This is the crux of the matter, and the solution at some point is to either have people deny themselves "extraordinary care" or have someone else do so.

There's a "motte and bailey" that goes on with healthcare - emergency services like handling broken legs and illness and such is actually relatively cheap; it's the prolonged costs of all the various things we die of that really puts a burden on things.

Sure we spend $5 million now and then to save premie infants, etc, but that's such a small portion of total healthcare spending as to be a rounding error.

https://www.cdc.gov/nchs/data/hus/2020-2021/HExpType.pdf breaks some of it down, but not in detail; I suspect that a huge amount of healthcare expenses can be directly tied to obesity and its consequences.