Political gladiators Rove, Carville take to healthcare arena at HIMSS13

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 began 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 absent of humor, offensive as it may have been. Carville, on several occasions, rolled his eyes or pretended he was falling asleep. After a few incidences, 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 go looking for those alternatives, he added, is Bill Clinton's Medicare reform commission to "steal the idea championed there by Democrat Senator John Breaux of Louisiana," Rove added, 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, eliciting laughter and applause from the audience. "If that trend were to continue, that would be about the best thing we could have." Carville pointed out that Medicare delivers healthcare cheaper than any other system. "If we have one problem that could kill us is our percent of GDP we spend on healthcare costs."

He candidly admitted that the ACA may not be perfect, but said it's the best step forward to address the millions of Americans who don't have health insurance. You find out what part of it works, he added, and keep going with it, and 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," Rove retorted. And although, Carville pointed out the Medicare delivers healthcare cheaper, Rove mentioned that Medicare pays the average healthcare provider roughly 80 percent of what the private insurance company pays. "There's a lot of cost shifting going on here," he added, 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 yelling match then ensued, with Rove interjecting again that Medicare has a lower reimbursement rate. Carville interrupted, "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," he said.