"Are there trends developing that simply look for the most efficient and least cost market structure for healthcare or is there a developing trend to induce lifestyle changes that result in better health?

Putting these two articles into consideration

Arrow, K. J. (1963). "Uncertainty and the Welfare Economics of Medical Care." The American Economic Review 53(5): 941-973.

Grossman, M. (1972). "On the Concept of Health Capital and the Demand for Health." The Journal of Political Economy 80(2): 223-255.