Healthcare was by far the feistiest part of Thursday’s HIMSS13 closing session featuring Karl Rove and James Carville.
During a wide-ranging debate that included the use of drones inside U.S. borders, elections history, gun control, immigration and the threat lawmakers face of being “primaried,” healthcare was, in fact, the only part of the discussion where both the conservative Rove and progressive Carville were visibly angry with each other.
And it all come down to the money.
Rove undertook the topic first by saying that the Patient Protection and Affordable Care Act will ultimately collapse. “Obamacare is going to be proven a gigantic disaster financially,” Rove said, adding that the Medicaid expansion and health insurance exchange provisions are financially unsustainable.
“If you’re a company, you’re stupid to continue carrying insurance,” Rove continued. “Dump it and pay the $2,000 fine per employee.”
Carville fired back. “I don’t want to say it too loud – the last three years have been the best three years in terms of containing healthcare costs,” Carville said, in an intentionally comical radio-staticky voice covered by his hand that drew laughs from the audience. “Medicare delivers healthcare cheaper than any other system.”
Rove countered that attributing lower healthcare costs in the last three years to Obamacare is inaccurate and that America’s healthcare costs also dipped during the early 1991-1992 recession as well. “Some of that may be related to the fact that people feel they can’t go to the doctor,” Rove said. “Let’s not give credit to a bill that hasn’t started yet.”
While a loud clap roared from the audience reacting to Rove, Carville piped right up. “This ain’t Fox News, you can’t just make stuff up,” he said, stating that he did not attribute the lower costs to Obamacare. “If we’re delivering healthcare at 18 percent of the GDP and no other country is breaking 12 percent, that’s something we might need to take a look at.”
Cutting Medicaid would potentially bankrupt families that need care, he added.
“Medicaid is busting state budgets. Medicaid, let’s be honest, it’s second-class healthcare. It’s a shame on this country,” Rove argued. “The Affordable Care Act is more of the traditional model that’s not working.”
Carville maintained that something needed to be done and the ACA is essentially a start, a work in progress such that can be tailored as the government learns what works and what does not. Rove stuck to the free market model. But they essentially agreed that the costs need to come down.
“The insurance companies are not trying to make providers rich,” Rove cracked, generating laughs among the crowd. Carville, also earning chuckles, suggested: “Read a hospital bill: it’s about as reliable as the price of a rug in Istanbul.”