I don't count insurance companies. An insurance company makes a voluntary decision to be an indirect participant in a risk-taking activity. They can enforce he

I don't count insurance companies. An insurance company makes a voluntary decision to be an indirect participant in a risk-taking activity. They can enforce helmet/seat-belt use as part of their policy if they wish, and deny coverage where appropriate. The taxpayer question is more complicated, since most people would probably agree that we can't allow an accident victim to bleed to death at the side of the road because they chose not to use their seat-belt. I'm fairly confident, however, that a solution could be devised without recourse to state interference in personal decisions.