人力仲介在移工健康中的角色與功能：臺灣與日本的案例研究

Abstract

本研究探討台灣與日本移工在醫療可及性、就業條件與仲介機制方面的結構性挑戰，並分析不同仲介機制如何影響移工的健康權益與勞動條件。研究發現，仲介機制在個人、組織、社區與政策層級皆對移工的健康決策與醫療可及性產生影響，其中台灣的私人仲介與日本的監理團體（Supervising Organizations）及支援機構（Registered support organizationss）在健康資源的提供與管理方式上存在顯著差異。 本研究發現，仲介不僅影響移工的聘雇過程，也在健康決策與醫療協助上扮演關鍵角色。在某些情境下，仲介與監理團體能夠協助移工獲取醫療資源，但在監管缺乏或雇主干預的情況下，也可能成為健康可及性的阻礙。此外，社區層級的社會觀感與歧視加劇了移工在醫療與工作場所的邊緣化，使他們更依賴非正式的支持系統來獲取健康資訊與協助。 本研究建議應減少對雇主與仲介的依賴，強化政府對移工健康保障的直接介入，提供標準化的健康服務，並改善社區層級的健康支持網絡，以確保移工在台灣與日本的勞動環境中獲得公平的醫療可及性與健康保障。

This study examines the structural challenges faced by migrant workers in healthcare access, employment conditions, and intermediary governance in Taiwan and Japan. The findings reveal that intermediaries play a crucial role in shaping healthcare accessibility and health-related decision-making at multiple levels, including individual, organizational, community, and policy domains. Taiwan’s private intermediaries and Japan’s supervising organizations and registered support organizations exhibit distinct approaches to managing migrant workers’ access to healthcare resources and employment conditions. The study finds that intermediaries influence not only recruitment processes but also healthcare accessibility and decision-making. In some cases, intermediaries and Supervising Organizations facilitate medical access, while in others, regulatory gaps and employer interference create barriers to care. Additionally, social perceptions and stigma at the community level further marginalize migrant workers in both healthcare and workplace settings, making them more reliant on informal support networks for health information and assistance. This study underscores the need to reduce reliance on employer- and intermediary-controlled health access by strengthening direct government intervention, standardizing healthcare services, and enhancing community-based health support systems to ensure equitable healthcare access and protections for migrant workers in Taiwan and Japan.