The only way the libertarian approach works with this is if people are allowed to die on the street, in their homes, etc. or have to suffer the consequences of their decisions. As long as they can fail to handle their medical emergencies or conditions and still get help or relief nothing’s going to change.
Let's say I don't smoke, I don't drink, I don't speed or disregard traffic laws, I work to keep my blood chemistry in good shape, etc. It takes a conscious effort on my part to do all the things that I feel are good for me, and I really have to work at resisting all sorts of temptations, but then someone comes along who's done none of these and has problems as a result. I still have to pay for it just as though I had made no effort to avoid the costs of poor choices.
I don't know the answer except to thank God, literally, that I am in a position to help those who can't or won't help themselves.
An on-line family dr friend, Dr. G, has paraphrased the late Baptist preacher, Adrian Rogers’ essay on the poor and wealth:
“You cannot legislate the diseased into health by legislating their doctors out of prosperity. What one person receives without working for, another person must work for without receiving. The government cannot give to anybody anything that the government does not first take from somebody else. When half of the people get the idea that they do not have to work at staying healthy because the other half is going to take care of them, and when the other half (even when motivated altruistically at first) gets the idea that it does no good to work and study because somebody else is going to get what they work for, that my dear friend, is the beginning of the end of Medicine as an independent profession. You cannot multiply health by dividing and diminishing its custodians.”