We're in this Healthcare Pickle because, initially, Insurance Companies almost never said "No"...
Many of you are now shaking your head and asking if I've finally fallen off the deep end. You're thinking of the, say, 1995 to 2005 time period well described by "Sicko". Let's go back to 1967...
I pick 1967 because that was the year of first heart transplant and the emergence of the question "Just because we CAN spend millions to extend a life 5-10 years, SHOULD we? And, in general, how are we to cope with the expensive new technologies just over the horizon?". Pick up a Time, a Newsweek, NYT editorial pages, etc. etc., that question was being kicked around.
The World's answer to that question tended to split two ways:
1.) in places where there were (or politically could be created) legitimate quasi-democratic institutions that could ration said procedures, they were and are controlled with numbers and waiting lists. Same was true of totalitarian regimes of all parts of the spectrum, although I'm not sure this was a burning issue in your average dictatorship.
2.) in the USA, doctors ached to perform the new High-Tech medicine, hospitals ( especially privately owned hospitals) lusted after the extra profits, and the Health Insurance companies said "Yes", passed along the increased costs, and grew richer and more politically powerful with each passing year. I'm sure everyone remembers how that went: healthcare was usually a (free to you) part of your benefit package. Then you had to kick in token amounts from each pay check, then co-pays, then bigger deductions and more "choices" each year, etc, etc.
The situation Sicko describes happens after premiums have reached the "what the market will bear" point. THEN, to maintain profits, insurance companies started to rescind coverage. THEN private insurance companies started to second guess doctor's orders.
I think 1.) is the correct answer. I think 2.) has led to and will lead to more and more obscenities over time. And I think the ACA is an attempt to cement 2.) into place permanently with laws all the way up to Supreme Court rulings. It's a first step alright. Wait till you see the NEXT steps.