There are two forms of paternalism at least as I see it. One that obviously comes from our parents as shocking as that may sound and I believe the only people it should come from. And as annoying as and in some cases positive parental paternalism may sound, our parents at least tend to have our best interests at heart even when they go too far.
So people in America can’t past their own health care costs on to other people. The Affordable Care Act doesn’t require people to live healthy and take care of themselves. What it says is that we are all responsible for our own health care costs at least those of us who can afford our own health insurance. And for those of us who choose to live unhealthy, they can still do that, but they won’t be able to pass the costs of their unhealthy decisions on to other people.