Ted Rall posted a not so good and superficially inflammatory diary at dKos: Via Sarah Palin: How Obama’s Idiotic ACA Might Lead to Real Health Care Reform.  It’s sort of the mirror image of Booman’s Getting to Single-Payer. The latter postulates that the ACA will be so successful the it will pave the way for single-payer.  Rall’s take is that it will be such a failure that single-payer will have to be put back on the table.  Can’t say I agree with either position because politically this country doesn’t seem to move in a positive direction based on either success or failure.  We can live with both outcomes for a very long time.

Rall was roundly condemned for using what many dKos contributors view as rightwing talking points to make his case that the ACA will fail.  The criticism wasn’t completely unfair.  However, it does depend on whether or not the ACA is experienced as a success in the next few years by various eligible voting populations.  There are so many moving parts in this program that everyone might want to be cautious in projecting where we’ll be with this in the near term.  And Democrats that are cheering on “Obamacare” (a RW term for a RW program, both of which Democrats now embrace) don’t seem to grasp that the ACA isn’t like the conceptually simple, straightforward, and liberal progressive Social Security or even Medicare programs.  But does the average person – liberal or conservative –  even grasp the structure of Medicare?

This comment in that Ted Rall diary suggests “not really.”            

How do you feel about Medicare? It’s the consummate “single-payer system”. I have it. I didn’t get it because I was “entitled”-or because the tooth fairy left it under my pillow. I got it for paying into it for 128 quarters (32 years).

First, Medicae was supposed to be “single-payer” for seniors and disabled Americans, but as Dr. Margaret Flowers points out, the Medicare Advantage plans are private insurance paid for with Medicare dollars.  (Sort of like handing public school dollars over to for-profit charter schools.)  This is problematical:

The Advantage plans primarily insure the healthiest seniors and cost more than traditional Medicare. Instead of cutting back, the Obama Administration boosted payment to the Advantage plans. And enrollment in the plans has increased by 30 percent since 2010.

Second, and the more than half wrong notion, is the “I got it for paying into it for 128 quarters (32 years).”  The less than half right part of that is that he/she along with employer matching paid into Medicare Part A – hospitalization.  General tax revenues and beneficiary premiums (roughly 3:1) pay for the larger portion, roughly two-thirds, of the Medicare costs.  

Unlike Social Security that has never (and may never) cost a single dime in general (income) tax revenues – it has always been fully funded with employee and employer SSDI contributions – Medicare Parts B, C, and D have always been taxpayer funded.  It is an “entitlement.” Not that there is anything wrong with entitlements. What’s wrong is for the “entitled” to go around saying that “I paid for it with my Medicare contributions.”  

Don’t expect the Medicare-paid-for-scooter riding Palin supporters ever to understand such a simple fact, but anyone to the left of them should and must.  Social Security and Medicare Part A are NOT entitlements. They’re collective, government run, insurance programs.  If seniors that vote in proportionally larger numbers for Republicans that advocate for entitlement cuts, they need to understand that they’re voting to cut the taxpayer funded portion of Medicare Parts B-D.  Maybe Obama and other Democratic elected officials should learn the same thing.