To my mind, the most surprising thing about the whole Whole Foods CEO w/ Ayn Rand health care outlook kerfuffle is that an op-ed ran at all. It is a publicly traded company, and one that depends heavily upon a brand aura. Whatever the WF brand is, most folks who shop there seem not to endorse a neo-liberal, neo-Hobbsean health care proposal that would run NICUs like they do in Sparta in 300. As such, a CEO who goes off-message vis-a-vis the brand seems like a liability, and the kind of liability the board of directors might want to discourage in the future.
As a private citizen, Mackey has the right to opine whatever he wants about health care* and nobody is disputing that. However, the current WF situaion points to a peculiar inversion of the fiction of the corporation. The corporation, a device that exists to give a company a legal status like that of a person, but apart from a person, has any number of benefits, but in the case of a founder/CEO like Mackey, who is strongly identified w/ his company, the nature of the corporation shapes the nature of the CEO, or at least when it does not, folks get mad.
More generally, the fuss reveals two contradictions. First in the Whole Foods brand. People shop there, and feel good about shopping there, and pay extra to shop there, b/c it feels good, b/c of the recyclable bags, the waterless toilets, the green products, organic produce, etcetera, etcetera. However, for every compact fluorescent bulb or cage free egg in the WF shopper's basket, there is something that is better, nicer, higher quality than what you get at the regular grocery store. In this light, advocating a pay-to-play health care system is absolutely consistent w/ the WF ethos -- pay more, you get better stuff, whether is lettuce or pharmaceuticals.
Pulling back further, this aspect of the WF ethos reveals a deeper contradiction in the culture of food in the United States, which is that heavily processed and engineered food is cheaper than the simpler and less processed stuff they sell at WF. Much of what one pays extra for at WF is an absence, rather than a presence, in the same way it usually costs more to drink in a bar that does not have ESPN on all 18 monitors.