While a lot of COPD is self-inflicted, not all of it is.
Nor does that account for those who are trying.
My f-i-l smoked for a while, not heavily and not long. He quit many years ago, but the damage was done and he is dying from emphysema.
So while it is true that it was self-inflicted, it isn’t like he didn’t do something about it. Besides, that was in the day when everyone was told that smoking didn’t harm anyone.
Sometimes people can be cut some slack.
The other thing is, the disparity between spending on COPD and other conditions, is way greater than can be justified, because even in many of those otehr conditions, cancer for example, much of that is self-inflicted through smoking, diet, lack of exercise, etc.
Making self-infliction a criteria for justifying spending is not good.
I’d hazard a guess that AIDS is far more self-inflicted than COPD.
Not necessarily. Though of course there are degrees of "self-inflicted". Only a very small percentage of COPD cases are caused by a genetic defect. Then there are some caused by occupational exposure, which in some cases the workers didn't realize carried a risk (in this country, at least, if they realized it, they could almost always have called OSHA and gotten the problem fixed, unless they were here illegally). The vast majority of people with COPD got it by smoking, while knowing full well that smoking carried a wide range of very serious health risks. A few got it from childhood exposure to parents who smoked heavily.
AIDS really has a pretty similar pattern, though probably somewhat more child-acquired-from-parent cases (even in the US) where babies were born with infections contracted from their mother. There are plenty of monogamous spouses who got it from their spouse -- some had no idea their spouse was sleeping with anyone else, much less any idea the spouse was HIV+; others fall into the "should have known" their spouse was putting them at risk category. A few people have gotten from being raped or from blood transfusions. But like COPD, the overwhelming majority got it by willfully engaging in unprotected and/or promiscuous sexual behavior that they knew full well carried a significant risk of contracting this deadly infection.
I think self-infliction is a very good criterion for justifying spending. Not just in health matters, but in all areas. I don't think we should be handing out food stamps and housing vouchers to people who are poor because they choose to play around instead of working. And I don't see why spending for healthcare or related research should be any different. Paying for self-inflicted conditions promotes a cultural idea that "you really couldn't help it", can't be expected to control yourself, and shouldn't have to suffer because you made dangerous choices that you knew full well were dangerous -- this promotes a cultural idea that we shouldn't be "judgemental" about such behavior, which leads to tacit acceptance of such behavior, which leads to a lot more people engaging in it. We're heading down a very slippery slope, with fully half the nation's healthcare spending being directly related to obesity and its predictable side effects. Most of this is public (tax) spending, and a huge amount is for people who have stuffed themselves into diabetes, then refused to manage their diabetes, and gone into kidney failure. Currently, kidney failure, regardless of cause, gets a person on full Medicare coverage for ALL their medical care (largely because kidney failure is so all-encompassing, that it's hard to classify other conditions as "unrelated"). The fact is that in many neighborhoods, the culture is now fully accepting of massive obesity, and fully accepting of massively obese parents giving even very young children virtually unlimited access to junk food. One reason it's so accepted is that these people don't literally end up either dying in gutters or bankrupting their families -- they end up getting all-encompassing taxpayer-paid medical care that many of their not-yet-in-kidney-failure friends and relatives are eager to get.
Of course, when it comes to paying for healthcare for an individual, the facts of how THAT person came to get a certain condition need to be paramount, regardless of how huge a percentage of people with the condition got it by self-infliction.