Yep, that's exactly the issue - if healthcare is socialised, then at least implement all available mechanisms that force people to watch their lifestyle (i.e. being fat means paying higher premiums). If healthcare is completely up to the individual, then I see no problem with the fatties; but then on the other hand unlucky people are fucked financially. I haven't yet found a really good solution that works in every single case. Maybe the Singaporeanian model: one state-run "high risk" insurance for things like severe accidents, for the minor health issues, you're on your own. Still not perfect because someone then has to decide what counts as bad luck and what counts as "your own fault / comfort issue / ..." ("mah beetus is gahnetic, all mah famaly has it"). Hm.