OK here's the plan. Guv passes a universal Health Plan that ALL must sign up for. When you do you get a very special invisible mark, in your forehead or your hand. The mark can easily be read from outerspace with a satellite, so "we" know who's with the program and who isn't, no hiding in caves to get away (we got bunker busters).
Maybe the mark could be a series of numbers, like 6 or more...
That should take care of the "pressure problem" noted above and motivate folks to get signed up.