I mean, do health insurance companies mandate best health practices in order to get health insurance? Of course not, they just charge premiums commensurate with the risk they're taking on.
Interestingly, basing insurance on healthiness seems to be a new trend happening right now.
I'm a runner, and recently I've seen a lot of ads for a company called HealthIQ (I think) that offers cheap life insurance, but only for people who can run a 9 minute mile.
I think breaking into health insurance would be much harder because a) the administration is way more complicated and b) most people get health insurance through their employers, and normal employers won't be able to guarantee that every employee can pass a healthiness test, but I imagine they're working on getting around these problems right now.
Fully-integrated HMOs (think Kaiser) have extensive tracking and best practices that reduce future risk and liabilities: well mother / we'll baby care and training, vaccinations and nutrition, preventive chechups, monitoring of dangerous conditions, ob/gyn checkups, breast, colon & prostate exams, etc.
There's only so much that individual initiative can accomplish, but systemic measures really can move the needle.
