Inter-Generational Equity in Healthcare: Family Savings Accounts Based on the Confucian Idea of “Love with Distinction”
Keywords:人口老齡化, 代際公平, 醫療保健制度設計, 家庭醫療儲蓄帳戶儒家家庭價值, 愛有差等
LANGUAGE NOTE | Document text in Chinese; abstract also in English.
Healthcare resource allocation, which has medical, ethical, and economic dimensions, has sparked recent controversy China. However, neither the concept of equality nor the concept of rights addresses the real problem of healthcare allocation that China is facing as its aging population increases. Given the real crises of the growing elderly population and the increased demands on the limited resources of the healthcare system, the author contends that a Confucian model that favors family management in the form of family savings accounts is more a feasible method for China than state management. Moreover, the family savings account model represents traditional Confucian family values and the Confucian concept of “love with distinction.”
The argument in support of the family savings account model is reinforced by the problem of the aging population and the idea of “inter-generation equity.” From an investment perspective, inter-generational equity follows the principle that an endowed institution’s spending rate must not exceed its after-inflation rate of compound return, so that investment gains are spent equally on the current and future constituents of the endowed assets. This idea also works well with the family-oriented health savings accounts, because the family as “a saving institution” is accountable for safeguarding against the unnecessary medical spending that often occurs when the money belongs to a public account or when savings are not allowed to be passed along to the next generation.
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