It's no longer your grandfather's Medicare.

The federal government's landmark program to guarantee health care to the elderly is conducting an experiment in privatization that's producing worrisome results.

State officials in Georgia and around the country continue to report that unscrupulous agents, working on commission, are fleecing elderly Americans into dropping traditional Medicare coverage and paying extra to buy private plans that do not meet their needs.

And they're not the only ones paying extra: Medicare — meaning the U.S. taxpayer — pays the companies providing the coverage, on average, 12 percent more to administer benefits than it would cost the government to handle the claims itself.

About 9 million of Medicare's 44 million beneficiaries have switched over to the plans. In the last two years alone, 3 million Medicare beneficiaries — about 100,000 of them in Georgia — have signed up. Marketing for the plans reaches its peak this weekend because Monday is the last day to enroll this year.

The experience to date with the plans, known as Medicare Advantage, holds important lessons in the continuing debate over the roles of government and private insurers in finding ways to cover the 47 million Americans who have no health insurance and the millions more who can barely afford what they've got.

Unfortunately, those lessons aren't very encouraging.

Traditional Medicare is financed through a payroll tax, with government paying hospitals and physicians directly for services. Beneficiaries are automatically covered for hospital stays and pay a premium that is heavily subsidized by the government for physician visits.

Another part of Medicare, implemented just three years ago, encourages the elderly to purchase private coverage for prescription drugs.

The Medicare Advantage plans are marketed to elderly Americans looking to coordinate all their benefits — hospitals, doctors and drugs — under one plan. Unlike traditional Medicare, where beneficiaries can choose doctors and hospitals, the Advantage plans frequently demand patients use a panel of doctors, or specific hospital and pharmacies. Often the plans promise to include a wider range of benefits than traditional Medicare offers.

With dozens of plans on the market, teasing out the costs vs. benefits — or trying to compare them with traditional Medicare coverage — can be daunting. That's especially the case for poor, elderly Americans who become easy targets for ethically challenged sales representatives.

On average, sales agents for these plans get a commission of $350 to $600 for each enrollee. Their clients too often get stuck with plans that don't meet their needs or that wind up costing more out of their own pockets than they would have spent under traditional Medicare.

In Georgia alone, Insurance Commissioner John Oxendine said, his office has justified 40 of 66 complaints since 2006 about Medicare Advantage plans involving marketing and sales. About a third of those were forwarded to the department's fraud division, he said.

One agent faces felony charges for signing up disabled and brain-injured people without their knowledge or consent.

Similar stories are surfacing around the country. Alabama Supreme Court Chief Justice Sue Bell Cobb told The New York Times recently that her 83-year-old mother signed up for one of the plans because she thought it provided dental care. Only after she dropped her traditional Medicare plan did she learn that the family doctor she had been seeing for years was not part of the plan.

Media reports prompted federal officials to more closely monitor sales tactics and begin fining some companies, resulting in fewer complaints of late, Medicare officials say.

Still, more vigilance is needed, both at the federal and state level. And if the industry itself doesn't become more willing to call out its worst offenders, the ethical stain will taint its efforts to play a larger role in working with the government to offer affordable health insurance options.

Moreover, the taxpayer subsidy for private plans should end.

Democrats in Congress tried last year to pull the plug on the subsidy, but the effort got bogged down in conflicting claims about whether the plans helped or hurt poor minority beneficiaries. But there is little question that the payment scheme is a financial drag on the entire Medicare program.

Over the next five years, the unnecessary private subsidy will cost the government more than $50 billion, about what it would cost to guarantee health insurance for every child in America not covered by insurance now.

Unlike industrialized nations that long ago adopted universal health coverage, the United States has conducted a decades-long debate on the issue. At the heart of that debate is whether the private market is better than the government at providing health insurance for Americans.

Medicare Advantage plans represent a basic experiment in how best to help elderly Americans protect themselves from the financial perils of sickness and poor health. If the private market is indeed the answer, the companies offering these plans shouldn't need a government subsidy to sell them.

— Mike King, for the editorial board