Milton on Health Care

Back in January, Miltonista rambled about the passage in Book XI in which Adam sees all manner of horrible illness. Since then, I've thought occasionally about the exchange that ensues. Adam grants it just that we should all suffer for debasing God's image, but ventures to ask if there might not be a better way to die. 

There is, said Michael, if thou well observe
The rule of not too much, by temperance taught
In what thou eat'st and drink'st, seeking from thence
Due nourishment, not gluttonous delight,
Till many years over thy head return:
So may'st thou live, till like ripe fruit thou drop 
Into thy mother's lap, or be with ease

Gathered, not harshly plucked, for death mature . . . .

This strikes me as a little too similar to John Mackey's libertarian/personal-responsibility bullshit. These lines really baffle me. They'd be inexplicable enough if they had been written by any poet with enough world experience to know this isn't how things work, but they come from a supremely temperate man who nonetheless turned blind and gouty. Are these lines bitterly ironic (another case of angels just not quite getting what it's like to be human)? A manifestation of the sheer force of ideology? Both?