The Family, Family Health Savings Accounts and Confucian Bioethics : A Summary

Recently implemented Chinese health insurance schemes have failed to achieve a Chinese health care system that is family-oriented, family-based, family-friendly, or even financially sustainable. With this diagnosis in hand, the authors argue that a financially and morally sustainable Chinese health care system should have as its core family health savings accounts (FHSAs), supplemented by appropriate health insurance plans. This essay’s arguments are set in the context of Confucian moral commitments that still shape the background culture of contemporary China. It critically examines these recent changes from the perspective of Confucian moral understandings and their emphasis on the centrality of the family, which understandings still structure the taken-for-granted expectations of most Chinese. In terms of these commitments, as well as concerns for financial sustainability, this essay argues for the need for health care policy to give central place to family-oriented health savings accounts. What is offered is an exposition of the discordance between the current health care system and the prevailing commitments of Confucian culture and morality. This article does not attempt to establish the priority of these Confucian commitments, which have received much recent attention from Chinese scholars. The goal is to offer the non-Chinese reader an insight into the dynamics and character of the debate regarding the structure of the Chinese health care systems and how they contrast with the presumptions of western social democratic polities.