Carville, Rove mix it up on last day of HIMSS

While they spoke to a much smaller crowd than former President Bill Clinton did the day before, political strategists James Carville and Karl Rove closed out the HIMSS annual conference and exhibition in lively fashion, and may have engaged the audience more than the former president did—even if their discussion barely mentioned health information technology.

Rove, the former deputy chief of staff for President George W. Bush, started by giving a plug to Dooky Chase's Restaurant, a local favorite. He later made a passing reference to how he thinks health IT could play a role in keeping healthcare costs down. Carville, a Louisiana native and a former Clinton adviser, told how he was involved in a "hackathon," where participating IT experts competed to create a winning mobile telephone application to be used during the Super Bowl held last month in New Orleans. The winning app was one that allowed tourists to tip street musicians using their cellphones, Carville said.

Carville, who now teaches at Tulane University in New Orleans, also told how the city appreciates that HIMSS brought almost 35,000 people to its restaurants and hotels.

"This is an enormous event for our city," Carville said. "You're the Super Bowl of conventions."

The two political opponents claimed to be friends, though their voices were frequently raised as they sought to counter the other's arguments while scoring points with the audience who applauded loudly when either man made a point they agreed with.

"I apologize for speaking while you're interrupting me, Karl," Carville said at one point while discussing the recent drop in President Barack Obama's approval rating to 48%.

Rove made repeated references to how Clinton worked with Republicans to pass welfare reform and how Bush worked with Democrats such as Sen. Max Baucus of Montana to get tax cuts passed and with Sen. Edward Kennedy of Massachusetts for passage of the No Child Left Behind Act. But Obama, Rove said, has yet to do anything similar.

Rove also advocated for a Medicare premium support program, and mentioned how the low reimbursement of Medicare and especially Medicaid lead to cost-shifting that puts the burden on patients with private insurance or on "the nation's credit card" to be paid by future generations.

"This isn't Fox News," Carville replied. "You can't just make stuff up."

Carville noted the success of Medicare by pointing to the only positive healthcare statistic where the U.S. leads the world: life expectancy for people over 65.

Rove countered that by saying Medicaid was a second-class system that was busting state budgets and was a "shame on our country."

When Carville disagreed, Rove replied "This is the second time you've called me a liar."

Both agreed that, despite its apparent dysfunction, there was still a chance Congress could pass an immigration reform bill.

Rove said it would have to come from the Senate and could be passed with a majority of Democrats and a sizeable GOP minority in the House. "I'm reasonably hopeful," he said.

Carville explained how the recent election results may be the stimulus to get immigration reform passed. He referenced what he said was an old Southern saying that "Sometimes you have to hit someone in the head with a two-by-four to get their attention."

"What you had on election night was pine on skull," Carville said. "I think we got their attention."

If Rove had been called on to advise Hillary Clinton in her primary race against Barack Obama, Rove said he would have told her to make a better and earlier effort of communicating her vision. Instead, Rove said, she thought she was entitled to the nomination because she "put up with Bill for eight years." (On two occasions, Rove also spoke in a reasonably good imitation of Bill Clinton's voice.)

If asked to advise GOP nominee Mitt Romney, Carville said he should have sent a "hard shock" to separate himself from "some of the unpleasant aspects of modern conservatism." He said this could have included not having fundraisers with Donald Trump after Trump made comments doubting Obama's citizenship.

When asked for an inspiring closing note, Rove told the story of how he worked odd jobs to get through college and lived in a room without a shower or a closet and had to hang his clothes on a nail. Despite this humble story, Rove noted how he was still able to work in the White House.

Carville referenced the young people who he sees at Tulane and those that came to help with the post-Hurricane Katrina cleanup.

"We are blessed with a younger generation that is going to do remarkable things," he said. "That's what makes me feel the best."

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