Just adding that some people go from disease to disease, and the illness keeps them from really getting a job or realizing their gifts. I don't see how that could count as "a just outcome of what they deliberately chose to do" at some junctures in their life. The costs of actually getting them free of it, rstoring a decent health for them and their kids, may be minute compared to what it will cost if they are forced to live off crime or simply the working life they are not able to bring to society.