18
that are already low compared to those in other industrialized nations, the Japan Nursing
Association also opposed opening the nursing market. Citing the bankruptcy of the elderly care
insurance system and the proposed cutbacks in medical fees eligible for coverage by health
insurance, the organization questioned the ability of the government to deliver the resources
needed to increase substantially the number of nurses–Japanese or otherwise.
46
Well aware of Japanese recalcitrance on this issue, the Philippines made clear at the
outset of negotiations that the immigration issue stood as its top priority. Yet, the issue presents a
major dilemma for the Philippines. The repatriation of income by overseas Filipinos is a critical
part of the national economy; more than 10 percent of the population work overseas and send
money home. At the same time, however, the exodus of skilled professionals poses a major
challenge for the future. The dilemma is particularly acute in the healthcare industry. The
Philippines is already the world’s leading exporter of nurses with more than 70 percent of all
nursing school graduates opting for more lucrative jobs overseas. And the exodus is not limited
to nurses. In 2004, more than 4,000 Philippine doctors were enrolled in nursing courses in hopes
of finding work abroad. The Philippine College of Surgeons warns that at the current rate doctors
are leaving the profession, there will be a dearth of experienced surgeons in the country by
2014.
47
Despite these concerns, the movement of healthcare workers took on even more political
significance for the Philippines with Japan’s November 2004 announcement that it would reduce
the number of entertainment visas issued to Philippine citizens. Roughly 70 percent of the 80,000
visas issued to Philippine citizens each year to work in Japan have been for female workers in the
entertainment industry. It is widely believed that many of these women are forced to work in the
Convention