Medicaid is intentionally handicapped since it’s a poor person program and poor people don’t have good political representation.

“For hospitals” is just Part A. And, “over 65 or disabled”.

For a lot of types of insurance I don't think it is clear cut at all.

(Note that the law in the article is about other types of insurance, not healthcare)

Everyone gets ill, everyone dies, smokers in most countries pay additional taxes on every packet of cigarettes they buy. But, even if they didn't, having a national insurance scheme (as we have in the UK), is the best way of spreading the risk of costly healthcare.

When you buy insurance you're not subsidising anybody, you're joining a pot of individuals who are trying to lower the overall risk of high medical bills. The more people, the easier it is to absorb exceptional costs.

You already do, when that guy gets cancer, dies and has no money left over, your taxes pay for his care. You're just cutting out the middle man at that point.

   How old is the smoker?  And you? What type of care does the plan for the pool you could both be in cover? There are risk pools of less than ten to over one million to choose from in private hc market currently... But the best argument is cost.  

   A single payor system would likely cost you much less overall for the same level of hc coverage as current options.   If you have to subsidize *more* smokers than you currently for a plan (risk pool) to be economically feasible but the cost of care is lowered enough that your overall cost is reduced it would save you money.  


  The reduced cost of care would increase the social and community improvement we see from a baseline level of charitable healthcare we as a nation have already agreed to subsidize. 


  A functional single payor system will likely require larger risk pools but greatly reduce cost by mitigating the current market forces that drive our ever inflating cost of care. Providing better charitable care for our sick is a noble and ethical goal to target as a society and you *being open to the idea* of subsidizing *more* smokers healthcare helps us achieve that so thanks for asking the question.