I don't think it's fair to characterize unhealthy people as making bad choices. Many choices do affect health, but plenty of healthy people end up needing medical care every day through no fault of their own. Then there's the systemic issues of our healthcare system, low-cost low-quality food (HFCS and other garbage), and even if the consumer knows how to take better care of themselves, they may not have the resources to do much better depending on their life situation (think juggling jobs and taking care of kids, etc). So, I don't think it's strictly a choice to be healthy or to be a drain on the system.