Meet the Press   |  December 22, 2013

What lies ahead for health care

A Meet the Press roundtable talks about the recent developments on the implementation of the Affordable Care Act and what lies ahead for the law.

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This content comes from Closed Captioning that was broadcast along with this program.

>>> we are back with our political roundtable here. i want to get back to the big political story, robert gibbs , which is the bosched health care care rollout. bosched health-care rollout was number one with government shutdown number two. here is the president on friday. listen.

>> since i'm in charge, obviously we screwed it up. i'm going to be making appropriate adjustments once we get through this year, and we've gotten through the initial surge of people who have been signing up.

>> what makes you think 2014 looks better on health care ?

>> well, i think they have no choice but it get it right. i've said this all along, that the most important thing in the second term was implementing health care reform the right way. 2013 was a forgettable year in that sense. they've got to do all they can to make the implementation of and the sign-up period as it goes and extends until the end of march, they've got to make that work.

>> listen, there are two issues here. there's first the competency issue. that's by far the most important issue. the least important issue is the mandate issue. basically when you have a government program, you build the system and you say to people, you have to work within the system and sometimes we have to limit your choice. we're going to mandate things. the american people don't like mandates any more. we're a much more individualistic culture. and when they've faced mandate or surrender on this bill, they've surrendered each time. if we can mandate all along so you have to expect they'll weaken and surrender on the mandate down the line.

>> i think there is something crazy when people say where government can't deliver health care . ever heard of medicare? ever heard of medicaid? and there's a man at a time to pay taxes for those things. this thing is complicated because president obama chose to go for a model that is a market-oriented model that republicans favor of helping people buy private health insurance . that proves to be very complicated. but what you're seeing already is there is an enormous appetite among all the americans who don't have health insurance to buy it, and that's what's going to save obamacare. this is filling a real need in the society. and you have to say, they sure lowered expectations for obamacare.

>> society is not the same as it was in the 1930s and the 1960s . there is less faith in government, it's much more consumer based. so if you can't force people in the system and people rebel against enforcement, then you have a problem.

>> edward burke believed in less confidence for them to deliver, and they keep backing off of things they say have to be in there.

>> i don't know how you can be optimistic about it working better next year when all we see are delays. i've lost track of the delays they've granted. i think one of the bigger problems, and longstanding problems, it has eroded the trust people have in this president. trust is a lot easier to establish than it is to recover once you've lost it. and that's something they'll have to work on.

>> every rich democracy in the world uses government to deliver health care . you had christine lagarde on. france spends less per capita in government spending to cover everybody than we spend for just medicare and medicaid . so this thing can work. it needs fixes, and i think the next move by the president is to tell republicans, you want to fix this or do you just want to get rid of it?

>> and know this. if all of these predictions are true and we're at sort of the low point of obamacare, we still don't have a majority of polling the belief we ought to repeal it. they believe we ought to repair it, because as e.j. said, there is tremendous demand for particularly the uninsured or those with preexisting conditions that have always been told no by insurance companies . there is tremendous demand for it. i believe david is right, but one quibble of them is i believe the technical aspect of the website is crucially important because quite frankly it is the intake valve for everything in health care right now. getting that and continuing to get that right is a huge, huge thing.

>> you agree that fixing the website is easier than fixing the policy? the policy is the crux of the matter and you've got problems that are going to continue to happen as the corporate mandate goes in. we're going to start seeing people losing their insurance, and there's going to be a lot of angry people.

>> isn't the crux of the matter that people don't like government telling them this is what is best for you, as a business this is how you have to operate. so in our quest to do good -- again, this is the argument -- it's too coercive.

>> corporations tell you you're too old for that program or whatever; sorry.

>> we have a much more individualistic country. we don't like the government telling us what to do.

>> but a lot of people don't want them to repeal obamacare. a lot of people saying repeal obamacare say it's just fine to have big government for people over 65. i agree you need to prove that government can do this competently. but we've done that on social security , we've done that on medicare, we need to do that on this.

>> in spanish there is a famous saying, the cure is worse than the illness. and i'm not sure, i'm afraid that obamacare is very much that.

>> the biggest issue --

>> you don't want to debate spanish with me? how do they say it in alabama?

>> what they're saying is exactly what e.j. said. you can't go to the doctor, you can't have that surgery, you can't get that covered. the biggest issue for hispanic voters in 2011 wasn't immigration, it was health care .

>> and the administration couldn't even get the spanish website going until two months after it