2022 Organizing Guide

Table of Contents

7. Medicare for All, not Medicare for Wall Street:
DSA Calls for the End of the Biden Administration’s Medicare Privatization Scheme

Capital continues to find new ways to exploit the healthcare financing system in the United States. The latest scheme in this decades-long battle is Direct Contracting, an attempt to further entrench the for-profit industry into the U.S. healthcare system.

Direct Contracting Entities (DCEs) are for-profit intermediaries in the Medicare program that ‘manage’ medical care for Medicare enrollees. The DCE program was created under the Trump administration as an effort to completely privatize the Medicare program. Now, the Biden administration has followed Trump’s lead, ignoring the calls from thousands of healthcare workers and patients to stop DCEs.

The policy predecessor to DCEs is the Medicare Advantage program, which uses tax subsidies to lure enrollees with lower out-of-pocket costs, but then charges premiums, restricts access to providers, and requires pre-authorizations for care. Medicare Advantage has grown to cover nearly 40% of Medicare beneficiaries. The public hugely subsidizes the profits of insurance companies that participate in the Medicare Advantage program, overpaying in the amount of $106 billion from 2010 to 2019. And DCEs are Medicare Advantage on overdrive: for every single dollar a private firm acting as a DCE receives from public money, 40 cents can be pocketed as profit. In contrast, traditional Medicare uses 98 cents of every dollar for direct patient care.

Medicare Advantage – or private Medicare plans – have been undermining the movement for universal single-payer healthcare for two decades. Allowing DCEs into the Medicare program creates even more opportunities for venture capitalists and private firms to pilfer public Medicare funding streams, threatening any movement for universal healthcare and Medicare for All.

Already, 53 Direct Contracting Entities have been created in 38 states. But the profiteers are not satisfied, because they see the potential for over a trillion dollars in profits made from public money in the next few years. The Center for Medicare and Medicaid Innovation, which is controlled by the Biden administration, plans to authorize 22 more DCEs in 2022.

Healthcare must be universal, guaranteed, public, and free – nothing less. The only way to push back on the further privatization of our public services is to fight for universal social programs through a mass working class movement. The wealthy and their politicians will continue to steal from us unless we organize together and fight back. We cannot win by fighting piecemeal. We can only win by organizing our class under a socialist program. Stop DCEs; fight for Medicare for All.

Organize Your Members: Hold a Political Education Event for Your Membership

  • For many people, DCEs are flying under the radar. We will need to educate our members and ourselves about 1) what DCEs are, 2) why DCEs are a threat to the fight for M4A, and 3) how we build the real political power we need to win M4A.
  • Use this slideshow to educate your members! Do a short presentation in a General Meeting or in your M4A Committee.
    • Start with the presentation, and then open it up for discussion. What do your members see as the obstacles to winning M4A? What can we do to build the socialist movement? What is power? What does it mean to have enough power to win M4A? Why is privatization a threat to the socialist political project?
  • Follow these basic organizing tips to make your pol ed event as successful as possible.
  • Don’t forget to have members sign-in at the event and to follow up with attendees or interested comrades afterwards with a specific, direct, organizing ask! You can use the ‘asks’ at the end of the slide show to inspire members to take action against DCEs. This is how we build power: by bringing people deeper into the movement one organizing ask at a time.

Activate Your Base: Canvassing to Build Opposition to DCEs and Support for M4A

  • Are you ready to take the next step in building your campaign against DCEs and for M4A?
  • Right now, DCEs are flying under the radar. But by generating just a little public outrage, we can stop them. Fighting against privatization and for a powerful, universal socialist program is how we build the opposition we deserve.
  • We have lots of resources on how to organize a canvass and why canvassing – building your base for socialist politics – is important for building working class political power. Check those out!
  • Pick a date and pick a neighborhood: try to target areas in your community where lots of seniors live, as anyone who is over the age of 65 is affected by the rise of DCEs!
  • Then use this pledge sheet and this fact sheet to get started canvassing!