Mr. Rivera’s remarks as prepared are below, followed by Mayor’s Bloomberg’s remarks as prepared.

Remarks by SEIU Healthcare Chair Dennis Rivera. Please check against delivery.

“Good Morning. My name is Dennis Rivera and I’m very proud to join you today to represent the more than 1.1 million healthcare workers who are part of SEIU Healthcare.

“Our members are more than the nurses, doctors, and healthcare workers who care for patients in your city hospitals, health centers, and nursing homes and keep them running – they are also the men and women on the front lines of the fight to make national healthcare reform a reality this year.

“And as we meet here today, thousands of SEIU Healthcare members are calling and emailing their members of Congress to ask that they support President Obama’s budget and match his commitment to solving our national healthcare crisis.

“As a New Yorker, I’ve witnessed first hand that Mayor Bloomberg shares the President’s commitment and I’ve been very inspired by his innovative work to ensure that every New Yorker can lead safer, healthier, and longer lives.

“At a time when national public health reports indicate that our children – especially children of lower to middle income families - are destined to live shorter, sicker lives, Mayor Bloomberg and his Health  Commissioner Dr. Thomas Frieden have created groundbreaking initiatives to reverse this troubling trend.

“For those of you who have had the pleasure to work with the Mayor and Dr. Frieden, you know that in together, they are a unique and unstoppable force. And thanks to their leadership and focus on investing in prevention, New York’s citizens are now living longer than ever.

“The public health initiative that deserves the most recognition for transforming the quality of life in our city is the Mayor’s comprehensive smoking-cessation program. What drove the Mayor and his administration to find a common sense solution to this crisis was harsh reality that smoking is slowly killing us? Each year, 440,000 people die in the US from tobacco use. Nearly 1 of every 5 deaths is related to smoking. Cigarettes kill more of us than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined.

“Through a combination of persuasion, passion, and unrelenting belief in the importance of this issue, the Mayor led New York to become the first city to tackle this epidemic head on and halt the spread of tobacco addiction, improve the quality of the air we breathe, and prevent the growing tally of senseless and premature deaths.

“Since its launch in 2003, the enormous difference this initiative has made in the lives of New Yorker’s is remarkable: the City’s 2007 smoking rate was 21% lower than the 2002 rate, there are 300,000 fewer New Yorkers who smoke; and there are 100,000 premature deaths prevented.

“Since the Mayor was elected to office, more New Yorkers have access to health insurance, our city and its doctors have increased access to electronic medical records, and he has launched the largest public hospital improvement project in the city’s history. Not only does investing in our public hospitals make an enormous difference in the quality of care in underserved communities, it’s also of critical importance to the economic health of these communities as well.

“These are just a few examples of the countless ways Mayor Bloomberg is charting the path to a healthier future, and New York is becoming a model for cities, states and countries across the globe.

“At a time when our cities - and our country as a whole - are faced with tremendous challenges, Mayor Bloomberg continues to be a man of tremendous vision. It is my sincere hope is that we have his leadership and vision to guide us for many, many years to come.

“It’s my great honor to introduce to you my friend, and my Mayor: Michael Bloomberg.”

Remarks by Mayor Bloomberg. Please check against delivery.

“Thank you Dennis, and good morning everyone. It’s great to be in Washington. Like many of you, I’ll be meeting with members of Congress while I’m here but before I go any further, I want to say a few words about what a great champion Dennis has been in expanding health care coverage in New York.

“Our state’s ‘Family Health Plus,’ which Dennis helped create, has provided coverage for thousands of working New Yorkers. Dennis also has pioneered innovative labor-management partnerships that have proven to be national models, and that other health care leaders are now emulating.

“I admire what he’s accomplished. But the reality is – and I think he’d agree with me: you can only achieve so much within the current framework.

“The kind of dramatic improvements in coverage and care that we desperately need will take a new approach: The same kind of comprehensive reforms that we’ve also got to bring about to fix our schools. We’ve got to address the fundamental problems plaguing our health care system.

“In many ways, they mirror what ails our schools, too: misplaced priorities, a lack of accountability, and intolerable outcomes. As big-city mayors, we know full well that good public schools and good public health go hand-in-hand. Children for whom every untreated earache and asthma attack can lead to long absences from school start their educational careers at an enormous disadvantage. And when parents get sick – and have to pay out of pocket for expensive treatment – the whole family suffers. So we’ve got to do more to keep our kids healthy – and their families – healthy.

“That’s why mayors across the nation enthusiastically applauded one of President Obama’s first acts in office: signing into law Congress’s expansion of the Children’s Health Insurance Program – known as ‘CHIP.” It’s also why we strongly support the President’s push to enact comprehensive health care reform this year.

“We need quality, affordable health care for every American. Because we know that the status quo in health care which each year costs our nation more than two trillion dollars – that’s right, I said trillion with a ‘t,’ that leaves our businesses less able to compete globally, that fails to provide some 46 million Americans without any health insurance coverage at all and leaves tens of millions more under-insured and at risk of financial ruin and that, despite its high costs, fails to prevent millions of avoidable and deadly heart attacks and strokes. It simply can’t be allowed to continue – especially as more and more Americans are losing their jobs and their health insurance coverage, worsening their health problems.

“Helping families get healthier helps our economy get healthier. Our reforms must be far-reaching. Expanding health insurance coverage is necessary. But it’s not enough. Because the scandalous truth is that today, America has a ‘disease care’ system, not a health care system.

“As a result, our median life expectancy, rate of infant mortality, and other key indicators of public health lag far behind those of other developed, and even some developing, nations. The right medicine is a reform package that dramatically realigns our priorities and improves the quality of care, that contains health costs and that significantly expands health insurance coverage.

“The time to act is now. Because inaction will only delay the nation’s economic recovery. The prospects for action are also very good indeed – and we can’t afford to miss this opportunity.

“President Obama has identified eight nonpartisan principles that should guide any health care reform package – and it’s hard to see how anyone could argue with them: one, protecting families’ financial health; two, making health care coverage affordable; three, aiming for universal coverage; four, providing portability of coverage; five, guaranteeing choice; six, investing in prevention and wellness; seven, improving patient safety and quality of care and eight, maintaining long-term fiscal sustainability.

“The eight principles are ones that every one of us, Democrats, Republicans, and Independents can rally around. And this time, unlike in 1994, there’s reason to hope that we can actually get reform done.

“In the past 15 years, health care costs have spiraled upward, and the number of uninsured has grown from 37 million to 46 million. That’s why today, support for health care reform is coming from members of both Houses of Congress, from both parties, from health care insurers, doctors, nurses, and other health care professionals as well as the nation’s major corporations and small businesses and also leaders of organized labor, including Dennis and his very capable successor at SEIU 1199, George Gresham, who is carrying on Dennis’s great work. They all recognize that ‘business as usual’ won’t cure health care in America.

“To that growing chorus we must also add our voices – the voices of urban America. And we need to be heard, for these two reasons: first, cities – along with counties – are the frontline health providers to millions of Americans. Often we’re all that stands between our constituents and catastrophic illness. And, second, as city leaders we are among the nation’s major purchasers of health insurance ourselves.

“New York City alone spends $4.4 billion every year on health insurance for 1.2 million employees, retirees, and their dependents. $4.4 billion! And like every city in the nation, we spend a growing share of our budget each year on health insurance coverage. So as mayors, we have plenty of skin in a game that will reshape the health care landscape both in terms of outcomes and costs.

“Unfortunately, in our Federal system, the nation’s cities often don’t get the attention we’re due. But in the case of health care reform, our perspectives, and our experiences, are so compelling that we must make them heard. At this juncture, nothing about health care reform is set in stone.

“That makes now the time to take a strong hand in molding any legislation that expands health care coverage, insures portability and choice, contains costs, and also improves health care outcomes.

“I believe mayors should demand a seat at the table in shaping the legislation, and the U.S. Conference of Mayors can help us do that. I’d like to expand on two of the principles President Obama has put forth that are particularly important to our cities, and that should receive special attention as the legislative process goes forward.

“First, we must invest in prevention and wellness. That is precisely what we’re not doing today, when some 95% of America’s medical expenditures are for disease care and, at most, five per cent are for prevention.
But when what are preventable factors leading to disease – high blood pressure, obesity, alcohol abuse, and smoking – all too often go unaddressed and lead to widespread, chronic, or deadly diabetes, heart disease, and strokes. Then we’re not getting our money’s worth. We’re not treating the most basic conditions effectively. And we’re not protecting the health of our citizens.

“The President’s strong emphasis on prevention and “wellness” as part of his reform principles is absolutely essential to both improving outcomes and controlling costs. Over the past seven years in New York, we’ve made prevention and better primary care – from curbing tobacco use to encouraging colon cancer screenings – central to our public health strategy. We need to make sure that a focus on prevention – and funding for prevention – is part of any health care reform plan.

“Second, we must improve quality of care by stressing rigorous accountability and transparency. And again, this is not a Democratic or Republican issue, nor is it a liberal or conservative issue. This is a basic management issue.

“Major expenditures of public dollars on health care reform have to be matched by explicit achievement targets and clear performance measures applied to health care providers, health plans, and public health initiatives.

“In New York, that’s what we’ve done with ‘Take Care New York.’ It encourages New Yorkers to work with primary care providers to meet specific, achievable goals that will improve their own health. We’ve let New Yorkers know the good news, and the bad, about Take Care New York’s progress. We haven’t flinched from putting the spotlight on the areas – like breast cancer screening – where we need to redouble our efforts.

“New York City’s public hospitals are also national leaders in reporting on patient safety, including the rate of infections acquired during hospital stays – a very troubling problem nationwide. Our taxpayers deserve to know that. That’s what accountability is about – and we need to make accountability the norm throughout the country, in big cities and small towns.

“Implementing these principles, and the others the President has stressed, is going to require more than funding. It’s going to require innovation.

“And health information technology – which the President is making a strong commitment to – is a potential game-changer. Clay Christensen, a scholar whose work on transformative change in business I’ve long admired, has argued that such transformation is almost always produced by what he calls ‘disruptive innovation.’

“Think of how personal computers made mainframe computing obsolete, or of the effect of the internet on information technology generally. That was disruptive innovation. EHR’s can be that kind disruptive innovation, too.

“That’s what we’re finding in New York City, where we’ve created the nation’s largest primary care electronic health record network. It links more than 1,100 doctors with more than a million patients in low-income communities with a prevention-focused EHR.

“We’re already seeing that EHRs bring prevention front and center in every doctor’s visit, simply by giving doctors the information that they need when they need it about patient vaccinations, screenings, and other essential disease prevention measures.

“EHRs also allow doctors – in many cases for the first time – to actually understand how many patients they’re treating and how well they’re doing in preventing illness. With that data, EHRs also create the potential to reward doctors for actually keeping people healthy. Today, the potential of EHRs is barely being realized; it’s been estimated that across the nation, for example, fewer than two per cent of hospitals have installed comprehensive EHRs.

“So by including more than $20 billion in funding for EHRs in Federal stimulus funding, President Obama shows he understands just how much our health care system needs a strong dose of disruptive innovation.

“New York and cities and counties across the nation have made tremendous strides in improving health care at the local level. We’ve enhanced prevention, improved patient care, and invested in innovative technology. We are, as you can tell, proud of our achievements.But in this time of economic emergency, we, and every other city in America, can’t do everything alone.

“We need Washington’s help to fix health care. And being mayors – whether we’re Democrats, Republicans, or Independents – we all subscribe to the same political philosophy: get it done.

“We’re all pragmatists at heart. Take for example, the idea that health reform should include a ‘public option’ to private insurance coverage. Clearly, we should keep the playing field level between the public and private sectors – and then let’s have them compete fairly.

“In this time of crisis, we have to be willing to try new things, and not stifle innovation – wherever it comes from – before it has a chance to prove itself. The health of our economy is tied to the health of our people.

“Our challenge is to keep Congress at the table until they come up with a workable solution – and not to walk away when the going gets tough. We’ve heard a lot about how government has to step in when a company is ‘too big to fail.’

“Well, this push for health care reform is too important to fail. It’s too important to our cities. It’s too important to our nation. It’s a challenge we can’t flinch from – and it’s an opportunity we must seize. Thank you all very much.”