A) I don't go around saying that either, because, apart from that being quite rude, black skin doesn't cost the NHS money and even if it did skin colour is not the responsibility of the individual. Given the lower rates of skin cancer amongst the Afro-carribean population it's proabably cost-effective, relative to caucasian skin.
B) This is in contrast to being a fat git. Or a (formerly white, now orange) sunbed-tanned-skin-cancer-volunteer dickhead. Both of these are irresponsible choices and worthy of criticism.
Are you incapable of seeing the difference between A and B?