And what about other choices that impact emergency care? Obesity related illness and injuries, smoking and other cancer-inducing habits, dangerous activities such as motor sports and rock climbing, workplace injuries without appropriate PPE, auto accidents without helmets and seat belts, etc.
And who is it that gets to be the moral arbiter of what is acceptable? To me, it seems like whoever is in power. What happens when “the other side” from your perspective wins an election cycle?
It literally gives government moral authority over who deserves care and who doesn't. "Universal" healthcare, as long as you're part of the universe that does exactly what the government tells you to do.
You should be allowed to have whatever private health care or sharing, etc you want, while having some basic amount of care commonly available. There will always be limits. Rich people can afford to hire their own private doctor and nurses. We can't realistically afford that for every individual.
And we have already identified these things really. From preventative care and reproductive health options which can be found free of charge, to things like EMTALA granting emergency care to everyone.
Identify the things which are fundamental and provide those to everyone, and allow the upper echelons and unique needs to operate in free market.
Or, for that matter, to other groups of people with an "illness that could have been prevented by a widely and freely available measure"?
A few spring to mind immediately – obesity first and foremost.
In broad terms, I agree with your approach: incentives at the personal level. Bottom-up. But in many countries (mine included, in EU), "health insurance" is really just a tax. There's no connection between your health & behaviour, and the "insurance" cost or fulfillment. So what you propose would essentially amount to privatizing health care, or at least turning it from an income tax into real insurance.
I’m all for the libertarian solution here: just charge people who refuse to get vaxxed more in premiums to fund their future more expensive Covid treatments. It should not be considered a preexisting condition. This would extend to group plans, except since the risk is all pooled, it would have to be for workplaces that don't mandate the vaccine. And areas of the country that have low vaccination rates should necessarily have higher insurance rates given that vaccines require mass adoption to be effective.
Couple the above with with a ban on advertising pharmaceuticals and we would see a 50% reduction in per capita health care spend almost overnight.