It’s often difficult to identify the cause of a health problem with certainty. In many cases, genetics, behavior, and bad luck all play a role, though how much each contributes is hard to say.
Where do we draw the line on bad choices? Eating like crap clearly isn’t healthy. Failing to exercise every day isn’t either. But do we want a health system that only caters to people who eat the recommended amount of vegetables and exercise regularly?
And then there’s the question of how the state monitors all this.
We could settle on an answer to these questions, and you’re right that letting people suffer the consequences of their actions — with the wealthy able to get care and everyone else left to suffer — is a logically consistent position.
But when it comes to reforming the healthcare system, there’s still #3. If emergency rooms treat people that can’t pay, the rest of us end up paying for their care. The only question is whether we do it with our taxes or our insurance premiums.