• With: Ezekiel Emanuel

    This is a RUSH transcript from "The O'Reilly Factor," March 4, 2014. This copy may not be in its final form and may be updated.

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    O'REILLY: "Factor Follow Up" segment tonight, American doctors and Obamacare. Last November the medical firm Jackson and Coker surveyed American doctors about the Affordable Healthcare Act. More than 3,000 physicians took part; 61 percent of them say their opinion of Obamacare has changed for the worse. Even more damning, 44 percent of American doctors say they will not participate in the Obamacare exchange. A disaster.

    With us now Dr. Ezekiel Emanuel, one of the architects of the Affordable Healthcare Act and author of the brand new big book "Reinventing American Healthcare."

    So if almost half of the doctors opt out, I don't see how this possibly works.

    EZEKIEL EMANUEL, M.D., FORMER OBAMACARE ADVISOR: First of all doctors will not opt out, not half of them that says they won't participate in the exchange. It's not doctors who participate in the exchange. It's insurance companies that participate in the exchange.

    (CROSSTALK)

    O'REILLY: Because they don't take the insurance companies.

    EMANUEL: The doctors will take who is in the exchange because they have to. There is a large number of people who will be there. Furthermore if you actually --

    (CROSSTALK)

    O'REILLY: Wait, wait I'm confused. I'm confused I didn't get to read your book but your book explains a lot of this.

    EMANUEL: Yes.

    O'REILLY: But I'm confused. From what I understand from my own personal doctor who is going to opt out, they are going to set up boutique services. All right, many, many American doctors. And they are going to charge people to a certain fee a year to see them. They are not going to accept any insurance as many doctors don't now. This is what I think may happen.

    So the pool of doctors then in America shrinks. You are telling me that's not going to happen?

    EMANUEL: No, I don't think that's going to happen.

    O'REILLY: You don't think?

    EMANUEL: Look, you don't know the other. You are just making speculation, too.

    O'REILLY: No, it's 44 percent say they are not going to participate in the insurance.

    EMANUEL: In the exchange.

    O'REILLY: Right.

    EMANUEL: But they don't -- they don't actually participate in the exchange. That's a misnomer and the question is a bad question.

    O'REILLY: They're not going to take Obamacare insurance.

    EMANUEL: They will take Obamacare insurance. Very few doctors can go and just take people who pay cash. Because healthcare is expensive the vast majority, 98 percent of Americans cannot simply pay cash for their healthcare.

    O'REILLY: They can take certain -- certain kinds of health insurance as you know. All right now --

    EMANUEL: But look --

    O'REILLY: Go ahead.

    EMANUEL: -- when you do poll doctors, especially young doctors, the under 40s, 60 percent of them actually support Obamacare and like it and those who have actually begun to transform their practice so they are really focusing on giving people -- keeping people healthy. They are focusing on people with chronic illness and keeping them out of the hospital, they actually like that practice better than the current practice.

    O'REILLY: All right you're generalizing but there are about 800,000 practicing physicians in this country right now.

    EMANUEL: Right. That's correct.

    O'REILLY: If 44 percent bail at this certain --

    EMANUEL: We are not going to have 44 percent bail out of the system.

    O'REILLY: (inaudible) also says that a lot of doctors are not going to get caught up in this. They are just not going to do it. So if they do and it cuts down to 500,000 or 550,000 it's going to be a problem. Now when I travel around, I travel a lot of places, all right? I see these clinics open up and I'm sure you do too.

    EMANUEL: Yes.

    O'REILLY: All right the healthcare clinics. And they are like walk- in clinics. You've got something wrong? Come on in and they are staffed by physician assistants.

    EMANUEL: Right.

    O'REILLY: And nurse practitioners and things like that.

    I think that's where this Affordable Care Act is going into that kind of treatment. Am I wrong?

    EMANUEL: That's going to be one part of a complex.

    O'REILLY: I think it's a growing part. It's going to be big.

    EMANUEL: It's going to be one part of a complex part of the healthcare system. So if your kid has a sore throat and you want to find out if it's strep throat or your kid has what appears to be an ear infection and you want to find out if it's otitis media. You really don't need to go to the pediatrician.