LAS VEGAS – During a dynamic, at times downright rowdy session on the final day of HIMSS 21, former governors Chris Christie, R-New Jersey, and Terry McAuliffe, D-Virginia, clashed on a range of issues such as the pharmaceutical industry and the finer points of COVID-19 response. But they broadly agreed on healthcare policy, strategies for revitalizing the healthcare workforce, and the importance of cooperation and bipartisanship.

HIMSS CEO Hal Wolf moderated the session. Here's where the two old friends and political rivals landed on some key topics:

On pharma companies

McAuliffe: I've got to go after the pharmaceutical companies. They've made too much money. Just during COVID-19, the pharmaceutical companies raised prices on over 1,000 drugs. This is a time when you should be lowering prices, when you're in a crisis.

Christie: Everybody likes to beat the crap out of these people, but then they're like, "Where is it? Where's my cure to cancer?" And it's all coming from the same place. And it's not happening in China. And it's not happening in India. And it's not happening in Canada or Europe, where they fix prices. We have this conversation: Healthcare is an investment. We've got to invest in healthcare. But not in the pharmaceutical companies, 'cause they're rotten SOBs who make too much money.

On Medicaid expansion

McAuliffe: My biggest fight [with members of the state's Republican legislature] was over Medicaid expansion. They just wouldn't do it, and it always bothered me. I have a business background. The idea that I ship 2.2 billion up to Washington, I get 100% back, I can get 400,000 people healthcare, I can save rural hospitals that are closing and I can add 65,000 jobs. They just wouldn't vote for it. Because it was Obamacare.

It really grinded on me. … They'd all come to me and say 'I've got an opioid crisis, I've got a mental health crisis'. And I'd say, 'Well vote for it'. [They said] 'I can't, I'll lose my primary.' … We finally got it done, and now folks, 537,000 people, have health coverage in Virginia [who] didn't have it four years ago. That's a big deal.

Christie: I wouldn't have reformed healthcare the way Obamacare did. But when I became governor of New Jersey, I signed the executive order expanding Medicaid, because it was good for the state. It wasn't good for me politically. I took a lot of heat from members of my party. … At the time, 90 percent of the cost was covered by the Federal government, 10 percent in state money.

You tell me how I'm supposed to turn that down. You tell me how I'm supposed to look at these people and say no. There was no one who could give me that answer. … And that's what you do with political capital when you're governor. You take a risk and you spend it to help people."

On healthcare staffing shortages

McAuliffe: I had this problem with nurses when I was governor. So I changed my whole education system to fast-track nurses in Virginia. I gave them tax breaks and I gave them scholarships. You want to be a nurse in Virginia, I will pay to get your nursing degree. I save money in the state.

We spend it now, we're going to get that money back. We need to do the same thing with doctors. If I have a shortage of [primary care] doctors, I'm going to offer free tuition. I'm going to do whatever it takes to get people out there to keep our city safe.

Christie: What we did in New Jersey was we consolidated our system with our state university and created more grant dollars and more opportunities to come to medical school, and gave them scholarships to incentivize primary care. States can do that, and it really doesn't cost you that much. Your hard costs at a medical school are pretty well set.

On COVID-19 crisis response

Christie: What happened with COVID-19, with the Trump administration is the president was never able to admit the severity of the crisis. He was only focused on re-election. And he figured if I can minimize what people think about this it won't hurt me, when in the end the exact opposite approach was needed.

If he had taken the opposite approach, he'd still be president today. You can't say it's going to disappear. You can't say it's under complete control. People don't want to hear that unless it's true, and in a crisis it's never true."

On combating vaccine hesitancy

McAuliffe: We've got 93 million Americans not vaccinated. This thing is ripping through our country. It will devastate our economy. And we could get rid of this thing in 30 or 60 days if people would get vaccinated. We could kill it once and for all. … We have 93 million Americans today and we need to do as much as we possibly can. Until we make it hard for people to get on planes and go to movie theaters, people just aren't going to do it.

Christie: People don't want to be indoctrinated, they want to be educated. They don't want to be told, 'You'll take the vaccine, because we're all taking it. And you'll take it and you'll like it.' Running ads by politicians saying 'We're all in this together'? People say 'No you're not. You're not in it with me. What do you know?'

On fixing partisan gridlock

McAuliffe: If I can draw lines that make you win no matter what, then the only place you can lose is in your primary. So that pushes people to the left or to the right, and you're not going to work with the other side. We've got to get to a point where you're pushing people into more competitive general elections. It will force you to work with the other side. … It's just bad. We've got to fix it for the sake of the country.

Christie: I've always been an advocate of term limits. … Look at the people in leadership on both sides. These people have been there forever. I can't remember a Congress without Nancy Pelosi. Mitch McConnell got elected to the Senate when I was a senior in high school.

When Joe Biden got elected to the Senate I was 10 years old. I'm sorry, whether it's Biden, or McConnell or Pelosi, no one's irreplaceable. No one's indispensable. The people who stay there for a long time, they dig in, they remember every slight, they keep score.