You are implicitly arguing that it should be the entire population, but lots of people see it as a chosen group with identifiably similar levels of risks.
I don’t think that’s true. What US voters don’t want is the level of care you get from a doctor who takes Medicaid. A single payer system can work here but because of how bad the “poor people doctors” treat patients it’s going to require some convincing.
A small minority don't want it, so they've spent a lot of money and effort to misrepresent what it's effects will be (see Wendell Potter's admission of this) to scare gullible voters out of wanting it. Even then, if it were in a national referendum it could pass.
Because you've eaten a burger, lived in a city, work in a chemicals factory, driven a car, crossed a road, [insert anything else that increases the chance of death or illness], ...
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.
OP succinctly summed up the exact reason universal single-payer healthcare will never be politically viable in the USA. The “why should I pay for something that also helps other people” attitude is pervasive and unstoppable here. People here won’t even do so much as put a piece of cloth over their faces to help keep others healthy while they buy their Ranch dressing and chow down on Buffalo Wild Wings. You think they’re going to put up with paying a little more in taxes for universal healthcare?
Why in the world wouldn't you? It's the same reason you should subsidize cancer patient health-care even if you don't have cancer: because people should live, and as a society we have more than enough resources to take care of everyone, if we pool them correctly.
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.
You are implicitly arguing that it should be the entire population, but lots of people see it as a chosen group with identifiably similar levels of risks.