From the archives: 2005: Economist on robotizing J health care, contrast with what’s happening nowadays


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Hi Blog.  Since it’s the summer and I’m trying to take some time off (and have a number of duties what with my students here in California), I’m going to start archiving old newsletters and mailings.  Here’s something I wrote back in December 2005 — a wistful article by The Economist about automating Japanese health care.  In light of all the recent articles on importing workers for Japan’s nursing industry, this comes off as quite antiquated — and it’s only two and a half years old!  My original comments precede article, and current articles follow in the Comments section.  Arudou Debito in the Bay Area

 ================== mailing December 26, 2005
Subject: Economist on robotics and culture in Japan

Hi All. From The Economist’s Christmas special. Tries to find a cultural basis for Japanese nonantipathy towards robots, and cites Tetsuwan Atomu (whose name in Japanese “refers to its atomic heart”; huh?), a country “lucky to be uninhibited by robophobia” (when compared to the awkwardness and riskiness of employing Filipina nurses), and how Japanese are loath to ask for directions (not to mention deal with other humans in linguistic honorifics)…

Am I the only one finds this article annoying? I think the author, not to mention the robotic researchers who paint Japanese society so oddly, should get outside more and have more human interaction. Could be that Japan is good at robotics simply because Japanese industry is world class at complex electronics, and this is merely the next outlet? Moreover, I doubt robots will ever effectively replace the human touch when it comes to health care, especially for the sick and the elderly–call me a Luddite. Bests, Debito in Sapporo


Japan’s humanoid robots
Better than people
Dec 20th 2005 | TOKYO
From The Economist print edition

Why the Japanese want their robots to act more like humans

HER name is MARIE, and her impressive set of skills comes in handy in a nursing home. MARIE can walk around under her own power. She can distinguish among similar-looking objects, such as different bottles of medicine, and has a delicate enough touch to work with frail patients. MARIE can interpret a range of facial expressions and gestures, and respond in ways that suggest compassion. Although her language skills are not ideal, she can recognise speech and respond clearly. Above all, she is inexpensive . Unfortunately for MARIE, however, she has one glaring trait that makes it hard for Japanese patients to accept her: she is a flesh-and-blood human being from the Philippines. If only she were a robot instead.

Robots, you see, are wonderful creatures, as many a Japanese will tell you. They are getting more adept all the time, and before too long will be able to do cheaply and easily many tasks that human workers do now. They will care for the sick, collect the rubbish, guard homes and offices, and give directions on the street.

This is great news in Japan, where the population has peaked, and may have begun shrinking in 2005. With too few young workers supporting an ageing population, somebody–or something–needs to fill the gap, especially since many of Japan’s young people will be needed in science, business and other creative or knowledge-intensive jobs.

Many workers from low-wage countries are eager to work in Japan. The Philippines, for example, has over 350,000 trained nurses, and has been pleading with Japan — which accepts only a token few — to let more in. Foreign pundits keep telling Japan to do itself a favour and make better use of cheap imported labour. But the consensus among Japanese is that visions of a future in which immigrant workers live harmoniously and unobtrusively in Japan are pure fancy. Making humanoid robots is clearly the simple and practical way to go.

Japan certainly has the technology. It is already the world leader in making industrial robots, which look nothing like pets or people but increasingly do much of the work in its factories. Japan is also racing far ahead of other countries in developing robots with more human features, or that can interact more easily with people. A government report released this May estimated that the market for “service robots” will reach エ1.1 trillion ($10 billion) within a decade.

The country showed off its newest robots at a world exposition this summer in Aichi prefecture. More than 22m visitors came, 95% of them Japanese. The robots stole the show, from the nanny robot that babysits to a Toyota that plays a trumpet. And Japan’s robots do not confine their talents to controlled environments. As they gain skills and confidence, robots such as Sony’s QRIO (pronounced メcurioモ) and Honda’s ASIMO are venturing to unlikely places. They have attended factory openings, greeted foreign leaders, and rung the opening bell on the New York Stock Exchange. ASIMO can even take the stage to accept awards.

The friendly face of technology

So Japan will need workers, and it is learning how to make robots that can do many of their jobs. But the country’s keen interest in robots may also reflect something else: it seems that plenty of Japanese really like dealing with robots.

Few Japanese have the fear of robots that seems to haunt westerners in seminars and Hollywood films. In western popular culture, robots are often a threat, either because they are manipulated by sinister forces or because something goes horribly wrong with them. By contrast, most Japanese view robots as friendly and benign. Robots like people, and can do good.

The Japanese are well aware of this cultural divide, and commentators devote lots of attention to explaining it. The two most favoured theories, which are assumed to reinforce each other, involve religion and popular culture.

Most Japanese take an eclectic approach to religious beliefs, and the native religion, Shintoism, is infused with animism: it does not make clear distinctions between inanimate things and organic beings. A popular Japanese theory about robots, therefore, is that there is no need to explain why Japanese are fond of them: what needs explaining, rather, is why westerners allow their Christian hang-ups to get in the way of a good technology. When Honda started making real progress with its humanoid-robot project, it consulted the Vatican on whether westerners would object to a robot made in man’s image.

Japanese popular culture has also consistently portrayed robots in a positive light, ever since Japan created its first famous cartoon robot, Tetsuwan Atomu, in 1951. Its name in Japanese refers to its atomic heart. Putting a nuclear core into a cartoon robot less than a decade after Hiroshima and Nagasaki might seem an odd way to endear people to the new character. But Tetsuwan Atom — being a robot, rather than a human — was able to use the technology for good.

Over the past half century, scores of other Japanese cartoons and films have featured benign robots that work with humans, in some cases even blending with them. One of the latest is a film called “Hinokio”, in which a reclusive boy sends a robot to school on his behalf and uses virtual-reality technology to interact with classmates. Among the broad Japanese public, it is a short leap to hope that real-world robots will soon be able to pursue good causes, whether helping to detect landmines in war-zones or finding and rescuing victims of disasters.

The prevailing view in Japan is that the country is lucky to be uninhibited by robophobia. With fewer of the complexes that trouble many westerners, so the theory goes, Japan is free to make use of a great new tool, just when its needs and abilities are happily about to converge. “Of all the nations involved in such research,” the Japan Times wrote in a 2004 editorial, “Japan is the most inclined to approach it in a spirit of fun.”

These sanguine explanations, however, may capture only part of the story. Although they are at ease with robots, many Japanese are not as comfortable around other people. That is especially true of foreigners. Immigrants cannot be programmed as robots can. You never know when they will do something spontaneous, ask an awkward question, or use the wrong honorific in conversation. But, even leaving foreigners out of it, being Japanese, and having always to watch what you say and do around others, is no picnic.

It is no surprise, therefore, that Japanese researchers are forging ahead with research on human interfaces. For many jobs, after all, lifelike features are superfluous. A robotic arm can gently help to lift and reposition hospital patients without being attached to a humanoid form. The same goes for robotic spoons that make it easier for the infirm to feed themselves, power suits that help lift heavy grocery bags, and a variety of machines that watch the house, vacuum the carpet and so on. Yet the demand for better robots in Japan goes far beyond such functionality. Many Japanese seem to like robot versions of living creatures precisely because they are different from the real thing.

An obvious example is AIBO, the robotic dog that Sony began selling in 1999. The bulk of its sales have been in Japan, and the company says there is a big difference between Japanese and American consumers. American AIBO buyers tend to be computer geeks who want to hack the robotic dog’s programming and delve in its innards. Most Japanese consumers, by contrast, like AIBO because it is a clean, safe and predictable pet.

AIBO is just a fake dog. As the country gets better at building interactive robots, their advantages for Japanese users will multiply. Hiroshi Ishiguro, a robotocist at Osaka University, cites the example of asking directions. In Japan, says Mr Ishiguro, people are even more reluctant than in other places to approach a stranger. Building robotic traffic police and guides will make it easier for people to overcome their diffidence.
(Contactable at

Karl MacDorman, another researcher at Osaka, sees similar social forces at work. Interacting with other people can be difficult for the Japanese, he says, “because they always have to think about what the other person is feeling, and how what they say will affect the other person.” But it is impossible to embarrass a robot, or be embarrassed, by saying the wrong thing.
(Contactable at

To understand how Japanese might find robots less intimidating than people, Mr MacDorman has been investigating eye movements, using headsets that monitor where subjects are looking. One oft-cited myth about Japanese, that they rarely make eye contact, is not really true. When answering questions put by another Japanese, Mr MacDorman’s subjects made eye contact around 30% of the time. But Japanese subjects behave intriguingly when they talk to Mr Ishiguro’s android, ReplieeQ1. The android’s face has been modeled on that of a famous newsreader, and sophisticated actuators allow it to mimic her facial movements. When answering the android’s questions, Mr MacDorman’s Japanese subjects were much more likely to look it in the eye than they were a real person. Mr MacDorman wants to do more tests, but he surmises that the discomfort many Japanese feel when dealing with other people has something to do with his results, and that they are much more at ease when talking to an android.

Eventually, interactive robots are going to become more common, not just in Japan but in other rich countries as well. As children and the elderly begin spending time with them, they are likely to develop emotional reactions to such lifelike machines. That is human nature. Upon meeting Sony’s QRIO, your correspondent promptly referred to it as “him” three times, despite trying to remember that it is just a battery-operated device.


What seems to set Japan apart from other countries is that few Japanese are all that worried about the effects that hordes of robots might have on its citizens. Nobody seems prepared to ask awkward questions about how it might turn out. If this bold social experiment produces lots of isolated people, there will of course be an outlet for their loneliness: they can confide in their robot pets and partners. Only in Japan could this be thought less risky than having a compassionate Filipina drop by for a chat.


4 comments on “From the archives: 2005: Economist on robotizing J health care, contrast with what’s happening nowadays

  • An interesting point about eye-movement and eye-contact: when I was studying at the master’s course at a Japanese University, I was told by one of the fellow graduate students that Japanese do not like to look other people in the eye because in this way this other person might guess what they are really thinking and try to use this against them – literally so. That amazed me at the time – it was about 15 years ago, but over the years I have found this to be an increasingly justifiable statement. I’m really sorry to disagree with you, David, but I have seen so many examples – and heard many people tell me about their motivations – well, I’m not Japanese, so they were not as secretive with me – have you ever considered this angle? (One aspect of being an outsider!) – that I can see why they feel more comfortable with robots – and vending machines for that matter, than with other human beings. Also one aspect of senile problems (in the medical sense), and probably of many other sick people here, is that they do not like being felt sorry for, and a sympathetic Filipina might be the last thing they want to encounter when they’re sick or weak… Hence, again, robots are preferable.
    But I find it pretty amazing how they are assured that the robots that could do all the necessary task can be so easily and readily made! It’s nice to have a futuristic anime, but to be so out of touch with reality as to think that this can be easily (even relatively) implemented in real life – when they struggle now with all the pension records etc. – is so childish!
    (Well, all this is my opinion, of course, and it does not apply to each and every Japanese person, but the number of people who do not fall into the groups I mentioned above – in my experience, – constitutes a very large proportion of the population, let’s face it!)

  • Contrast with what’s actually happening:

    「インドネシア人看護師ら、100病院・施設が受け入れ 」








    (2008年8月7日11時33分 読売新聞)

  • Aging Japan gets serious about immigration
    By Isabel Reynolds
    Reuters August 7, 2008
    Courtesy MS

    Jakarta nurse Yanti Kartina left her family in Indonesia and joined 200 other nurses moving to Japan where a rapidly growing elderly population has created a desperate need for carers in old age homes and hospitals.

    The nurses, who are expected to learn Japanese and requalify as they work, are seen as an important test case as Japan struggles with the world’s fastest growing elderly population and a workforce that is forecast to shrink, potentially devastating the economy.

    “Japan is the first developed country to face this kind of population crisis,” said Hidenori Sakanaka, a former immigration bureau chief in the capital of Tokyo who now heads a think tank.

    With more than a quarter of Japanese expected to be aged over 65 by 2015, the country faces serious economic consequences, including labor shortages that could weigh on GDP.

    A group of ruling party politicians see immigration as a possible solution and have presented Prime Minister Yasuo Fukuda with a radical new proposal that seeks to have immigrants make up 10 percent of the population in 50 years’ time. Government figures show the workforce is on course to shrink by eight million in the next 10 years.

    If the necessary laws are passed, mass immigration could transform a country once so wary of foreigners that it excluded them almost entirely for more than 200 years until the 19th century.

    “I don’t think there is any way forward but to accept immigrants,” Sakanaka said.

    Even now, the idea of allowing in more foreigners is often described as a risk to Japan’s relatively crime-free and homogeneous society.

    Many landlords refuse to rent apartments to foreigners and few Japanese employers offer immigrant workers the same rights as their Japanese colleagues. Less than two percent of Japan’s almost 128 million population are currently foreign-born.

    Tetsufumi Yamakawa, chief economist at Goldman Sachs in Tokyo, believes immigration, combined with efforts to draw more women and elderly people into the labor market, could lift growth above the annual one percent or less forecast by many analysts.

    “I think this is very good timing to start thinking about this,” he said. “The decline is already in sight.”

    The Indonesian nurses, who have been recruited to work in short-staffed hospitals and old peoples’ homes, are the latest wave of controlled immigration. Government officials hope they will face fewer problems than their predecessors.


    More than 300,000 immigrant Brazilians of Japanese descent, have been a boon for Japan’s automotive and electronics factories, where many of them work. They have also boosted the Brazilian economy, remitting $2.2 billion dollars home in 2005 alone, according to the Inter-American Development Bank.

    But in many ways, the Brazilians have failed to fit in even though they are the descendants of Japanese who left rural areas to start afresh in Latin America, mostly in the early 20th century.

    Believing their heritage would give them an advantage in blending in, the Japanese government loosened conditions for working visas for them in 1990. The move was not entirely successful.

    The Brazilians complain of discrimination and lack of schooling for their children, many of whom speak only Portuguese, while their Japanese neighbors are often shocked by their late-night parties and failure to conform to rules such as trash recycling.

    “They were just brought in and nothing was done to help them in terms of welfare afterwards,” said ruling Liberal Democratic Party (LDP) lawmaker Hirohiko Nakamura, a member of the committee that produced the new immigration report.

    “Then people blame the foreigners for the problems, even though it’s Japan that invited them here and didn’t do anything for them,” he added.

    The worst case, he says, are the tens of thousands of mostly Chinese workers allowed in on temporary “trainee” visas that allow them to work in menial jobs on farms and in factories.

    That system has kept some small regional businesses ticking over, but reports of abuses such as extremely low pay, sexual harassment and confiscated passports abound.


    Many say that despite the desperate need for workers, Japan is setting hurdles too high for the latest batch of immigrants.

    The Indonesian nurses and care workers will have only six months of Japanese study before starting full-time work. They must pass the relevant national examinations within three or four years while working as assistants, or be forced to return home.

    Lawmaker Nakamura is optimistic about their chances, citing the example of some of the country’s highest profile immigrants.

    “Look at the Mongolian sumo wrestlers! They speak Japanese really well,” he said.

    But former immigration bureau chief Sakanaka worries that the Indonesian nursing programme would end in failure because of the complexity of the Japanese language and because he thinks the rules have been made too strict.

    “I think the system will turn out to be an embarrassment,” he said. “Almost nobody will pass and they will be told to go home.”

    He advocates inviting in younger foreigners and allowing them to complete their training in Japanese before starting work.

    On a broader basis, he and others say, opposition to immigration in Japan is less wide-spread than allegations of discrimination and exclusion would suggest.

    “Certainly it is going to take time for Japan to be more accepting,” said Yamakawa of Goldman Sachs.

    “But I do not believe in the superficial argument that Japan has had a homogeneous population for so long that it cannot accept anyone from outside.”


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