Without the ACA it would have been even worse. And by worse I mean that even if the premiums were lower, we would still have horrible limitations like maximum lifetime coverage amounts or exclusions for pre-existing conditions.

There is a legitimate shortage of physicians in many areas, especially in primary care. This has a variety of causes including bottlenecks in the training pipeline, shitty working conditions that drive experienced doctors out of the profession, and an aging populace that has drastically increased demand. More and more doctors are opting out of taking any sort of insurance and shifting to concierge medicine or cash-pay models.