We could stop socializing the costs of self-destructive behavior by returning to real health insurance in which people pay risk-based premiums adjusted for lifestyle factors under their own control. Gain weight; see your premiums increase. Smoke, drink, or drug; see your premiums increase. Be sexually promiscuous; see your premiums increase. I suppose the best way to enforce the latter would be to exclude STDs, including AIDS, from standard coverages, and let those who think they need such coverage purchase a rider. Just cut out all the subsidies and let the chips fall where they may.
Xlnt idea. The closets would be full very quickly.