Obama hopes for 'sensible' health debate 'once I'm gone'

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President Obama said Monday he hopes the country can have a “sensible conversation” about reforming healthcare spending “once I’m gone,” because the debate has become so politicized. 

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In meeting with the nation’s governors at the White House, Obama took a question from Kentucky Gov. Matt Bevin (R) about how to control the debt. 

Obama pointed to healthcare costs in Medicare and Medicaid as the main driver of the debt, but said that some actions on that front might have to wait. 

“Maybe once I’m gone we can go back to having a sensible conversation between Democrats and Republicans about how we should incentivize greater efficiency, better outcomes, higher quality for lower cost in our healthcare system, and if we do that, that’s going to make the biggest difference,” Obama said. 

The president acknowledged the fierce debate around ObamaCare has dominated the conversation for the past several years.

“My hope is that we get into a serious conversation, maybe it will have to happen once I’m gone, because the Affordable Care Act and the debate around healthcare has gotten so politicized, so toxic, that we can’t have a sensible conversation about it,” Obama added.

Obama also took a jab at Bevin, himself. Bevin has vowed to roll back Kentucky’s expansion of Medicaid under ObamaCare, though he wants to negotiate with the administration to reach a compromise on changes, rather than completely eliminate it. 

Obama touted Medicaid expansion, and said, “It’s going to save you money over the long term, it’s been done really well in Kentucky, but that’s a whole 'nother question.” 

The administration is already trying to make the kinds of shifts in healthcare payments that Obama referred to, moving to paying based on the quality of care instead of simply the number of procedures provided. 

Health and Human Services Secretary Sylvia BurwellSylvia Mathews BurwellHHS launches contest to make bills simpler Obama administration takes step to reform Medicare payments Rubio breaks with GOP, backs Obama Zika request MORE has set a goal of having 30 percent of Medicare payments be based on quality by the end of 2016, using new payment models created under ObamaCare that seek to incentivize efficiency and coordination among care providers. 

There is also a bipartisan effort in the Senate Finance Committee to make Medicare payments for chronic care more efficient, which backers are hoping can move forward even in an election year.