IMO they should just charge a premium for smoking that about covers the expense overall
Look at automotive insurance points systems. People have to buy it so the sellers lean on the legislatures and before you know it a ticket costs the same points and screws you out of just as much money as an actual accident.
Surely that was a satirical comment and was meant to be an illustrative example of exactly the sort of mindset that runs political cover for a system as it pivots from providing enough value to become entrenched to using that entrenched position to behave in an extractive manner.
In my state if grandma gets pulled over for an out of date inspection sticker it's the same number of points as actually causing an accident. Someone is being fleeced.
I have zero faith that letting the government choose at the behest of industry who ought to pay more for healthcare that it wouldn't devolve into the same exact sort of exercise in finding a reason to charge everyone more.
And as a driver, I certainly want everyone around me to be required to properly maintain their cars.
What you're saying seems to make sense on face value but in reality letting insurance leverage safety inspections is just a politically less thorny wealth proxy. The inspections themselves don't provide all that much value (IMO this is because of how comprehensive they are, 90/10 rule and all that) and multiple states have ended their programs because they don't actually provide meaningful improvement for the money.
Regardless, even if there is somme hand wavy justification for it that some people agree with, it's flawed to the point it's probably not something we want to do with medical because it would make insurance unaffordable for so many people on flimsy at best pretexts.