As of this moment, the United States of America is officially a dictatorship.
The US Supreme Court, in upholding the individual mandate, has stated that Washington has the right to order individual people to enter into contracts against their will, under penalty of fines and imprisonment.
This decision goes far beyond health care. If all they wanted was socialized medicine, they could've done what all of Europe does - pay for everybody's treatment and raise taxes to pay for it. But the individual mandate goes far beyond that - it says that you must contract with a third party to buy a product you don't want and that they don't want to sell you. And if either party refuses for any reason, you can be fined and jailed.
Now that the precedent has been set, they can order anyone to do anything and the Supreme Court says it's OK. The Constitution, and any concept of individual liberty no longer has any relevance in this country.
Even if Obama loses the next election, and even if Republicans sweep Congress and repeal Obamacare, this Supreme Court decision will remain. Washington has been permanently granted the right to order you to do any damn thing they want you to do, and if you don't like it, your only recourse is to leave the country.
Welcome to the brave new world.