The solution to the problem does not seem all that perplexing to me. Insurance costs should be based on your measure of exposure for the insurance company. Teenage drivers, those with tickets, and those who have had accidents pay more for auto insurance. If you weigh 300 pounds, never exercise, and smoke, you should pay higher premiums than someone who takes care of himself. If you engage in the highest risk factor, male to male anal sex (which is now celebrated in elementary school curriculum), your premiums should be through the roof.
Unfortunately the whole mess is set up by actuarial tables instead of a case by case/individual process. I smoke and the only med I’m on is for psoriasis. Other than that, my own health is good to excellent. Granted some smokers are in terrible health and end up costing more insurance wise. I was probably in a lot better health and in better shape than a lot of my co-workers were. But, due to the tables, I get to pay more. Same for life insurance. I declined to certifiy being smoke free so it costs me more for my life insurance. Oh well.