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There are many aspects to "socialized medicine", and while we might be a few years from certain of them, we are not that close to the worst of it. The worst being, that the practice of medicine is completely under the control of the government so that there is no such thing as "private practice", the government determines what level of medical care will be provided, and it is paid for by the government. The resistance to complete socialization of medicine would be enormous if presented as a political goal, so instead, things will change bit by bit. A first step has already been taken, which is that few people now pay for their own medical expenses, instead we pay for insurance and the insurance company pays the expenses. The cost of medical care becomes an abstraction, having no evident effect on one's own life. Facts that reduce medical costs are not rewarded, and those that increase expenses are not penalized. Instead, your personal costs are the net medical costs of Society As A Whole, divided by the size of society. There have been ways to relate individual facts to cost, whereby one could select less vs. more coverage and opt out of coverage for sex-reassignment etc. Or, pay your own expenses as long as it's below some figure like $8,000 (this is for people who know how to save money). Much of that is now illegal. Another first step that has been taken is the changing extent to which medical practitioners have any free choice in what they do. For example, for the past 40+ years, it has been illegal to deny emergency medical treatment to a person who cannot pay. Compare that to the situation that does not yet exist in other economic spheres: it is presently legal to deny a person a house if they can't afford it, it is presently legal to deny a person food if they can't afford it, and so on. Additionally, the cost of all medical care goes up because every cotton-pickin' device or substance is subject to onerous and expensive regulatory scrutiny, and somebody has to pay that cost. I am not at all sanguine about the chances for a roll-back of Obamacare. I doubt very much that it will become legal to charge more for more-expensive patients (analogous to home and car insurance). So the question is, what is likely to be the next step towards medical oblivion? That's hard to predict, but from a political perspective, the most obvious issue is the roughly 10% of uninsured adults. This number can be made near-zero in three ways. First, increase government subsidies to those who can't afford it. Second, stiffen the penalties for the uninsured who can afford it. Third, increase the burden on employers, so that all employers have to provide full medical coverage for any employee. A third possibility, of course, would be to slowly dial back the level of care (thus the cost). This would not be easy to do at present. The government could not just say "you have to limit the number of heart-bypass surgeries that you do in a year": it does not have that power. But the government could easily give itself that power, by passing a law mandating a restriction in the number of heart-bypass surgeries allowed. Obviously, it would not start with anything so politically charged. It would start by identifying kinds of medical treatment where there wouldn't be a huge outcry at rationing. Most people view political questions in terms of how it will affect them personally in the next year or two: "I'm not gay, I don't care about same-sex marriage", "I don't drive, I don't care about outlawing gas engines". Once the underlying statutory mechanism is installed and made general enough, it is relatively easy to expand the rationing list either by administrative fiat or by minor legislative list-changing (in the same way that Congress periodically adds new drugs to the various schedules of controlled substances). A fourth possibility, much more remote, is direct regulation of costs. For example, government-set rates for doctor's pay, government-set rates for pharmaceuticals, government-set rates for the sale of equipment. Price controls have not been popular in the US. Price controls are widespread for "basic rights" such as water, gas, electricity, internet and garbage, but this is because those goods are widely provided by a regulatory monopoly. The obvious way to bring prices under control, then, is to first create a regulatory monopoly: all doctors now work for the National Health Service. I believe that, coupled with some empty rhetoric about making medical care more "fair" and uniform, this is the last step necessary to bring about the total collapse of health care in the US.

Unless a principled right rises in popularity and power, it is inevitable. I hope the unprincipled right's broken promise to those who rebelled against the left and big government, and the bitter pill of what they had to vote for, will bear fruit and give rise to something .. something better than Gary Johnson. Socialized medicine will look exactly like the various universal systems throughout the world (e.g. Canada). Second rate and backward. You will count on taxes raising by another 33 to 50 percent ending up to a quarter to a third of your tax dollars going to support it. Doctors will be even less free from regulations to do medicine as they see best, in fact because they are beholden to the government system they will become (essentially) government workers, part of the "public sector". As medical salaries dwindle (controlled by government), medical services will suffer. R&D will not be value driven but forced. It's spirit dead, cutting edge medicine will disappear. U.S. citizens will look to escape from the US medical system to get treatment in freer countries (New Zealand?) the same way Canadians rely upon US innovations and come to the US as and when needed. Waiting times for diagnostics and seeing specialists will become unreasonable to the point that lives will be risked due to delays, and emergency room deaths will sky rocket due to the unavailability of beds. Soon after the medical system is decimated, the pharmaceutical industry will be nationalized in the name of keeping prices "in control". Drug development will stagnate as the fires of profit is put out in favor of the dull inept motivation of force ... i.e. public funding. Truly egalitarian, everyone will be barred from good health care in equal measure. Individuals will languish and die... for the "good of the people" and in the name of "equality".

Yes, except for the "person without rights" part. There's no such thing, in Objectivism. Every human being has rights.

The part of your question that throws a curve into these otherwise obvious answers (obviously, initiating force against a fellow human is always a crime, but self harm or the harm of an animal you own is not a crime per se) is the "you see" part. While animals don't have rights, that doesn't mean that a moral, civilized society should tolerate public acts of barbarism, anymore than it should tolerate public sex, people relieving themselves in public, etc. While a person doesn't have the right to prevent another person from harming himself, or an animal he owns, he does have the right not to be subjected to witnessing those disturbing acts. If a person is hurting an animal or himself on his lawn, in plain view of the neighborhood, that absolutely violates the neighbors' rights, and the government should act to stop him. In fact, the neighbors themselves have the right to use force to stop the person immediately, and even rescue the animal (and never give it back...much like how property damage entitles the victim to monetary compensation, emotional damage entitles them to the emotional satisfaction rescuing the animal brings). What the neighbors and the government don't have the right to, however, is to dictate how he behaves in his own sound proof basement, where the only way you would even know what he's doing is by violating his privacy.