When was it not?
Technology changed a lot of things...So did increased costs. So did different types of treatment options along with the types of drugs and treatments excluded under some insurance plans.
Fifty years ago a doctor's choices were limited. The CEO of a Fortune 500 company and the local dog catcher received about the same kind of care. Now, with boutique medical practices and the growth of HMOs, there is a wide division between the type of care available to the dog catcher and the CEO.
Mostly, this doesn't matter -- unless you want a house call or a suite for your hospital stay. But for serious illness, it's a matter of life or death.