The U.S. healthcare system had been designed to avoid sick people. For-profit insurers spent billions finding and marketing their policies to healthy people. They routinely dropped coverage of policy holders who become seriously sick or disabled, as well as delayed or denied payment for legitimate claims. Of course, corporations were seeking to maximize profits.
However, the social consequences have been devastating. The U.S. has the highest rates of infant mortality, the largest portions of populations never seeing a doctor and receiving no preventive care and the most expensive uses of emergency rooms.
Finding and marketing to healthy people is expensive and profits adequate to satisfy shareholders are expensive. Thus we have ended up with the most expensive healthcare system in the world.
The Affordable Care Act is a modest solution since it relies on private insurance companies. Minimum standards are set and the marketplace is where customers can compare policies of those insurance companies who have been approved.