people don't realize those in medicare benefited. and how they benefited is there's something called the doughnut hole which had to do with drug prices.11 million seniors have saved $23 billion. you can do the math. that's on average over $2,000. so the affordable care act wasn't just about the marketplace which has helped get 20 million insured. >> it's not perfect. it has flaws in the system. where are the places you thi it has not lived up to the expectations when it started. where could it be improved? >> we want to continue to work to create more competition and more affordability. the president did a piece in jama, "journal of medicine."