I do not think that Japan has free health care, but what Japan does is cap the cost of services. All of the hospitals in Japan cannot charge more for a room than the same price as a night in a really good hotel. The hospitals stay competitive (in service - thus to the benefit of the consumer) because the consumers know that it will cost them the same to spend one night in a crappy hospital or one night in a luxury hospital. Recently I was in a really bad wreck (caused by an illegal who did not get hurt - his life is not changed) and had to spend some time in the hospital. Over $2k per night and there is no way in the world you can convince me that the room and care was worth $2k. In Japan knee replacements are the same price anywhere in the country. This weeds out the bad doctors. In Japan the consumers are happy and the health care providers are happy. Taxes are not impacted at all. However, in all fairness to US doctors, I do not know if the Japanese doctors have less school loan to repay. Also, this is the first that I have heard about Japan penalizing fat or lazy people. I think there are enough models of successful medicine around the world that we could borrow ideas from different models but would be foolish to take up any model exclusively. By the way, you bring up an excellent point about the illegal immigrants being a burden upon our medical industry.
Likewise, I went to the hospital emergency room on the weekend when my finger swelled up and turned cherry red.... (my regular doctors office was closed)
I was there 35 minutes tops.... they gave me a script for anti-biotics and said to go home. (in retrospect, I was just paranoid that I had something serious, which it was not)
Anyway, they just sent me a bill for $1,100 and claimed they gave me a discount!
No wonder medicare (or whatever) is broke... and getting worse.
If insurance companies were allowed to 'spread risk' by issuing CATASTROPHIC plans only, that would eliminate many problems.
I am willing to pay for regular doctor visits and testing. No problem.
I just worry about a catastrophic auto accident or cancer/disease, which would cost $200,000 or more.
THAT is what insurance is for.... not the everyday expenses.