Its a chicken and egg problem as well, the way we regulate and manage health care and health insurance (at least in the US) allows for costs to pretty easily bleed out to the rest of society. That implies that we must then be collectivist in other policies, though that is counter to many of the original goals of our country and the question is whether we changed those goals or inadvertantly built a system that requires changing gials after the fact.
We have a similar problem with immigration laws. Our immigration laws today are completely counter to what they once were, and counter to what is still written on the Statue of Liberty. We have immigration laws now that are necessary because of the welfare programs we implemented, even if we wanted to live up to the older ideals we couldn't without abandoning those welfare programs entirely.
But isn't the point of non-socialized healthcare, like in the US, that you pay for care out of pocket? Or maybe via your insurance, which will probably increase your premium if you repeatedly engage in stupid actions that need expensive fixing?
There's a line to draw somewhere, but even the most ra-ra-individualist heavily depends on society, and has/should have obligations in turn.
If many people started doing stupid things though then yes it would raise premiums for all.
But I guess that might be the debate line of which you spoke.
I don't have stats on hand, but I seem to remember that smoking costs much more than alcohol, despite a sizeable (1/3? not sure) proportion of car accidents being caused by the latter. Alcohol and drug use is already considered an aggravating circumstance in some situations (car crashes, assault, etc).
But yeah, I think there are activities that are clearly extremely risky and some that are clearly not. I guess alcohol lies somewhere in the middle: I never felt compelled to drive after drinking; I usually just zone out on my couch or go to bed.
There's also the fact that alcohol seems pretty much unstoppable. See how well prohibition worked in the US. Ditto for drugs and smoking, where, despite our local flavor of "war on drugs", cannabis consumption has exploded in recent years. Taxes on tobacco are extremely high here, yet many people still smoke. I understand smoking is relatively less popular than before, but people do still smoke. Alcohol consumption has also gone down, but people do still drink. Despite the communication campaigns that they're not healthy.
So I think that since there are some activities in which people tend to engage in anyway, even if they're outlawed (cannabis comes to mind), we, as a society, should figure out ways to mitigate that. Have people be accountable. Wanna do stupid shit? Knock yourself out, but don't have society bear the burden.
I don't know, as someone who mostly rides motorbikes, I wouldn't be shocked if I had to pay a premium at the hospital if I left half my face on the pavement in a crash because I figured wearing a helmet, or even serious equipment, was somehow not cool, or whatever people tell themselves to justify riding next to naked. Yes, I wear all my gear even under 40ºC. Even in the US desert, where I understand helmet wear is not mandatory. Yes, I sweat. I've only ever had a minor crash despite riding a big-ass "dangerous" crotch rocket, but I enjoy having my skin attached to my body more than not sweating. Should I pay a (lower?) premium anyway, since motorbikes are statistically more dangerous than walking? Maybe?
There are many studies a quick google away that show a much more nuanced take ie [0] and [1]. But the strongest evidence is our most successful societies and civilizations have been intentionally drinking alcohol for ~10000 years [2]. If it was only detrimental then I'm pretty sure it would have worked its way out by now. I acknowledge there are negative issues.
[0]: https://www.webmd.com/diet/ss/slideshow-skinny-cocktails [1]: https://nutritionsource.hsph.harvard.edu/healthy-drinks/drin... [2]: https://en.wikipedia.org/wiki/History_of_alcoholic_beverages
Obviously there are downsides too, but booze is popular for very good reasons.
US insurers can only discriminate by age and smoking status.