Here is where I would start.

Infuse...Here is that word again..."Personal Responsibility" into the system. If you smoke, eat poorly and don't exercise then you pay more or are not covered for certain vice related illnesses and conditions. I'm sorry but if you smoke in this day and age and don't know about Lung Cancer then you need to be removed from the gene pool. If however, you don't smoke, drink in moderation and live a healthy lifestyle you pay less because you cost the system less. The healthy pay as much as the stupid to balance out the risk in most cases. Medi-Caid and Medi-Care recipients should be screened and rewarded for lifestyle. If my taxes are paying for someone who weighs 340 pounds because he eats at Burger King every night I'd say he is headed for Heart Disease regardless of what we pay to keep his ass alive.

If you provide incentive for good health you will get good health because people will either change behavior or die off and the remaining citizens will live healthier and have more services and tax dollars for legitimate accidents and illnesses.

Lifestyle is a choice and has concequences...Unless you are a Progressive.