The newest and most original scapegoat upon which we can place the blame for the high cost of health care are those whose life style choices puts their health or lives at risk. Of course, if our health care cost and access problems are a consequence of unhealthy choices made by autonomous individuals, we are relieved of the obligation of figuring out how to reform our health care delivery system. In that case, the solution to our health care problem is obvious - we merely need to impose appropriate penalties on those who make costly, immoral and unhealthy life style choices. The call for some kind of mechanism that would make people pay for the health consequences of their life style choices is coming from a variety of sources. Some physicians have announced that they will automatically reject alcoholic liver transplant candidates, or put them lower on the priority list, because their moral fault - their alcoholism - caused them to need the transplant. At least one state has attempted to deny Medicaid funding for liver transplants for former alcoholics unless they can prove abstinence for at least two years prior to the transplant.
Robert L. Schwartz,
Life Style, Health Status, and Distributive Justice,
Available at: https://digitalrepository.unm.edu/law_facultyscholarship/106