Allow me to chime in on this, if I may. And please feel free to flame me as the new guy. I can take it.
I am also against government ruling our lives, so I agree when Canadianguy says that Insurance companies and government already take alot from our lives. But i disagree on the point of a persons right to choose to be reckless when it becomes a danger to me and my family. My wife and I just had our first daughter in May, and since then my attitudes have changed alot. Whereas before idiot drivers (75% on the roads these days) were a mere annoyance, now I have an urge to run them off the road and beat the piss outta them. Not the answer I know, and I would never do it, but I get really angry when I think "who the hell are you to take that risk with my families life?"
IN short, I beleive that insurance may be the answer. To use your own example of the Marlboro man. What if he was out on a boat, injured or maimed me so that I could no longer support my family. As you said, he is poor, so I will never get a dime out of him. SO your answer is that my family should just suffer in the name of liberty? No thanks. I would rather take comfort in the idea that, while mine and my families lives may be forever altered, at least I can sue his ass off and his insurance company will pay.
If I owned a cottage on a really busy tourist lake, I would ask the other cottage owners on the lake if they would pitch in on a private security boat to go out and bust lame tourists for water infractions, at least on weekends.
Cheers.