I would like to provide some context for the article “Patients Adrift: The Elderly and Japan's Life-Threatening Health Reforms” by Hiratate Hideaki, recently translated from Shukan Kinyobi for publication in Japan Focus. Japan has a long and honorable tradition of muckraking reporting on its medical care system. To illustrate that point with a personal anecdote: My colleague Naoki Ikegami and I published a book about a decade ago called Japan's Medical Care (Nihon no Iryou, Chuuou Kouron Shinsho) itself a translation of a book we published in English called The Art of Balance in Health Policy: Maintaining Japan's Low-Cost, Egalitarian System (Cambridge University Press). Although it pointed out quite a few problems, the overall tone of our book was as positive as the English title indicates. Many Japanese readers told us it was the first time they had ever read anything good about their own medical care system. They were used to reading magazine articles and books full of pitiful anecdotes and unrelenting criticism.