It's a shame really. Cultural habits like toilet use are very resistant to change, even if there are health or hygiene benefits. You don't know what you are missing until you've lived in Japan with a Toto Washlet installed.

You use a lot less toilet paper, and while the heated seat may seem decadent, it is actually very relaxing in the colder seasons — ostensibly a good thing when voiding your bowels. The best thing though is when you are ill and have diarrhoea. On a Western toilet the toilet paper feels like 80-grit sandpaper after the fourth time you go. With a washlet you've still got diarrhoea, but at least you leave the bathroom feeling clean with your skin not nearly as irritated.