International migration of healthcare providers is rapidly emerging within Asia. In the post-Cold War period, affluent, aging, and labor-thirsty Asian countries, such as Singapore and Taiwan, are accepting foreign-born care workers from their neighboring labor-abundant countries. In contrast, Japan—the fastest aging society in the world with an acute appetite for care work forth—is near absent in the HCP migration regime.
Japan has been highly restrictive of foreign-born nurses and caregivers, but is gradually and selectively accepting Southeast Asian HCPs under a special bilateral arrangement (called economic partnership agreements or EPAs). Nine years past since inception in 2008, Japan’s first attempt of managed immigration of Asian HCPs has been fumbling, with fewer-than-expected candidates and sponsoring care facilities, as well as the poor success rate of Asian candidates to work as healthcare professionals in Japan. Many scholars, practitioners, and journalists attribute the scheme’s failure to Japan’s HCP immigration under the EPA framework per se. What went wrong with the policy?
This paper examines political causes of the failure of Japan’s EPA immigration policy. Drawing from an agent-focused approach of new institutionalism, I probe into how the policy was twisted and “drifted” in its institutionalization and implementation processes by political forces inside Japan. The political forces constitute (1) “dual compromise” by the nation’s trade negotiators at the “two-level game” of bilateral economic negotiations (Robert Putnam 1988) and (2) politics of non-compliance exercised by clientelistic bureaucrats at the domestic level of policy adaptation. The paper also provides a tentative projection for a future trajectory of Japan’s immigration of HCPs beyond the EPA framework.
