Column  Finance and the Social Security System  2010.03.26

A roadmap to create 2.8 million jobs in healthcare

The highlight of the "New Growth Strategy (Basic Policies)," announced at the end of last year by the Hatoyama administration, is "fostering industries and employment to meet demands for medical-, nursing-, and health-care services by 2020, thereby creating new markets worth about 45 trillion yen and new jobs for 2.8 million people." Although the Hatoyama administration claims that it will announce a roadmap to this goal by June, the public seems unimpressed. This is because the Democratic Party of Japan is withdrawing its commitments in the manifesto for the last general election one after another by reason of declines in tax revenues. And a mere 0.19% increase in medical fees in the revised medical fee scheme effective from April 2010 is considered a disappointment.

However, the government is moving in the right direction in that it intends to convert the medical- and nursing-care sector to an engine of Japan's economic growth and thereby create jobs. As Figure 1 shows, the number of employees has been steadily growing in the health-care and welfare sector,

Figure 1. Change in the number of employees in Japan (in 1000s)
  Average for 2004 Average for 2008 As of Nov. 2009
All sectors 53,550 55,240 54,660
  Health care and welfare 4,980 5,650 5,950
  Medical care 2,770 2,880 N/A
Public health 90 90
Social insurance, social welfare, nursing care 2,110 2,670
Other 48,570 49,590 48,710

Note: The numbers have been rounded and therefore the sum of them will not always be equal to the total. N/A = Not Available
Source: Compiled based on the Labor Force Survey, Ministry of Health, Labor and Welfare


whereas that in other sectors has begun to fall. I heard the following statement from a friend of mine who is an executive at a nurses' school: "We are receiving many applications for 2010 spring admission from even outside the prefecture. Some of them are college students graduating this March or people who have been fired. This is unprecedented." This incident suggests that more and more people are trying to find a way out in the medical- and nursing-care sector at a tough time when about 30% of university graduates cannot find employment. To prevent its New Growth Strategy from becoming pie in the sky, the Hatoyama administration must chart its roadmap and follow it in a way that allows the progress to be assessed halfway through the process.

The government should take the following two measures. First, identify the professions for which to develop and enhance education systems. In this connection, the U.S. Department of Labor publishes the Occupational Outlook Handbook (http://data.bls.gov/cgi-bin/print.pl/oco/home.htm) every two years. The Handbook includes 43 medical- and nursing-care professions and describes, for each of them, educational systems, earnings, the work environment, current employment, and necessary employment ten years from now. The Handbook serves as an important source of information based on which policy effectiveness is assessed periodically. Second, subsidize educational expenses paid by those who seek to obtain qualifications in the medical- and nursing-care sector. There may be individuals who have had difficulty finding jobs after graduation from college, and then change their mind and decide to pursue careers in the medical- and nursing-care sector. The cost of education of such people should be fully subsidized by the government on the condition that they obtain the necessary qualifications and find employment in the sector. This scheme has been proven effective by many public and private medical institutions, which have adopted it to secure nurses. These subsidies could be financed by cutting funds earmarked for child allowances and free high school education.