As head of 1199 SEIU United Healthcare Workers East for nearly two decades, Dennis Rivera was widely considered the most powerful labor leader in New York State, winning legislative victories through close political relationships with state leaders from both parties. He is now spearheading the Service Employees International Union’s political campaign to influence the health care debate taking place in Congress and build national support for changes. In an interview with KHN Correspondent Jordan Rau, Rivera talked about what the country’s largest health care union, with 1.1 million members, is trying to accomplish.

Q: Where did you get the idea of the war room you’ve set up in SEIU’s Washington headquarters and what are you doing with it?

A: In one of the conversations with [SEIU President Andy Stern] I suggested we have [a war room] like we did in New York, on our seventh floor. We are running it like it is a presidential campaign, but as I told other people, our ‘candidate’ is basically health care reform. We have folks who are doing constant research about what the opposition is doing. We have a media response team and we have research of what those people are doing. At the same time our lobbying team is keeping track of all of the members in the committees of jurisdiction and what positions they’re taking on the issues that are important to us as they relate to health care reform. We and our coalition partners are close to assembling, in our own respective organizations, close to 100 million Americans by name, address, phone number, and e-mail address. In SEIU alone we have 32 million of them. [One day] we sent 600,000 e-mails with a message.
From soup to nuts we’re trying to manage this process in a more efficient way, as opposed to what happened in ’93 and ’94, when we didn’t have any of this technology.

Q: What happened back then?

A: We couldn’t respond to things quickly. I remember, like it was today, when Hillary Clinton in 1994 was asking all of the allies in this battle to gin up support for their position and it was very difficult. We did not have the infrastructure to do it. Because of that, we were prepared this time so that when things happen, we can respond quickly, we know who to communicate with and we know what to do.

Q: Lawmakers are considering many different ways to structure a public insurer that would compete with private ones. What will SEIU consider a strong public plan?

A. We need a public-sponsored plan without triggers. We want a public-sponsored plan that, if possible, will have the same rates as Medicare, a public-sponsored plan that will be available to anybody in the country who wants to get coverage under that health care plan.

Q. Where do you believe the public plan would make the biggest difference?

The areas that we view the greatest benefits are where there’s not a lot of competition; strong market penetration by only one insurance company or a few insurance companies. The members of our union who go to the premier hospitals in New York City – New York University Medical Center, Columbia Presbyterian- have access to the best doctors and hospitals, yet our insurance for an average family in New York City was $7,000. For our members who live in the rural areas in the north country, in upstate New York– areas that basically have community hospitals, the areas that only have one insurer – the premiums for a family will be like $15,000 or $16,000. When I found out about it, I wanted to know how could it be? The only rationale was the lack of competition in those areas. In areas where there’s only one insurer who controls 50 percent, 60 percent, 70 percent of the market, (those) will be the areas of the greatest benefit.

Q: One of SEIU’s priorities in the current debate in Congress is to change the country’s long-term care system. What do you want to do?

A: A study we have done of our patients shows that the majority want to spend the balance of their days, whether they are disabled or infirm, at home rather than in an institutional facility On average, that is dramatically cheaper. In fact, if we only shift three percent of the patients that are right now in nursing homes into home care, that would save close to $6 billion a year. We believe that is something the patient wants, cheaper health care and more humane.