re: "Structure"
If you'll read again Tom, you'll notice I didn't advocate mandates for people taking care of themselves, simply a system that doesn't reward them for their bad behavior. You want to smoke? Go for it. Just don't expect your government health care for your lung cancer to be cheap anymore. You want to do drugs? Your hepatitis A is now a costly adventure. However, if you want cheap health care for your poor choices in life, then you better start towing the line and work to end your bad behavior.
Of course the possibility exists that government will overreach their bounds and push for control of things they don't have business in but guess what Tom? The people that seem to be doing the most of that these days are Republicans.
Art