[SamuelAdams]

One could argue that type 2 diabetes is something many inflict on themselves. Should people without this disease pay for their treatment?

What if the person with type 2 diabetes is a 15 year old kid, and their parents taught them bad eating habits which lead to type 2 diabetes? Should the parent's insurance cover that? Or should the parent not get hired because of something their dependent did to themselves?

[sarah180]

No, but we should have a tax on sugar that offsets the cost of sugar-related illnesses like diabetes and obesity. Let people make their own decisions, but don't socialize the costs of substances we know are harmful like sugar and drugs.

This solution has many virtues. It discourages harmful behavior without being paternalistic. It comprehensively prevents an entire class of free-rider problems. It prevents people feeling like they're subsidizing another's bad behavior because everybody knows the smoker is paying their way.

[Cougher]

And decades ago, people who ate "too much" saturated fat would have been penalized while people who replaced it with hydrogenated oils would have paid less while ultimately costing much more. All these years later, we now know that there was some pretty bad dietary advice/policy and the result could have been a whole lot worse if people were financially incentivized to change their diets.

[sarah180]

This is a reasonable counterargument—though I'm not especially persuaded and it's a little bit of a straw man. Are you arguing that there's not enough evidence to substantiate an actionable belief that nicotine, alcohol & sugar correlate with significantly increased health costs? We already tax two of these on that premise—though not nearly the levels required to offset the costs they create.