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Prime Minister Shinzo Abe revisited a Tokyo hospital Monday for what he said was a follow-up medical checkup, further stoking speculation that his health may be deteriorating and that his imminent exit may be a possibility.

His visit to Keio University Hospital, coming just a week after an earlier checkup, arguably took some shine off what had been expected to be a moment of triumph Monday, when he became the nation’s longest-serving prime minister in terms of consecutive tenure in office.

The milestone means Abe has bested Eisaku Sato, his great-uncle who had been the previous record-holder for the past half a century.

Speaking to a gaggle of reporters in the Prime Minister’s Office, Abe said his visit was to collect results of his examination from last week and undergo an “additional checkup.” He added that he would offer a fuller explanation on the results at a later date, without further elaborating.

Earlier in the day, top government spokesman Yoshihide Suga had sought to quell speculation over the prime minister’s health.

“I see him every day, but I don’t notice anything strange about him,” Suga told a regular briefing, echoing Abe in describing the hospital visit as a checkup.

But Suga’s assurances didn’t stop unnamed government and ruling party sources from intimating to local media that Abe’s visit was of a more serious nature, involving him receiving treatment for his underlying condition, known as ulcerative colitis, which is a chronic, inflammatory disease of the large intestine. It’s the same disease that forced him to bow out in disgrace in 2007, when he put an abrupt end to his first stint in power only a year after taking office.

Recent weeks have seen a flurry of speculation over Abe’s growing fatigue, with his aides publicly voicing concerns the prime minister had been stretched thin dealing with the novel coronavirus pandemic virtually nonstop since late January.

That, coupled with the plunge of his Cabinet’s approval ratings to the lowest level since his return to power in December 2012, has been fueling talk that he may not make it until he serves out his historic third term as leader of his ruling Liberal Democratic Party — and therefore as prime minister — through September 2021.

Nagatacho, the political epicenter of the nation, is now gripped by rumors of his early resignation, a snap election and intensifying power struggles among post-Abe candidates.

Kyodo News agency’s two-day telephone survey this weekend showed support for the Abe Cabinet had slipped from 38.8 percent a month ago to 36.0 percent, the second lowest since he retook office in 2012.

The 65-year-old Abe has enjoyed a stable footing since his return to power, consolidating power with an unprecedented winning streak in national elections, three times in the Lower House and another three in the Upper House.

Many observers, however, say this feat has less to do with a genuine public mandate for the LDP’s policies than a distrust of an ever-fragmented opposition. The lack of viable alternatives has played a major part in allowing Abe to win elections and thus engineer a resilient comeback from a series of what at times looked like fatal scandals, such as allegations of cronyism as well as the falsification of public records, they say.

Abe can also be credited for the longevity of his administration, which ended an era of political instability from 2006 to 2012 that had been fraught with short-lived leadership — a phenomenon often ridiculed as a “revolving door” of prime ministers.

But at the same time, critics say that Abe, for someone who has reigned for so long, stands out for not having achieved some of his biggest ambitions.

His career-long mission of amending the nation’s postwar, pacifist Constitution, as well as putting to rest decades-old diplomatic issues such as the abduction of Japanese nationals by North Korean agents and territorial disputes with Russia, have all been left unresolved.

On Monday, Abe said he was aware that stability itself shouldn’t be regarded as a goal.

“In the world of politics, what matters is not how many days you have been in office, but what you have accomplished,” he said of his record-breaking consecutive days in office.

“Over the past seven years and eight months, I have put my heart and soul, day by day, into delivering on policies I promised to the people. It is thanks to these efforts that I think I am where I am today.”

Suga, one of Abe’s closest allies, stressed the administration had spent the past seven-plus years making an all-out effort to “revitalize the economy, reconstruct diplomacy and national security and realize a social security system benefiting all generations.”

Going forward, the government’s priority boils down to containing the virus pandemic, with Abe “determined to prevent the kind of explosion of cases that we have seen across Europe from happening in Japan, and to protect the lives and health of the people,” he said.

But it is COVID-19 that has critically deprived Abe of one of the few achievements he would often talk up on the campaign trail to mobilize public support for his government: economic growth.

Although already reeling from Abe’s decision in fall 2019 to increase sales tax from 8 to 10 percent, the nation’s economy, which had enjoyed a boost under his “Abenomics” policy mix, has now taken a critical hit from the pandemic.

Recent government data showed Japan’s economy suffered its biggest contraction ever in the April to June quarter, falling an annualized 27.8 percent, as the pandemic froze spending, brought businesses to a grinding halt and curtailed exports.

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