In the grand finale of the 2013 HIMSS Annual Conference and Exhibition in New Orleans, Karl Rove and James Carville took the stage for a most theatrical debate on sequestration, party politics, immigration and, of course, healthcare reform.
The debate started out light — amiable even. Rove, former deputy chief of staff for President George W. Bush, began by telling the audience of healthcare IT professionals his favorite restaurant in the Crescent City (Dooky Chase, for those inquiring minds). Political consultant James Carville opened by thanking the audience for selecting New Orleans as conference destination. "You're The Super Bowl of conventions," he said.
After arguing topics of party politics and sequestration, by the time Carville and Rove started on the subject of healthcare, the conversation proved considerably more heated — although never devoid of humor, offensive as it may have been. Carville, on several occasions, rolled his eyes at his opponent or pretended he was falling asleep. And, after he repeated this several times, Rove responded by feigning a deep slumber himself when Carville spoke.
When asked about healthcare, Rove called President Obama's Affordable Care Act a "gigantic disaster, financially," saying the nation needed to find alternatives — and quickly. The best place to find those alternatives, Rove contended, is Bill Clinton's Medicare reform commission and "steal the idea championed there by Democrat Senator John Breaux of Louisiana," referring to Breaux's premium support proposal.
"I don't want to say it too loud," Carville said, "(but) the last three years have been the best three years in terms of healthcare costs," he whispered to the audience — a comment eliciting laughter and applause from the crowd. "If that trend were to continue, that would be about the best thing we could have." Carville supplemented his point by citing the fact that Medicare delivers healthcare cheaper than any other system. "If we have one problem that could kill us, it is our percent of GDP we spend on healthcare costs."
Carville candidly conceded that the ACA is not absent of imperfections, but contended it's the best step forward to address the millions of Americans who are without health insurance. You find out what part of it works, he added, and keep going with it; then find out what doesn't, and tweak it.
"Let's not give credit to a bill that we're raising taxes and robbing money out of Medicare for, but have yet to begin operating," retorted Rove. And although Carville called attention to the lower costs associated with Medicare healthcare delivery, Rove referenced the fact that Medicare pays the average healthcare provider roughly 80 percent of what private insurance companies ladle out. "There's a lot of cost shifting going on here," he said, and those costs are being covered by non-Medicare patients.
"I never said that Obama didn't have anything to do. I merely said these last three years have been the best three years we've hard," Carville blurted out. "This ain't Fox News, you can't just make stuff up."
A litany of shouting matches ensued, punctuated with Rove's interjections again that Medicare has a lower reimbursement rate. Another interruption from Carville, "If the hospital's charging $18 for an Advil, you don't pay 'em."
After several back and forths, interruptions and accusations, moderator Mark Romig, CEO of New Orleans Tourism Marketing Corporation attempted to move the conversation onto the topic of immigration. "Now moving on to something a little less controversial."
[See also: Clinton urges IT pros to help healthcare]