More from The Healing of America by T.R. Reid (p.87):
Everyone in Japan is required to sign up with a health insurance plan. This is a “personal mandate,” an issue that became controversial during the 2008 presidential election in the United States. Every nation that relies on health insurance has that requirement (except the USA), and in Japan the mandate is not controversial at all. “It’s considered an element of personal responsibility, that you insure yourself against health care costs,” Dr. Ikegami (the country’s best-known health care economist) told me [T.R. Reid]. “And who can be against personal responsibility?”