Academic journal article Migration Letters

Healthcare: The Case of Japan

Academic journal article Migration Letters

Healthcare: The Case of Japan

Article excerpt


Japan requires all of the healthcare practitioners to be qualified by national examinations and to be fluent in Japanese. Consequently, the number of immigrant workers remains very low, although Japan is faced with staff shortage. Even under the special bilateral arrangement that allows nurses and certified care workers from Indonesia and Philippines to practice temporally, there are very few who passed the Japan's national examination: it is difficult for them to read technical terms written in Japanese, especially written in Chinese characters (Kanji). In care subsector, where wage is lower than physicians and nurses and qualifications/licenses are not necessarily required, the number of employed foreign-born residents is rapidly increased. Some local governments have started to support them to complete language and care-work courses. These facts show that language support is necessary if Japan considers that matching local staff demands is important for competitiveness. If Japan considers that development of inbound and outbound business leads to competitiveness, it is necessary for Japan to introduce systematic efforts to bring up foreign-born staffs, but language fluency requirement is not necessary in accepting foreign-born workers.

Keywords: Aging population, staff shortage, inbound and outbound businesses, Economic Partnership Agreement (EPA), language support.


Today, developed economies are equally faced with low competitiveness, high unemployment rate, and aging population. As far as healthcare sector is concerned, aging population requires more financial and human resource than ever, but low birth rate reveals that younger generation cannot supply enough financial and human resource to afford seniors. Especially, Japan enters the era of aging population more rapidly than any other OECD countries, and it has to tackle with the shortage of healthcare workforce. This paper analyzes Japan's healthcare sector in terms of migration and competitiveness, and outlines Japan's status quo and problems to be solved.

The first section of this paper outlines Japan's healthcare sector, by introducing the statistical data. The second section exhibits the positions of the ministries toward the status quo in the healthcare sector. The section highlights that there is two ways of understanding of "competitiveness": the one is increasing the number of workforce in order to match local staff demands; the other is developing inbound and outbound businesses for healthcarerelated industries. The varied and conflicting interests among ministries cur- rently make Japan's healthcare sector regulated one. The third section touches on the migrant employment pattern in Japan. It examines the stadsdcal trends of foreign-born workers, and introduces Japan's attempts to invite overseas practitioners under bilateral agreements. It also focuses on the MHLW (Ministry of Health, Labour and Law), the key regulator in this sector, to exhibit its posidon for accepting foreign-born workers. Then, this secdon introduces the actual situations in care subsector, to reveal that the MHLW's calculadons and human resource plans do not work in reality. The fourth secdon touches on the alternative opdons and scenarios for Japan in terms of compedriveness and migration.

Outlines of Japan's healthcare sector

One of the key features of Japan's healthcare sector is its size in the national economy. The OECD Health Data 2011 reported that Japan's total expenditure on health is 8.5% of gross domestic product (data in 2008). Although the amount itself has been steadily increasing, it is relatively low, if compared with other OECD member countries such as the United States (16.0%), France (11.1%), Germany (10.7%) and the UK (9.8%). People's expenditure on health is also lower than other major OECD countries. In 2008, Japan's total expenditure on health per capita (PPP: purchasing power parity) was 2,878 US dollar, and it was lower than the OECD average (3,101 US dollar). …

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