It's a dangerous question. It does apply in this thread though. It's a basic concept that can be reiterated any way you wish with any subject regarding health. If we know something is detrimental to our health, and the public health in general, then if you choose to engage in that behavior or lifestyle or consumption of, or refusal of something that results in known detriment to health, should it incur a premium regarding their health care or insurance for said health care? When does it end? This logic cannot carry obviously. Some things will be targeted based on how they're impacting throughput in the system. Every couple of years this changes in terms of subject matter. For a long time it was heart attack, then stroke, now it's sepsis, and the next one is obesity. And it all stems from who's funding the system. There will always be a popular crusade on something, like smoking (now), or pick something else. It depends on what the for-profit insurance system wants to target to reduce their payouts until you get on medicaid. It's not about saving lives, unfortunately. It's the result of lobbying by for-profit systems to avoid paying out. And it's a pick and choose thing. The next big one is obesity, in a very big way.
This obviously begins to side rail from the original thread, so I'll leave it there. But just pointing out that it's not some computer system with utopian ideals (this isn't Star Fleet) that takes anything that is self-induced, like smoking, and turns it into a punishment system. It's the result of for-profit humans leading a business and lobbying for what will allow them to be as profitable as possible without incurring litigation that crashes their profits. Health care is a business in the USA, disguised as health care. COVID? Smoking? Alcoholism? Any at-risk behavior? Any consumption of anything that is known to cause issues with health? Any cancer risk? Obesity? It's literally handled the same in terms of it being ethical or not, and is heavily impacted by who is at helm of liability and payout schemes. It's wealth generating with pretty words to make the public not feel like cattle.
You start to get into dangerous water because many things are legal but lethal to health. And health doesn't rule all. The amendments do. Those virtual freedoms. So there are dirty ways around that because it's all profitable and supports the economy. Let's keep it legal to smoke, and let them generate wealth, while causing harm to people who will eventually need health care, and charge them more for it because of their bad choices of using a legal product that causes bad health results. Insert whatever you want. You cannot force something and not expect legal issues, like a vaccine. But to suggest they be punished in their health care in some way for not taking the COVID vaccine? You can't. It's not that its not ethical, it's a legal thing. And you bet your butt for-profit insurance is going to absolutely capitalize on COVID. And again, soon, there will be penalties for you being obese/fat. Just wait until you see the outcry of obese America when they're told their health care costs more because they chose a poor diet for a lifetime.