I definitely do not agree they are equally dystopian. In the "pay for yourself" dystopia, the poor and uneducated continue to eat poorly and die early, horribl

I definitely do not agree they are equally dystopian. In the "pay for yourself" dystopia, the poor and uneducated continue to eat poorly and die early, horrible deaths. [I know this is hyperbole, but is somewhat supported by literature on type II diabetes risks etc] In the "tax the risk" dystopia, the poor and uneducated are essentially given a prodding to make better choices, while still leaving that choice as an option. In the current system the true cost of poor choices is deferred onto the rest of the population. We currently all pay the tax for poor choices of individuals. This gives no real incentive to change behaviour, and given what we know about ego:willpower interactions doesn't help a large portion of the population.