billion. so sales grew. but net profit dropped from the year before. that has -- the stock dropped, ended jeff bezos' brief run as the world's richest person. he briefly dethroned bill gates thursday morning. >> which had twitter going nuts when he was the world's richest man. for moments. i'm christine romans. >> i'm dave briggs. the health care repeal and replace failed in large part to john mccain. "new day" starts now. welcome to our viewers in the united states and around the world. this is "new day." it is friday, july 28th, 6:00 here in new york. we do begin with breaking news. republicans' seven-year push to dismantle obamacare goes down in a stunning defeat. senator john mccain living up to his nickname, the maverick, casting the decisive vote against the gop's last-ditch

effort to repeal major parts of obamacare. >> what a night it was. president trump blasting the senate vote saying that three senators let the american people down. the president tried to sway mccain, but that did not work. what is next in the health care fight? phil mattingly is live on capitol hill with all of the breaking details. you've had a very long night, phil. >> reporter: good morning. a lot of people have had a long night. the furious lobbying not just taking place behind the scenes but in public view on the senate floor. senate majority leader trying his best just to get the 50 votes he needed to move forward. in the end, one senator made clear wasn't going to happen. >> the yeas are 49, the nays are 51. the motion is not agreed to. >> reporter: the republican party's seven-year effort to repeal obamacare collapsing after a dramatic senate floor vote that dragged on into the early morning. [ gasp ]

in the end with senator john mccain casting the decisive final no vote. siding lisa murkowski and susan collins who voiced disapproval on every measure voted this week. the republicans' last-ditch amendment, the skinny deal voted down 49-51. >> this is a disappointment. i regret that our efforts were simply not enough this time. >> reporter: mccain rejecting despress plea was vice president -- desperate pleas from vice president and mitch mcconnell. none of it swaying the veteran senator who lived up to his nickname, the maverick. >> tonight was an unfortunate night. it was a sad night. i don't believe this journey is over. >> now, mr. president, it's time to move on. >> reporter: the vote capping off a day of uncertainty as

republicans shuffled back and forth to meetings on the senate floor, desperately trying to rangle votes for a skeletal bill to move it back to the house. the failure was seen early thursday evening as mccain joined colleagues castigating the bill and the . >> we've got to have republicans and democrats sit down together and come up with a bill that gets a majority in both houses. >> reporter: mccain's close friend, senator lindsey graham making clear the merits of the bill were lacking. >> the skinny bill as policy is a disaster. the skinny bill as a replacement for obamacare is a fraud. >> reporter: each seeking assurance that the house would not pass the senate bill the republicans were trying to pass themselves. ryan eventually relenting saying the house was willing to go to conference, but it wasn't enough for mccain who said in a statement that the speak's

assuran assurance, quote, did not ease his concern that this shell of a bill could be taken up and passed at any time. >> obviously a very dramatic night and morning. but the idea that the senate majority leader would put the bill on the floor and have it fail is big. the idea he would put the bill, the thing these republicans have campaigned on for more than seven years as the basis for why they have the majority in the senate, majority in the house and in part why they have the white house and have that fail, it is a dramatic, huge, huge deal. what happens going forward, it's an open question. senator mcconnell saying they're going to move on. we've seen fits and starts and failures and revivals. one senior gop aide told me in a text this morning, this was a kill shot. we don't know how we'll move forward from here. at least for the moment, the republican repeal effort seems dead. >> phil, thank you for underscoring just how big a night it was on capitol hill and how dramatic some of these

moments were. we'll be back with you in a moment. president trump reacting to the defeat of twitter vowing again to let obamacare implode and blaming everyone else. cnn's athena jones with more. good morning, athena. >> reporter: good morning, alisyn. this is a setback for the president and this white house which has struggled to show they could get big things done legislatively with republicans in control of both houses of congress. the president took to twitter not long after that bill failed writing three republicans and 48 democrats let the american people down. as i said from the beginning, let me obamacare implode, then deal. watch. that tweet telegraphing the president's strategy of publicly blaming and shaming those republicans who blocked this effort, but also highlighting something we've heard from the president for months now, this idea that obamacare should be allowed to implode or explode or

collapse, whatever word you want to use. that, of course, would have wide ranging implications for a lot of people. as we heard in that earlier piece, it was arizona senator john mccain who cast the third no vote, this despite the president seeking with senator mccain, trying to lobby him in a last-minute phone call on the floor as vice president mike pence had gone to the capitol hoping to cast the tie breaking vote. in the end, he played the role of last-minute lobbyist. the white house is likely to turn their attention to tax reform. the other key question is whether the white house can show they're good at something other than infighting. alisyn, chris? >> athena, thank you very much. >> big morning. it's still going on. the lights in the white house were on until just a couple hours ago. let's figure out how we got to this point.

let's bring back phil mattingly and bring in cnn political analyst ron brownstein, washington correspondent for "the new yorker" ryan lizza. gentlemen, thank you for being with us, especially after such a long night. professor brownstein, on one level this is a reflection of the obvious, right? easy to say repeal and replace, easy to campaign on it. to actually do it when millions and millions of lives are on the line and you have a structure in place, not so easy, and yet this is billed as a shocker. why? >> because the majority leader has had a history of pulling rabbits out of his hat and we're in a more parliamentary era where the parties usually stick together. i think there are two levels of problems. the first is a structural problem, that this bill was revoking health care from over 20 million people. that was the core of what it was doing, not reforming the health care system. taking away health care from 20

million people, many of whom, as we've talked about many times, were republican voters. i think what ultimately killed it more than that was the tactical choice to try to short-circuit all the process, no hearings, no markup, no engagement with democrats, trying to do this solely among republicans. the house that left them vulnerable to be whip-sawed by every faction. and the senate didn't have enough margin for error. finally, chris, i would point out that the president was simply no help in trying to do something this big. whatever his role internally in terms of trying to rangel republicans, and you get mixed reviews on that, in terms of ability to sway the public, it wasn't here. this was looking at under 20% support. in the end i think all the forces weighed it down. proved again that thomas jefferson was right when he said a long time ago, great innovation should not be forced

upon a slen jer majority. they didn't have the votes to do it on a party line basis. the question is are they willing to try to shore up the markets in obamacare which do have problems but would require them in all likelihood to abandon the quest to retrench medicaid. >> phil mattingly, for people who are just waking up, i want to visit that moment of john mccain walking up in that dramatic and poignant moment and giving the thumbs down. you could hear -- right there. if we have the audio, you can hear the democratic side of the chamber was about to erupt, even more so. but chuck schumer waved them off, this is no time to spike the football. after the week that john mccain has had -- have had, it's just remarkable. i guess the call that the president made to john mccain -- i don't know if you can fill in some color on that, but it

didn't work. >> it didn't at all. an audible gasp you're hearing and a lot of shuffling. reporters sprinting out of the chamber. reporters aren't allowed to have cell phones in the chamber. while we had been hearing in the hours leading up that there was a chance mccain would be no, we've heard that a lot with senator mccain in various bills up to this point. when he put the thumbs down, it was that dramatic of the moment, everybody sprinting out to tell their editors, all of that happening. when it comes to what thement did last night, the vice president was the main person lobbyist, he would have been the tiebreaker had senator mccain voted for this. what i'm told is mike pence and senator mccain had stepped off the floor, the vice president working with senator mccain for 15, 20 minutes trying to assure him, trying to make clear this shell of a bill they were passing wouldn't be signed into law, house republicans wouldn't

pass it. at one point during that conversation the president connected with the vice president, the vice president handed the phone to senator mccain and the president made his pitch. i'm told it wasn't a very long conversation, but john mccain simply wasn't going to be moved. it's worth noting here that throughout the day mccain kept dropping hints this was coming. he had several calls with senator chuck schumer -- you have to keep in mind that the bill that mccain cares about is on deck, the national authorization act. so the signs were there, but the fact that republicans couldn't figure out a way to get him to buy into this, it was a major moment, and i can tell you that even as leaders got their heads around the fact that he wasn't going to come around even as dramatic as it was in the senate chamber for the members themselves and the staff that i've been talking to this morning, they just thought they were going to get there. they thought they had figured out a way to keep the process moving. to have it short-circuited in

such a dramatic moment, it was breathtaking. >> john mccain has a gift for political theater. ordinarily there's a roll call, they call the name and you vote. he didn't follow that ro ses. he walked in before the roll call and gave the thumbs down. >> it's a statement -- no way to see it in another way other than he was making a statement after his surgery and being called back from this. you have to wonder if republicans are happy they called him back from his convalescence in arizona. >> this is a man who votes his conscience. he had been talking to his governor. when you look at arizona, when you look at maine where collins is from, when you look at alaska, you have similar dynamics at play with why this bill -- which didn't touch medicaid. that's part of the skin any. that's a non-starter in states where you have big pockets of people who are either old or

poor, and those states all check those boxes. he had been talking to his governor. so it made sense -- not political sense but real economic sense to real people's lives that there would be difficulty for these senators in going along with something that just sucks money out of the system and takes care of the young and the healthy. >> look, sometimes things here in washington do happen the way they happen in the movies, a senator gets off his -- i don't want to say death bed, but gets out of a serious operation with a very serious diagnosis, obviously the issue of health care is related to that, comes to washington, makes a dramatic speech, senator mccain. what was at the core of his speech the other day? it was about the process. let's be honest, john mccain is not a health care wonk. this is not his issue. he's never taken a great interest in health care, but he cared about the process.

as ron brownstein said, there were no hearings, no markup, and what he was being asked to do this morning, a couple hours ago, was just frankly a crazy process of, don't worry, this bill is not what we actually want to go into law, we want to get it across the senate line, pushed into a conference committee and we'll keep going. i think a lot of people looked at that and said that's really not the way the united states congress is supposed to work, but one person who has made a huge -- he's made this the core issue for him is jain. interestingly he did vote for one of the other bills this week. he was a yes vote on one of the other three bills that came along, but he not only delivered the death knell for this health care process, but perhaps for president trump's entire presidency in this first year. his entire legislative agenda was premised on passing health

care as part of this multilayered process of health care, tax reform and the budget. that is all now in shambles. >> here is what president trump had to say via twitter. he said three republicans and 48 democrats let the american people down. as i said from the beginning, let obamacare implode. then deal. watch. ron, how much of this can you lay at the president's feet? this wasn't his plan. this is republicans for the past seven years. where is president trump on this today? >> several points you can make on that. first, he made the fundamental choice at the beginning to go in a very different direction than he promised during the campaign when he famously pledged to not cut medicaid, medicare or social secure. he went all the way down the rode with the ryan-infused health bill that was fundamentally about rolling back the government role in health care, cutting taxes, reducing

federal spending on both subsidies and fundamentally transforming medicaid. that was the core problem. they could never get over the line with that kind of maximal bill, i think largely because it hurt so many of their own constituents and in the process turned against them, several of the key republican governors, as well as every single interest in the medical community, from doctors and hospitals to all the patient groups and aarp and so forth. but i think the biggest thing the president did is what he didn't do, the failure to build any suppopublic bill for this b including older and blue collar whites who are cornerstones in the republican coalition. he didn't provide the air cover they needed. and he didn't question the process that cut out democrats from the beginning and left them with very little margin for error. now the question is, are they ready to deal with the real problem and the exchanges. in listening to mitch mcconnell, it doesn't sound like they're planning on going down that

route. >> we'll talk about that next. all the viewers want to know where health care stands. that's next. >> we'll talk about it because what happens now, not the politics of it, the policy, the reality, what the president just suggested, let the aca implode. one, is that a fair reflection of what's going on, and is that the real risk for republicans, allowing people to lose health care on their watch. we've got a great panel next. hi. i'm the one clocking in...

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as i said, we look forward to our colleagues on the other side suggesting what they have in mind. so now, mr. president, it's time to move on. >> senator mcconnell, not just tired after an all-night effort, but crestfallen. they failed, republicans, to get their own version of repeal and replace for the aca. so now what? what does this mean to the president's agenda? what does this mean to americans' ability to depend on health care. let's bring back our panel, perfect group of reporters for this. ron brownstein, ryan lizza, phil mattingly. phil, in a way that sets us up for where we should have been all along, which is republicans, you're in control, but you have to work with the democrats. we know there are issues in the

individual markets. we also know now there's a higher level of popularity for the aca than we've seen since its inception, so fix what's there. is that a reality? >> it's a difficult dynamic. look, there are republicans who are game for this. there's a recognition that short-term stabilization, some funding mechanism for the marketplace right now, obviously the cost sharing reduction money for the insurers, that needs to be settled as well. laura alexander who chairs the senate health committee is ready to move forward on a bipartisan basis. the baseline for republicans that they campaigned on is repeal. if repeal is not what they're pursuing, conservatives made very clear they're not going to help fix something. they were never for a fix, they didn't campaign on fixes. basically you would have to get individuals who made very clear that is their only position here to modify that stance in order for people like speaker paul ryan or senate majority leader mitch mcconnell to everything

something like that to the floor. there's clearly going to be work done at the senate house and committee level. whether you pass something and send it to the president's desk is an open question. there's a lot of uncertainty whether conservatives would, not just even come on board, but allow it to move through the process. >> ron, talk about the ripple effect of what happened last night. the tax reform -- the success of the health care battle had a direct correlation to what happens with tax reform and the budgets, et cetera, et cetera. so now where does this leave us? >> right. they wanted the dollars from particularly the medicaid cuts that would have resurfaced as part of a tax reform. it could have a rebound effect. cutting taxes is easier for republicans to coalesce around than retrenching a new

entitlement that over 20 million people now depend upon. it's possible they may rally around the idea of cutting taxes, although there's a divide there of whether it will be revenue neutral and thus permanent or a net tax cut and only last ten years. i think on health care, the key question is are you willing to stabilize the exchanges. the problem has been, in the individual market, as chris pointed out, not in medicaid. the problem in the individual market has been worse in states that did not expand medicaid. there are things you can do, but as phil i think correctly points out, it's not clear that republicans want to do that which is an enormous roll of the dice. they are now running government and will be accountable for outcomes. and if totally torches on their watch, that could be an issue on 2018. >> one quick more beat on this, ryan lizza, the president's reaction, the president's posture, his recommendation, let the aca implode. let's put to the side for a

second there is misinformation and misperception that the aca is in a death spiral. put that aside because this is about politics, not necessary reality. his sell is let it fail. that's a tricky dynamic for the steward of american well-being, let it fail. what would that mean? that would mean let people suffer, let care not be delivered. is that a saleable proposition? >> just think of what the presidential oath is. the presidential oath is to take care that the laws are faithfully executed. the idea that the president of the united states would tweet so glibly that as president he's not going to support a law that is not just on the books, but attempt to repeal it has just failed, so it's the law of the land. i think the real question is does he mean it and will he actually take affirmative actions to undermine the law because, as you pointed out,

chris, it's not -- there was a lot of exaggeration about the death spiral of obamacare. it has some serious problems that both democrats and republicans agree on, but it's not just going to collapse the way trump says unless the federal government takes some affirmative actions to do that. i think that's one major question, does anything from the white house push that process along. secondly, they have a real process issue in congress as phil and ron were noting. they have to do a new budget. when they do the new budget, the old budget reconciliation bill they were using to push health care through -- i know this is a little confusing, that then disappears and they no longer have this reconciliation process, this 50-vote process in the senate. they won't have that anymore. so it really is sort of the end of the line forgetting this through the senate on a 50-vote margin. >> phil, we have less than a

minute. next agenda item, the border wall. mexico does not appear to be paying for it. so there is a big budget item, $1.6 billion. where is capitol hill on this? >> the house is through. they got it done yesterday. republicans were able to insert it in the bill, not have to take a stand-alone vote on that issue and were able to get it through even though there were a couple republicans opposed to it. here is the issue, senate democrats made it clear they won't support anything that funds the border wall. the other issue is when you're talking about this process moving forward, senate democrats are going to be needed to actually pass this. this is the appropriations process, not budget reconciliation. you need 60 votes to move forward which means republicans need at least eight democrats to come forward. so long as they hold firm on that, we have a problem and leadership has a problem. it will be interesting to see negotiations play out going forward. chuck schumer has made it clear, the border wall is their issue that is their red line. they won't vote for anything that funds the border all.

we're looking for another fight on appropriations when it comes to that issue, one of a series of very, very hefty fights to come. guys, obviously the next big issue is tax reform. we'll see how that goes. that's going to be a long and complicated process as well. >> one little note for people because we like to tell you what to look for going forward. the best indication that there's a chance something positive could be done on health care will be in the form of drug pricing. if you see republicans and democrats in the short term come out with something on drug pricing -- because that's the biggest area -- >> of agreement, for sure. gentlemen, thank you very much for all that reporting. politics uncensored. white house communications director anthony scaramucci exposing not only a war in the west wing, but a vulgar rant-filled mindset in this interview. ryan lizza had it. he shares his extraordinary interview with us next. it's not a quick fix.

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i'm gonna just go back to doing what i was doing. find your awesome with the xfinity x1 voice remote. fomy doctor recommended ibgard. abdominal pain and bloating. now i'm in control of my ibs. nonprescription ibgard- calms the angry gut. so infighting and chaos appears to be consuming the trump white house as there's this war between two of the president's top advisers and it is now playing out in public. >> at least two. >> sure. here is the picture if you need a visual of this, of this stand offer. there's tension between the white house communications director, anthony scaramucci and

chief of staff reince priebus in the oval office. and that photograph captures it. >> this is one of those rather moments where we now know what has been suspected, what's going on in this white house is atypical and it is counterproductive. yesterday we had an exclusive interview with anthony scaramucci. he came on to explain what was going on, the frustration about leaks, the disorder. that's why he was brought in. ""the new yorker's"" ryan lizza was on yesterday, on today, had a big interview with scaramucci where scaramucci went off in the interview with him about what was going on, how he felt about it, he used coarse language. let's talk about this, the interplay of what's going on. you've got ryan there. you see him on your screen. a couple things we want to discuss. let's deal with the substance and then the reporting issues that the interview brings up. in terms of what you now know

about what's going on in that white house, what do we know? >> we know anthony scaramucci was not wanted in that role. the chief of staff -- obviously the president has the final word, but the chief of staff makes most staffing decisions. reince priebus didn't want anthony scaramucci to come to the white house and that was going on for about six months. he blocked scaramucci from meeting privately with the president, finally scaramucci got the president's attention and he got the job despite reince's objections. we saw a press conference a week ago where they tried to -- where scaramucci tried to say things were papered over. and since then, since that week, there were a number of stories that came out that were critical of scaramucci, and scaramucci believed they all came from reince. so when he saw me wednesday

night report about a dinner, a private dinner that scaramucci and others had with president trump, for whatever reason, scaramucci believed that information came from reince priebus, and he called me to ask me about it. >> and all hell broke loose, i think it's fair to say. >> that's where it started, he called me. >> for people who may have been in a hermetically sealed cave yesterday and somehow missed the news of your incredibly -- well, whatever, a lot of fireworks. i'm struggling for the words. >> and she's an author. you don't know how to say this in a nice way. >> i will attempt to read a portion of the phone call -- >> careful. >> i tried this on air yesterday. it's not as easy as it looks. >> i'm going to try it. here is just a portion of what scaramucci told you. reince is a blanking paranoid

schizophrenic, paranoiac. he channeled priebus, as he spoke, oh, bill shine is coming in. let me leak this blanking thing and see if i can blank block these people the way i blank -- chris is doing a great job of being my sensor. he doesn't seem to understand the rules of journalism. he wanted you to reveal your sources to him, and he told you you would be a patriotic american if you would. he also doesn't seem to understand the rules of off the record. so tell us where today your impressions are of this phone conversation you had with scaramucci. >> that's how the interview started. he called me and started asking me about how i knew about this

dinn dinner. basically, as he worked himself up, talked about it as if it was a fact that reince leaked it to me. i said it a couple times yesterday, reince did not leak it to me. he was not the source. privately i know scaramucci now knows one of my sources about that dinner. i think that source actually went to scaramucci and told him this person was a confirming source. it's not very interesting to confirm to journalists who the president is having dinner with. it happens all the time. it's frankly one of the things that the white house is fairly open about. it's strange that the dinner set him off. the back story is he had been increasingly upset, paranoid that negative stories in the press were coming from the chief of staff. so that's how the conversation

started. then just launched into a series of questions. he's the white house communications director. the communication director spokesman for one of the most powerful institutions in the world. as a reporter, when you get them on the line, you want to ask some tough questions. >> not off the record. >> let's talk about that. obviously there's a dispute. anthony scaramucci apologized for his language. he said he was passionate. he didn't apologize for what the context was of the two other gentlemen. >> he didn't apologize to steve bannon or reince priebus. >> there's probably good reason for that because in his mind, and as we both heard from plenty of sources, he's got a two-headed dog trying to bite him in that white house. it's bannon and priebus. he's got a reason for paranoia and to be upset.

we know that. how he handles it, that's a matter of dispute. there's a different issue, ryan, he made a mistake trusting you he says. he thought this was off the record. you say you had it all recorded. in the recordings which you haven't released yet, does it ever come up whether or not this is on the record? >> i had a conversation with anthony yesterday afternoon. i didn't want to post the piece until i had a chance to talk to him and walk him through what was going to be in the piece and explain it. i will say in that conversation anthony made 100% clear to me, look, i understand that interview was not off the record, totally within your rights to publish it. i don't want to say anything more about that conversation, but that was the takeaway from that conversation. >> he says he knows it is on the record? i want to stop you, ryan. it wasn't that he felt it should be off the record and that you

were burning him if you wrote on it? >> we had a conversation yesterday where we both agreed that the conversation was 100% on the record, right? now, did he want me to publish it? no. after the fact, the morning after, he was not very excited about the fact that it would be published, but the key question that you asked about being on the record, we were in agreement and we had a conversation -- in fact, that conversation was recorded as well. so there was no ambiguity about this, chris. the communications director at the white house called me and we conducted an interview without setting any ground rules at the top. just like anthony scaramucci called into your show -- just as if he called into your show right now and started talking and later says, wait a second, i wish i hadn't said that. >> when somebody calls in, they

know it's on the record because you're on television. >> as the communications director, he should know the rules. >> that's why i'm asking how the conversation went, ryan. as we know, people don't call you and say off the record or on the record all the time. it's about the relationship you have with them. you say the key point. you have a recording of anthony scaramucci saying to you i know this was on the record. >> yes. we talked about it before the piece was posted. the communications director at the white house called the reporter, started talking and i conducted an interview with him and then i reported on the interview. that's as clear as day. >> yes, it is. we are happy that you published that interview so that we could all see, this is not just a team of rivals in the white house. it is the hadfields and mccoys at the moment. i think your interview captured the mood there.

ryan, thank you very much for being on with us for these past two days and explaining all the reporti reporting. >> appreciate it, ryan. >> thanks, guys. see you soon. back to the policy at the heart of the matter. the aca, obamacare, is here to stay, for now at least. it's the law of the land, but there are problems, there are cost issues. so will the people come first? and if they do, if they have the political courage to work together, what does need to be addressed? we have one of the architects of the aca who has those answers next.

john mccain, he's the face on your screen because he cast the decisive vote that ended the debate on whether or not the skinny repeal would become the bill out of the senate. it didn't pass. the question is, now what? let's bring in dr. ezekiel emanuel, one of the architects of obamacare, the chair of medical ethics and health policy at the university of pennsylvania and the author of "prescription for the future:

the 12 transformational practices of highly effective medical organizations." doc, good to have you. >> nice to be here again. >> let's check the main boxes. the first one, why was the skinny repeal insufficient even for some republican senators to vote for? >> well, it was just bad policy. look at lindsey graham who called it a pig and a poke, a disaster. everyone knew it wasn't policy. it was there as a face saving device to get into negotiations with the house. i think that senator mccain realized that it really was a trap because, if they couldn't come to agreement on a big bill with the house, then the fallback was this terrible pig in a poke bill. >> why terrible -- the operative notion was this, the aca doesn't work, it's too expensive for

people, deductibles are too high, you've got insurers fleeing too many markets. we're going to fix that by healthy people getting one kind of bill and not mandating all these things that makes it too expensive. what do you say? >> well, look, the skinny bill would have basically completely eliminated the individual insurance market. 15 million people would have been thrown off of coverage. insurers would have fleed that market, much, much worse than anything that's happened under the current affordable care act. the real thing we need to do, chris, is to move on to cost control and to change how we deliver care. that's what i address in my book. the real issue, as americans have said over and over again now, is affordability. they need more affordable care. the only way over the long term to make care more affordable is to change how we care for patients, especially patients with chronic illness. and why i try to document in my

book are 12 different things that doctors and hospitals and home health agencies can do to change that care and to make it much more effective, much more affordable and improve the quality. that in the long run is going to bring the premiums down, make the deductibles more affordable. that's the direction we have to go. hopefully the republicans are open for it. >> help us understand. are you saying that the solution lies with the providers or the policymakers or a combination of both? >> it's a combination of both. you need providers to provide the right playing field, mainly changing how they pay hospitals and doctors. there are a few other things they need to do. they need to change policies. and then doctors and hospitals with new incentives need to change how they care for patients. just to give you one example, we know that chronic illness accounts for about 84% of all the spending in the health care system, and there are lots of places that have done better at keeping patients with diabetes

or heart disease out of the hospital, at home and healthier by actually hiring chronic care coordinators, reaching out to patients, not waiting till they get sick, changing how they schedule their appointments so they can come in any time, things are sliding down a little bit. those kind of changes can make a huge difference. decrease hospitalization 10, 20, 30%, reduce the amount of other resources people use like home care. it can be very, very cost saving as well as improving the health of people. that's where we need to be today. >> if people want to know where do we go from here, there's a book they should read, "prescription for the future." you've got a dozen ideas in there literally about what can be done on the provider level and how our policy makers can make that into the standard for the country. that will bring costs down and that makes it better for people. do i have it right, doc? >> you got it perfectly.

you can do the pr pour the book, chris. >> you've only been telling me this for anti five years. glad i finally figured it out. dr. ezekiel emanuel, thank you very much. >> hopefully the political system will figure it out because that's where the american public wants us to do. get the costs under control so we can afford it and get good quality care. it's doable. >> the most hopeful thing i've heard in about 42 hours. >> jeff sessions breaking his silence last night over president trump's relentless attacks. what's next for sessions? former attorney general alberto gonzalez sharing his thoughts next. only exclusive retailers carry tempur-pedic. find yours at tempurpedic.com.

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well, it's kind of hurtful, but the president of the united states is a strong leader. if he wants to make a change, he certainly can do so. i will be glad to yield in that circumstance, no doubt about it. >> that's attorney general jeff sessions speaking out about president trump's repeated public criticism of him. he says he stands by his decision to recuse himself from the fbi's russia investigation. joining us is former attorney general alberto gonzalez. he served in president george w. bush's administration. he's the dean at belmont university law school and the author of "truth and allegiance." do you think jeff sessions will be in his job a month from now or do you think president trump will fire him and make an august recess appointment? >> i think that's very

unpredictable. i will say i admire the way jeff sessions has handled this. he's says very little as i think is appropriate and he's put his head down and is working hard on behalf of the american people. we must remember the cabinet secretary serve as the pleasure of the president. >> the president no longer has the pleasure of his service. i think it's fair to assess it that way, given the president's tweets. >> i think the correct response is you could be upset at the performance of the cabinet secretary and not make a decision to remove him. so the president will make a decision on his own based upon whatever factors he believes are appropriate, in deciding whether he wants to have jeff sessions continue. as i said, i think jeff sessions is doing the absolute right thing which is to say very little about this and continue to work hard on behalf of the american people. >> jeff sessions did go on last night and said a little more about this, and how he feels about his own decision to recuse

himself. listen to this. >> i'm confident i made the right decision, the decision that's consistent for rule of law. an attorney general who doesn't follow the law is not very effective in leading the department of justice. i think with 15 years in that department, having served in that great department, knowing the integrity that's required of the attorney general, i believe i made the right decision. >> do you think jeff sessions made the right decision? >> i think based on the reporting, if, in fact, his ethics advisers are telling him this is the right course of action both under the law and under the regulations of the department of justice, yes, i do believe it. it's hard for me to second-guess his decision based upon the public reporting. i stand behind the decision by jeff sessions. i think it's the benefit of the department of justice. and i think strengthens his position as the attorney general. >> so in that case, what do you think of president trump dressing him down so publicly?

>> listen, i don't know president trump, and people have different management styles, different ways in which they express frustration or deal with subordinates. i'm not going to criticize the president's manner in the way he deals with his cabinet secretary. it's certainly different than when i was attorney general for the united states working for president george w. bush. again, you serve at the pleasure of the president. >> do you think this shows a pattern of some kind, of the president publicly going after our law enforcement leaders? i'll give you the most recent list. there was james comey, former fbi director, now jeff sessions, robert mueller he's quite disenchanted with, even fbi director andrew mccabe. are you comfortable with the president of the united states seeming not to respect the independence of our law enforcement and judicial leaders? >> well, of the cower

individuals you mentioned, i know three quite well, of course, mueller, comey and jeff sessions. these are people that are not going to be intimidated. these are tough jobs, and you make tough decisions and you're going to be criticized. and you know that, but you continue to do your job. i don't believe they're going to be affected in any way from moving forward an enforcing the laws of this country, just based on the criticism of the president of the united states. >> i hear you, but why do you seem reluctant to tell the president to knock it off? >> listen, i will say this, i don't think it's helpful to attack the attorney general. the attorney general must be seen as strong and enjoying the full support of the president of the united states because it's the attorney general who will tell the other cabinet secretaries, no, you can't do that under the rule of law. having the full public support

of the president can be very effective and helpful for the attorney general to be effective in doing his or her job. to that extent, i am worried about the public criticism. >> alberto gonzalez, we appreciate you coming on "new day." >> thanks for having me. >> the repeal to obamacare went down in stunning defeat last night. what happens next? we have it all covered for you. when heartburn hits fight back fast with new tums chewy bites. fast relief in every bite. crunchy outside. chewy inside. tum tum tum tum new tums chewy bites.

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>> there are going to be a great many americans who tonight feel a sense of betrayal. >> senator john mccain voted no. he has made his career out of being a maverick. >> this is a moment that he understands is going to help cement that. >> got to have republicans and democrats sit down together and come up with a bill that gets a majority in both houses. >> we really do have to work together. this has been one of the least productive legislative periods in the history of the united states of america. >> a lot of finger-pointing. everybody is going to blame somebody else. >> this is "new day" with chris cuomo and alisyn camerota. >> we begin with breaking news. stunning defeat and high drama in the senate. senator john mccain casting the deci