Contrary to outraged cries from Republicans that it's some sort of radical departure from our "free enterprise" system, Obamacare is in fact a direct continuation of the bipartisan neoliberal consensus of the past thirty years. The guiding principle of this consensus is the use of state power to protect corporate profits – which consist mostly of rents on artificial scarcity – from the radical deflationary effects of technologies of abundance.
In the spirit of the original American state capitalist, Alexander Hamilton, this consensus seeks to maintain the value of the enormous concentrations of land and capital owned by the rentier classes, and guarantees the returns on them.
The Digital Millennium Copyright Act and subsequent draconian digital copyright legislation sought to guarantee the artificial scarcity rents of the proprietary content industries in the face of technologies of abundance like file-sharing. Both the Paulsen and Geithner versions of TARP use taxpayer money to prop up bubble-inflated real estate prices. And now we have Obamacare, which operates on essentially the same premises as Bush's Medicare Part D:
It's probably not a coincidence that, upon news that the Supreme Court had held up the individual mandate, health insurance companies' stock immediately began to rise.
A free market healthcare reform, in contrast, would do just the opposite. It would eliminate all these monopolies and artificial scarcities enforced by the state, and allow market competition to drive healthcare prices down to the actual cost of provision. It would include:
So our choice is not one between a healthcare system administered by the state, and one administered by Columbia HCA, Pfizer and Kaiser Permanente. Those are really just two sides of the same coin, with ordinary people locked into dependence on unaccountable state and corporate bureaucracies that keep healthcare artificially scarce.
Obamacare is actually a corporate welfare program for the big healthcare corporations. The real choice is between the corporate-state healthcare system of Clinton, Bush, Obama and Romney, and a genuine free market healthcare system controlled by us.