does the government force medicare patients to go to India for surgery today?
the "rationing" boogeyman is only going to go so far - if employer provided health plans starting forcing workers to go to India for surgery, those people are going to turn around and vote for politicians who provide a national health care plan that avoids that.
Who said anything about "forcing" them to do anything?
I know a guy in New York City who was going in for open-heart surgery a couple of years ago. His insurance company called him up and extended an offer to him. Instead of going somewhere like Columbia Presbyterian or another NYC hospital, they offered to fly him down to the DeBakey Institute in Texas (probably the top cardiovascular center in the U.S.) for the surgery.
They covered his entire stay, and even put his wife up in a hotel down there for the entire duration of his recuperation period.
It actually cost the insurance company less that way! -- and he was thrilled to do it.
Now THAT is a free market approach to health care that works.
For a 50K per year employee, the employer's share of the health insurane plus social security, medicare, workmans comp, unemployment insurance, etc., plus any other state taxes must be approaching the 'Eurosclerotic' level of 40%-50% of wages.
I wouldn't be surprised to see mandatory national health insurance in 5-10 years.