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An Invisible Policy Shift: International Health-Care Migration to Japan

Hitherto Japan’s migration policy in a nutshell read “exclusively highly skilled migration” and “exclusively temporary migration.” Faced with the enormous speed of Japan’s demographic change, however, the government has started to open up the national labor market to foreign workers. Under bilateral Economic Partnership Agreements that Japan tied with the Philippines in 2006 and with Indonesia in 2007, up to 1,000 health-care workers per nation per year are invited to relocate to Japan and work in their professions there. Labor market liberalization at this point precedes sector-specific and nation-specific. The pioneering sector is the health-care sector, a traditional center of feminized work, and with its low prestige and low income despite the long working hours, a highly marginalized profession in Japan and elsewhere. The health care sector is also the one business sector most directly confronted with Japan’s population aging: The number of beneficiaries of long-term care insurance is expected to almost double by 2025 (from 4.5 to 8.4 million), while even today there is a severe shortage of qualified workers in the field. In this paper I will argue that Japan’s demographic change triggered a migration policy shift, which despite its fundamental character did not become an issue neither in the nation’s public nor its political discourse. The invisible nature of this policy shift will once again support the notion of health-care work as a marginalized profession - by many governmental officials - deemed to be best conducted by groups with limited access to political decision making, such as lower educated female workers or labor migrants. The policy process, which led to this invisible policy reform, is studied through a qualitative content analysis of government documents and expert interviews. Special focus shall be placed on the activities of national-level political actors, such as the Ministry of Health, Labour and Welfare, the Ministry of Justice, the Japan Nursing Association, and the Japan Business Federation.