The American health care system is currently in a state of limbo.

Last week, Republicans failed to repeal and replace the Affordable Care Act — also known as Obamacare. The latest CBS News poll shows 49 percent of Americans approve of Obamacare, up from 36 percent in July 2010.

However, 63 percent of Americans surveyed said the law needs some changes.

In this installment of our series, “Issues That Matter,” Cleveland Clinic CEO Dr. Toby Cosgrove, who is also a member of President Trump’s strategic and policy forum, looks at what the Affordable Care Act did well – and where it falls short.

“It tried to improve coverage, it tried to improve quality, and it tried to reduce costs. It certainly expanded coverage,” he told “CBS This Morning” Friday. “The quality metrics across the country have gradually improved. The problem is costs continue to rise and they will continue to rise for a couple of reasons.”

The first reason, Cosgrove says, is that the number of older Americans continues to grow. There are also more ways to treat sick people.

The key to reform then, he says, is for Congress to make the health care system more efficient in treating sick people and keeping people well while also getting down costs.

“Every country in the world is looking at the same problem with the rising cost of health care, and unless we try to have the most efficient care and we try to keep people well and out of the health care delivery system, then I think we’re not going to be able to control [costs],” Cosgrove said.

Next month, Cosgrove is meeting with President Trump, who said last week that Obamacare will soon “explode” on its own. When asked what advice he will give the President, Cosgrove said he will focus on making sure the system is working as efficiently as possible.

“One of the things we have to do is we’ve got to keep people well,” he said. “Right now, 10 percent of the health care costs in the United States result from obesity. We need to address this issue.”

Skyrocketing prices of pharmaceutical drugs and limits on practicing telemedicine are also straining the health care system, he said.

Cosgrove remains optimistic that such things can be changed.

“I think they could happen because it’s hard to argue against decreasing costs and I think this could be a bipartisan supported bill,” he said.

Cosgrove also addressed the opioid epidemic currently plaguing the United States, which he called “a disaster.”

“I don’t think most people realize the magnitude of the problem. During the entire Vietnam War, 53,000 people died,” he said. “Last year, from overdoses of opiates, 53,000 people died. Essentially, we have a Vietnam War taking place in our country every year.”

The introduction of powerful opioids fentanyl and carfentanil – an elephant tranquilizer – into the drug supply has only exacerbated the epidemic, Cosgrove said.

He said pharmaceutical companies, the medical community, and patients can all play a role in reducing the damage of the opioid epidemic.

“This goes across all segments of society and I think the big problem is that society does not recognize the magnitude of the problem,” he said.