that obamacare
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says kids can stay on your insurance plan until they are 26. they think that's a good idea. they think it's a good idea, if you have a pre-existing condition, you can still get health insurance. i assume they still think it's a good idea that seniors have gotten discounts on their prescription drugs and closed the doughnut ole during the course of obamacare. they approve of some of the changes we've made to encourage a healthier system that rewards quality rather than just the numbers of procedures involved and how we pay providers. so we could make a list of all the things as terrible as obamacare is, actually they think works, according to them.
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all right, let's make a list of the things they don't like or the american people are concerned about. well, what we know is that people would always like lower costs on their premiums and of-of-pocket expenses and although the affordable care act provides a lot of subsidies to a lot of subsidies, we would love to see even higher subsidies to relieve the costs even more, but that costs money. what we also know is that where we have seen problems in the implementation of the affordable care act, it has been in certain areas, particularly more rural areas, less densely populated areas, where we're not seeing as many insurers, so there's not as
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much competition. well, one way that we have suggested you could solve that problem is to say that, if, in fact, there aren't enough insurers to drive competition and reduce costs and give people enough choices, then we should have a public option that's available. so if you look at the things that people are frustrated about with obamacare, the affordable care act, the big things are the subsidies aren't as high as they'd like and don't have as many options as they're like and i'm happy to provide both those things. i signed on to a republican plan to give more subsidies to people to make it even cheaper and have whereic op shon -- option there isn't an option. i don't think that's the thing
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they want to do. [laughter] president obama: but i guess my point is this. that it is possible for people of goodwill to try to come up with significant improvements to the law we already have, but it does require to be specific about what it is that you think needs to be changed. and that so far has not happened. and my advice to the president-elect -- until fact we talked about this when i met hourhim for an hour 1/2 -- and a half right after he got elected, make your team and make the republican members of congress come up with things that they can show will actually make this work better for people. and if they're convincing, i think you will find that there
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are a lot of democrats out there, including me, that would be prepared to support it. but so far, at least, that's not what is happening. >> i think obamacare has exposed between controlling costs in the system and controlling economic pain for individuals. the law has come in under budget but it is hirblinge deductibles, higher co-pays and in a couple of years if it doesn't change, the excise tax on high value insurance will come into play, the individual mandate and the individual people while they keep the usage of health care down and costs, they make health care feel more expensive and more unusable. do you think the affordable care act got the balance on controlling system-wide costs versus isolating individuals from their health expenses? let me make a couple of
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distinctions. what happened at the eginning of the marketplaces wonks those who aren't -- [laughter] resident obama: this is like a wonkapalooza. there is some serious policy detail here. so the marketplace is where insurers put up -- here's the insurance package we're offering and you can choose from a variety of different packages and once you've chosen, you can figure out the subsidies that you are qualified for and give u a sense of your out of
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pocket costs here. a lot of insurers underpriced early on because they had done surveys. and look, people who were purchasing health insurance are like purchasing anything else. they would like to get the best deal for the lowest price. when you buy a tv, you can see what the picture looks like. when you are buying health insurance, it's tempting to initially buy the cheapest thing until heaven forbid you get sick and turns out, i can't see the doctor i want or specialist i want or this is more inconvenient than i expected. people bought oftentimes the cheapest insurance they could. insurance companies wanted to get as much market share as possible ended up creating a
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very low cost plans, but those are going to have restrictions on. and that's not just if you are buying health insurance in obamacare, that's generally how it is even when employers buy health insurance for their employees. now i think that what we're eeing is insurers now making adjustments, saying, ok, we need to charge more and that is something that the good news is, appears to have may have stabilized and may be a one-time thing and now we are able to do an he valuation of have we gotten this balance right as you say. we can't get health care for free. you are going to have to pay for
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it one way or another. either the government is going to pay more so that people don't have as many out of pocket costs or -- and that means in some fashion, higher taxes for somebody, or individuals are going to have to pay more out of pocket one way or the other. the same is true for employers. either employers pay more for a really good health care package but that takes something out of the employers' bottom line or putting more costs on to workers in the form of higher deductibles and higher co-pays. and i think a lot of the good work that can be done in lowering costs has to do with not cost shifting but making the system work better. and we have done a lot of work on that. what i referred to earlier, incentivizing a system that
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instead of ordering five tests because doctors and providers are getting paid for the tests, you have a system where you are going to get reimbursed if the person gets healthy quicker and does not return to the hospital. well, it turns out that over time that can be a cost reduction. those are the kinds of things we are implementing in the system in the consequence of obamacare. the more we do that kind of stuff, the less we are going to see cost shifting. the inteng hasn't been to see make it less expensive to get more health care. e proof of that is, even though per person, costs have not gone up a lot, the overall spending on health care has gone up, because more people have come into the system.
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we want people to use the health care system, we just don't want them to use it in the emergency room. we want them to use it to stay healthy and smoking cessation plans and getting regular checkups and mammograms. but those are the things that are ultimately going to save us as much money as we can. >> i have a wonky follow-up question. what about controlling prices. we have the highest in the united states. most other developed countries, they regulate how much you can charge for an m.r.i. that is at the core of this tension, the fact we have high prices and americans don't go to the doctor. this is something the health care law did not tackle and what would you think about the role of price controls in american medicine.
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president obama: this is the irony of this whole debate. the things that people are most dissatisfied with about obamacare or about the fordable care act are things that essentially in other countries are solved by more government control, not less. and so republicans are pointing at these things to stir up dissatisfaction, but when it comes to, all right what's the solution for it, their answer is less government regulation and letting folks charge even more and doing whatever they want and letting the marketplace work its will. i think that there are strengths to our system because we have a more market-based system. our health care system is more innovative. prescription drugs is probably the best example of this. it is true that we essentially
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come up with the new drugs in this country because our drug companies are fat and wealthy enough that they can invest in the research and development. they make bigger profits which ey can plow back into drug development. and we have other countries that are free riders on that system. so they can negotiate with the drug companies and force much lower prices, but they generally don't have a drug industry that develops new drugs. that's true. this is an example of where you probably do want some balance to maintain innovation, but to have some tougher negotiations around the system as a whole. use are trying to
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medicare as the place where since there is no health care provider or stakeholder in the health care industry that does doesn't in some ways want to get medicare business, we are trying to use medicare as a lever to get better deals for consumers and better prices for consumers, not just those in medicare, but also people throughout the system. but as i said, the irony is, when we try to do that, the people who are most resistant are the very republican members of congress who are criticizing us or at least telling the american people that you should want lower prices on various procedures. if we want to control prices for nsumers more the marketplace
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by itself will not do that. and the reason is because health re is not exactly like other products. it's not like buying a flat-screen tv. if you're sick or your kid is sick, most of the time, you are not in a position to negotiate right there and then. you can't walk out of the store and say, i'm going to see if i could get a better deal. when sha got meningitis said,s four months old, i make my child better and i'll worry about the bills later. the traditional marketplace doesn't work perfectly in the health care system. there are areas where we can increase marketplace competition and make it better, but if we
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want to get at some of these costs, there has to be some more expansive regulation in certain areas than we currently have. i recently took a trip to kentucky and on a different topic and huge coverage under the health care law but voted overwhelming president-elect trump and i met kathy and is an obamacare roll-up and supported you in 2008 and 2012 but voted for president-elect trump. and she would like to ask you a question. president obama: go ahead, kathy. the mike's on.
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audience member: i'm so excited to meet you. president obama: good to see you. audience member: i'm a little bit nervous, i have enrolled and talked to numerous residents of kentucky and signed up for the first time so it was working, the affordable care act. and also we have been going over the years and i have talked to people, but recently we found in that there was choices our area and increase in the premiums and deductibles and our facilities aren't even taking some of them. and many residents of kentucky are looking at their affordable care as unaffordable and unusable and i have the opportunity to ask you a few questions that you probably went over. but how do you think this happened? how can we fix it?
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do we start all over again? what do you think we should do? president obama: first of all, i want to thank you for being out there enrolling people. that has been hugely important. [applause] president obama: the second point i would make is that kentucky is a place where this has really worked and worked for two reasons. one is that kentucky expanded medicaid and we haven't talked a lot about that but a big chunk of obamacare was making medicaid accessible to more people. and those states that expanded medicaid have seen a much bigger jump in the uninsured than those states who didn't. by the way, those states who didn't, they didn't do so just out of politics. i'll be swre blunt. because -- very blunt.
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the federal government was going to pay for this medicaid expansion and states -- there are some states because they had all this uncompensated care ended up making money by providing more health insurance to your people. it was a hard bargain, a hard deal to turn down and yet you have a number of states that turned it down mainly because of republican governors and republican state legislators didn't want it to work. kentucky was one of those that did expand medicaid and had an active program. because i don't poll that well in kentucky, they didn't call it amacare, but called it kentuckyconnect. and there were a whole lot of ople who didn't like
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obamacare. you signed them up. and didn't tell them it was obamacare all the time and it actually worked. what is true in kentucky is true in some other states. you had a governor who ran explicitly on the idea of rolling back obamacare, even though it was working and so the ate marketplace, the state exchange dismantled which means we shifted everything onto the federal exchange. most people got shifted but indicated a lack of interest and effort on his part in making the thing work. he promised to roll back medicaid but started realizing as wasn't as good politics it was when he was running, so he hasn't done that. but what is also true -- and this is my main criticism of as
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it was when obamacare, the affordable care act, is that the subsidies aren't as high as they probably should be for a lot of working people. if you don't qualify if you don't qualify for medicaid, where you don't have to pay for the most part for your coverage and instead you're buying insurance on the marketplace, so you're a working person but you don't have a lot of money, particularly if you e older, where you use the health care system more, and you need a better benefit package than somebody 18 or 20 might, then there are families where the premiums are still too high. and as i said earlier, there are some parts of the country, where
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there are only a handful of hospitals and a few doctors and where you don't have a lot of competition and insurers are looking, saying, we're not going to make a lot of money there. so you don't have a lot of insurance plans in those areas. so the two things that we could do that would really make it work even better for people in kentucky would be, number one, provide more subsidies to folks who are working hard every day but still find the premiums, even with the subsidies, hard to meet. d have a public option for those communities where they're not getting a lot of competition and insurers aren't coming in. the problem is that that's not what is being proposed by mitch mcconnell, the senator from kentucky. instead, what he's proposing, i
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gather, is you're going to repeal the law, then come up with something, except you will have taken away all the -- the way we pay for the subsidies for working people is we're taxing wealthier folks a little higher. he wants to cut those taxes and that money would be gone right away. and then he's going to promise you, or those people who you've been signing up, better health care except there's not going to be any money to pay for it. and nobody has explained to me yet how that is going to work. and so i think this takes me back to the point i made earlier. if in fact the people you've been signing up, the folks in fully mmunities, are not satisfied with the benefits that
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they're getting now and are hopeful for something better, then at the very least you should be putting pressure on your members of congress to say, show us exactly what the deal is going to be for us before you take away the deal that we got. because the people you sign up for, they may in the -- they may not be as happy as they'd like but tell me if i'm wrong, they like it better than not having any insurance at all. and some people didn't have insurance. i get letters from folks who say, for the first time in my life -- i have had a bad hip for 15 years and i've been pain-free for the first time because i finally got insurance. all right? so i -- the answer is not for them not to have insurance. and if we go back to a system where they've got to buy it on their own, they're not going to buy it. because they'll have even less
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subsidy. how much time do we got? we got low time? i've got all kinds of time. >> it's your schedule. we're happy to keep you as long as you'd like. president obama: there's a couple of points i want to make in closing. >> one thing we haven't touched on yet is delivery system. which is a big part of the law. so what's a change that's overperformed your expectations, and one that's not panned out as you'd hoped? president obama: something that worked better than we expected, or at least as well as we expected, is the issue of hospital readmissions. now, it turns out that a lot of times, you go to the hospital, let's say you get your appendix taken out, and then you go home
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and then there's a complication, and then you have to go back into the hospital. that's obviously inconvenient for you and it's expensive for the system as a whole. and it turns out that there are just a few things you can do that help reduce people being readmitted. first of all, making sure that the first procedure goes well. but secondly, making sure that there's good followup. it might be that a hospital or a health care system pays for when you do go home, you just getting some phone calls to remind you to take the medicine that you've got to take to make sure you heal properly. because if, you know, they may have done a study and it turns out that people forget. to do what they're supposed to do. they don't follow exactly their doctor's instructions and can't
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afford to have a nurse in their house doing it for them. maybe there's just a few things that can be done to make sure they do what they are supposed to do and that way they don't have complications. what we've seen is a significant reduction in hospital readmissions over the course of this law, just by doing some smart incentivizing. just saying to hospitals, we'll reimburse you or we'll give you some other benefit for doing smart followup. that's an area where i think we've made some real progress. the other place, and this is connected, where i think we've got some good bipartisan support, is just encouraging what's called shifting from what's called fee for service payments, where you get paid by the procedure, which means that
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you may end up getting five tests instead of getting one test that's emailed to five providers who are treating you. and we've started to see some real movement when we say to the system as a whole, we're going to pay you for outcomes. did the patient do well? and that has been helpful. i think of areas where we haven't seen as much improvement as i'd like, it's probably one thing that comes to ind is on the electronic medical records. if you think about how wired and plugged in everybody is now, you can basically do everything off your phone, the fact that there are still just mountains of
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paperwork and you don't understand what these bills are that still get sent to your house and nobody -- and the doctors still have to input stuff and the nurses are spending all their time on all this administrative work, we put a big slug of money into trying to encourage everybody to digitalize. you know. catch up with the rest of the world here. and it's proven to be harder than we expected, partly because everybody has different systems, they don't all talk to each other, it requires retraining people in how to use them effectively, and i'm optimistic that over time, it's inevitable that it's going to get better because every other part of our lives, it's, you know, become
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paperless. but it's been a lot slower than i would have expected. nd some of it has to do with the fact that it's decentralized and has different systems. in some cases you have economic incentives that are pushing against making the system work better. for example, you know, there are service providers, people make money on keeping people's medical records. so making it easier for everybody to access each other's medical records means that there's some folks who could lose business. and that has turned out to be a little more complicated than i expected. >> do you have any closing remarks? one thing i'm interested in is what do you see your role in this debate we're gearing up for as? president obama: let me make a couple of closing remarks. number one, i think it is just ant to remember that
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because people campaigned on repealing this law, it is a much more complicated process to repeal this law than i think was being present odd then ecampaign trail, as my republican friends are discovering. the way this process is going to work, there's this rushed vote that's taking place this week, next week, to quote-unquote, repeal obamacare. but really all that is is a resolution that is then nstructing these committees in congress to start actually drafting a law that specifically would say what's being repealed and what's not. then after that, they'd have to
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make a decision about what's going to replace it. and how long is that going to take? and that stretches the process out further. and so i think whether you originally supported obamacare or you didn't, whether you like me or you don't, the one thing i would just ask all the american sloganto do is adopt the of the great state of missouri, show me. show me. do not rush this process. and to republicans, i would say, what are you scared of? if you are absolutely convinced, as you have been ad-- adamant about for the last seven years that you can come up with
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something better, go ahead and come up with it. i'll even cut you some slack for the fact that you've been saying you've come up with something better for seven years and aye never seen it. but restart the clock. it's interesting that we're here in blare house because this is a place where i met in front of the american people with republicans who had already indicated their adamant opposition to health care and i sat with them for a couple of hours, how long was it? eight hours. kathleen sebelius , my secretary of health and human services, remembered. eight hours on live tv to talk about here's why we're trying to do what we're doing here. challenging them to come up with better answers than the ones we'd come up with. and we spent a year of really
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significant debate. and i would think that given that we now have proof that 20 million people do have health insurance, that we're at the lowest rate of uninsured in our history, that health care costs, rather than spiking way up have actually gone up slower than they have in 50 years, given that the vast majority of people who get health insurance through obamacare have said they're satisfied with their care, and that they're better off than when they didn't have care, given that even though a lot of people don't know it, even if you're not getting health insurance through obamacare, you've benefited because if you get health insurance on the job, it doesn't have a lifetime limit. it doesn't have fine print that could end up costing you a lot of money. given all those things, i would think that you'd at least want to explain to the american
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people what it is that you want to do. minimum i think, is a expectation out of this congress and out of the president-elect. i'd make a second point and that is that we just worked on a bipartisan basis to sign something called the cures bill. that included two really important, bipartisan priorities. one was joe biden's cancer moon shot initiative. because we're seeing so many medical breakthroughs in so many areas that we have an opportunity to make a real dent in how we deal with cancer. which affects everybody. in some fashion. somebody's been touched in your family with this terrible disease. so we got a lot more money for research in that and the bill
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also contained a big investment in opioid -- the opioid challenge. as many of you know, you're seeing more and more communities that are being ravaged by initially prescription drugs, then that ends up being a gateway into heroin. some of which is synthetic ,eroin being produced, fentanyl has terrible rates of overdose deaths. this is not a inner city problem, per se. this is reaching every community. in some ways it's worse in a lot of rural communities. so there was a bipartisan effort for us to put some more money into that. but here's the thing. if we just put money into cancer research and just put money into
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dealing with the opioid crisis, and now we're taking away money that is providing drug treatment services in those very same communities by repealing obamacare and taking away the ability to access a doctor to get new cancer treatments, then we're not really helping anybody. so that's a second point i want to make. a third point i want to make is i would encourage local communities to get involved in this process. and you know, i think part of the problem with this whole law has been that the people who benefit aren't out there making noise, the people who ideologically opposed to it have been really loud. now is the time for people who have benefited or seen their
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families benefit to tell their stories. because ultimately this is not a -- this is not a political game. this is really something that affects people in the most personal ways. my friend is here in the front natoma's of you heard story before a cancer survivor who because she had now a pre-existing condition was faced with either keeping her health insurance at such a high rate, the only way she could get health insurance with a pre-existing condition was to basically pay so much that she could no longer afford to pay her house.e on
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and i remember her writing to me and i thought, you know, that could be my mom. that could be yours. and that's not a choice that people should have to make. and when most people, even if they're not obama supporters, hear natoma's story or the stories of other people who have been helped, they know it's wrong to just take away their health care. and it becomes less about who is winning here in washington, it becomes about how we're doing right by our fellow americans. those stories have to be heard. and i would just encourage people to start telling their stories. tell their stories, you know, you're not only going to get a lot of tension in washington, they want to know this vote and this insult that was hurled back an forth between whoever, but you know what, tell that story in your local newspapers. talk to your local reporters. congress regations.
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that are involved in caring for those in need. make sure that you're telling stories in church. in services. so that people know. because the one thing that i'm convinced about is, the american people want to do the right thing. it's hard to get good information and you know, unless you're reading vox every day which is hard to do. >> not that hard to do. president obama: getting the details of all this policy is -- it's hard. it's complicated. you don't know what's true, what's not true. i mean, those folks in kentucky that you've signed up, you know, there are a lot of people who voted for not just president but
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also for a member of congress who said explicitly, we're going to eliminate this. i understand why people might think, ok, he's going to eliminate it but he will give us something better. but this is hard. you know. and what we don't want is a situation where they make a promise that they can't keep. and i worked on this a long time. if we had had a better way to do this, we would have done it. it would have been in my interest to do it. because i knew i was going to be judged on whether or not it worked. and those areas that don't work had to do with there not being enough money in the system and not adding a public option and i'm more than happy to put those
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in place any time, any place. but that's not, so far, what the republicans are proposing. you deserve to know what it is that they're doing. anyway, i appreciate you guys taking the time to real quick -- >> tell us about your role going forward. anyway, i president obama: my role going forward? i do deserve a little sleep. [applause] and i've got to take michelle on vacation. so -- but i've said consistently that the most important office in the democracy is the office of citizen. and i will be a citizen. who still remembers what it was like when his mom died of cancer younger than i am now. and who didn't have all the
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insurance and disability insurance and support and wasn't using the health care system and not -- enough to have early detection that might have prevented her from passing away. michelle's dad had multiple sclerosis, was part of that generation that didn't have a lot of expectations about health care so just kind of suffered and for years. i mean those are our stories. so it's not like i'm going to suddenly fade away on this. i will be a part of the work of our fellow citizens in trying to make sure that the wealthiest country on earth is able to do the same thing that every other advanced country is able to do. i mean, it's not as if this has
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never been done before. if you're in canada you've got health care. no matter who you are. if you're in france, you've got health care. if you're in england, you've got health care. if you're in australia, you've got health care. if you're in new zealand, you have health care. i remember talking to my friend john keye, prime minister of new zealand. he is part of the conservative party in new zealand. and he said to me in the middle of this health care debate, he said, if i proposed that we took away people's health care, that we repeal it, i'd be run out of office by my own party. because it was just assumed that in a country this wealthy that this is one of the basic rights, t privileges, of citizenship
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n a wealthy country like ours. so i'll be working with all of you. but my voice is going to be less important than the voices of people who are directly affected. and so i would urge everybody to make your voice heard. now is the time to do it. the people who have opposed this were opposing it not based on facts, but were opposing it based on sort of an ideological concern about expansion of the state and taxes on wealthier people that are helping people who don't have as much money, and i respect their role in the democracy. they've been really fighting hard. folks here got to fight just as
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hard. my final piece of advice would be to the news media, which is, generally speaking, when obamacare has worked well, it wasn't attributed to obamacare and when there were problems, they got front page headlines. i think that hopefully now is the time where people can be -- this doesn't apply to vox, by the way. but i think it would be a good time for people to be more measured and take a look at what's -- what are the facts of this thing. because the stakes are high. even on this whole premium issue, increase issue, that happened right before the election, it is true, as i said that insurers adjusted and hiked premiums, but i kept on trying to explain, number one, if you're getting a tax subsidy, this wasn't going to affect your out of pocket costs because the tax credit would just go up, but
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nobody heard that. and number two, these increases in premiums only apply to people buying health insurancen the exchanges, in fact, 85% of the people don't get health insurance through obamacare. and for you, your health care premiums actually have gone up a lot less since obamacare was passed than they did before obamacare was passed. the average family probably saved about $3,000 in lower health care premiums than if you'd seen those same health care cost trends increase at the pace they did before the law was passed. but you know, i didn't see a lot of headlines about that. which i understand. i mean, because it's not -- it's not controversial enough. or a little too complicated to get in a sound bite. so that's why individual voices
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are so important. that's why i'm so appreciative of journalists who actually know what they're talking about. thank you. >> thank you, mr. president. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2017] >> a newly declassified report on russian hacking

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