Freedumb!

Mandatory health insurance is a great idea! Why, look what benefits have flowed from private plans in Medicare!

Dorothy K. Barksdale, a 70-year-old seamstress, vividly remembers the day an insurance agent visited her home and signed her up for a private Medicare health plan.

“He put his foot inside my door and kept talking,” Ms. Barksdale said. “I told him that I don’t need any kind of insurance. He pushed his way into my apartment, sat down, asked me questions and started writing papers.”

Such experiences help explain why Ms. Barksdale and some of her neighbors here in eastern Mississippi are wary of the sales pitches they are now receiving again. Many said they had been tricked into enrolling in private Medicare plans, sometimes without realizing it.

And why is this happening in Mississippi? Probably has to do with the poverty rate. Because everyone knows poor people are dumb? No; it's because the free market is so awesome! Oh, and Medicare rules that are supposed to give low income recipients more choice. No one could foresee that would be abused by insurance agents, apparently:

Under the Medicare Advantage program, the government pays insurers an average of $9,000 a year for each person enrolled in a private plan. Agents say they typically receive commissions of $350 to $600 for each person they enroll. Agents can buy the names of prospective customers from marketing organizations like the Premier Agent Group in Dallas, which offers “100 red-hot Medicare Advantage leads” for $1,000, according to the company’s Web site.

States license insurance agents, but they have a limited ability to regulate the private Medicare plans. In one instance, the Mississippi Insurance Department on Dec. 11 revoked the license of an agent in Meridian, Miss., after finding that he had been involved in the “fraudulent enrollment” of a 75-year-old woman in a Medicare plan.

Most people who sign up for private Medicare plans are locked in for a full year, but many low-income beneficiaries are allowed to switch plans each month. For that reason, some agents tend to focus on them, the Medicare commission said.

Public officials say they have seen evidence of that practice.

Gee; I can get a commission every month trolling the same population of low income elderly, using high pressure tactics? Who could have foreseen that insurance agents would be pushy? Who could even think that profits would make insurance companies greedy?

O.K., more seriously, it’s actually Mr. Obama who’s being unrealistic here, believing that the insurance and drug industries — which are, in large part, the cause of our health care problems — will be willing to play a constructive role in health reform. The fact is that there’s no way to reduce the gross wastefulness of our health system without also reducing the profits of the industries that generate the waste.

Oh, well, yeah, there's that. And there's also Mississippi.

But who really cares about Mississippi? Besides, Paul Krugman is shrill.