The Patient Protection and Affordable Care Act—otherwise known as ObamaCare—is almost four years old. Despite the technical troubles, what every American should know about the law is that whatever its provisions, whatever the press propagandizes or reports, the individual has no control of, or choice in, health insurance or medicine. Not if you’re a doctor, patient or policyholder.

As many are beginning to realize, health plan terms, prices and treatment are under central government control. Medicine and insurance are no longer in any meaningful sense a profession, a term which implies a degree of autonomy on the part of professionals. This is despite opposition, to the extent it is opposition, from conservatives including Texas Sen. Ted Cruz, who, to his credit, tried to stop ObamaCare. His effort makes Cruz ObamaCare’s most recognizable political opponent.

Cruz rails against “extremism” and “absolutism” in his attacks on ObamaCare, though he read from Ayn Rand’s absolutist novel Atlas Shrugged, which he fails to fully grasp, during his 21-hour standoff. And Cruz undercuts his own case by opposing a woman’s right to abortion while claiming that ObamaCare violates individual rights. So his crusade is crucially limited by his contradiction.

Except for a few voices for reason, no one understands and rejects ObamaCare’s moral premise, which is the ideal Ayn Rand rightly identified as the root of government-controlled medicine: altruism.

Rand convincingly argued in Atlas Shrugged that egoism is the highest virtue in ethics and therefore that capitalism, which inherently recognizes this morality, is the system which fits human nature. Capitalism, like the United States of America, is based on the principle of individual rights. So, any politician advocating a ban on abortion contradicts the argument for abolition of a government takeover of medicine. We simply cannot win the case for capitalism without asserting the fundamental right to one’s own life, which means drawing the distinction between potential and actual life.

ObamaCare is not the end of the world. It is, however, the end of free choice in health care. This historic dictate, as some of us warned, is a deathblow to liberty, a leap toward dictatorship. It’s been the law for over three years and all the tinkering, grandstanding and maneuvering will not stop it. It will proceed on its premise, which is to say it will lead to dictatorship and death, mass death.

Those who protest ObamaCare and think that the mandate is wrong must oppose the law on moral grounds. They must admit that health care is not a right – and assert that free choice in medicine is – and speak up, write and elect those who accept pure capitalism as the ideal and nothing less … or prepare to scream for bloody life – your own, your child’s and grandparent’s life – in a new, American dictatorship. Those who support ObamaCare already know it’s based on the idea that health care is a right.

For those who reject the law or, reading this, think my words are too extreme and haven’t decided what they think about ObamaCare, when the reality hits – and it will – brace yourself and remember that bureaucrats are made, not born, and that the best in medicine will shrug, quit and leave. You will hear that the dictate is helping others—you’re already hearing it, accompanied by its underlying message: helping others is the moral ideal, so there are simply winners and losers—and that ObamaCare is the law. In other words, if you’re worse off, tough luck. These are the same types that rail against capitalism as dog-eat-dog.

When you hear the slogans, ask yourself if ObamaCare is helping you. If it is, ask yourself at whose expense and by what right. Remember, too, that slavery was once the law and that half the country claimed with some degree of credibility that they were gaining from the enslavement. The Orwellian-named ObamaCare robs from some to pay for others, destroying everyone’s right to choose health insurance, doctors and treatment.

In practice and in theory, ObamaCare is what its proponents claim it eradicates: a brutal system pitting the powerful against the powerless. Three years of ObamaCare already demonstrates that fact. The nation’s health care system may not withstand three years more. The law is the law, so we must resolve to undo the law. It can be done. But abolition of a death-premise dictate can be achieved only by the love for life, with reverence for the right to control one’s life. No counterfeit claim will do.

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Scott Holleran is a writer and journalist. His articles have been published in the Philadelphia Inquirer, Los Angeles Times and Wall Street Journal. Visit his Web site at