Tuesday, August 22, 2006

Negotiating FTA Quotas for Philippine Nurses Masks A Bigger Problem

The Shisaku blog has an interesting entry where Shisaku juxtaposes what he sees (and I agree with him) as “a shift toward a greater acceptance, indeed desire, for non-Japanese participation in the national workforce” and “the very public fiasco over the opening up nursing positions for qualified Philippina [ed. actually, the nursing profession in Japan has been co-ed for some time now] applicants”.


This is a perfect example for Mancur Olsen’s Logic of Collective Action. There is no Japan Federation of Fast Food Freeters (and Students and Housewives) to protest the encroachment of aliens with or without work visas into their neck of the woods. Nurses, on the other hand, are well-organized profession, with their very own LDP representative in the Upper House.


Moreover, there are no FTA negotiations over part-time gyudon waiters/waitresses quotas to rally the opposition, which is where our negotiations with the Philippines over the nursing profession quota come in. That was doubly embarrassing because one reason free traders like to negotiate big packages instead of individual issues is to concentrate wide but shallow support and bring them to bear on the special interests that dominate individual issues. So much for political leadership.

But the troubles over the quota negotiations mask a more fundamental problem, which is that Japanese nurses are being underpaid. How can I be sure? Because there’s a shortage of nurses, that’s how. Nursing is a typical 3K (kitsui-difficult, kitanai-dirty, kiken-dangerous) that requires years of training. And they’re far below the doctors on the medical totem pole. It’s no wonder that they often quit early, and never return.


Like most problems in the medical sector, this nursing shortage has its roots in the national healthcare system and, more specifically, how it sets prices. I confess that I have no idea what to do with it. Mr. Abe’s healthcare program, as far as I can gather from his book “美しい国へ (Towards A Beautiful Nation)”, is heavy on prevention, which in itself is okay. But the book says next to nothing about the finances of the healthcare system (and paints what seems to me to be a rather optimistic picture of the public pension system), much less the system’s structure and design. I hope that the soon-to-be-announced program of his will give us a better indication of his objectives and programs in this respect.


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