Problems and the potential direction of reforms for the current individual medical savings accounts in the Chinese health care system.

Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China.

Individuals are inadequate: recognizing the family-centeredness of Chinese bioethics and Chinese health system.

This paper is aimed at a critical assessment of the moral framework of the current Chinese health system from a Confucian perspective, by focusing on the debate between the individual directed approach and the family-oriented approach to a health care system. Concerned with the nature and status of the family in communal life, the paper deals with the following questions: to cope with the frailties of material life (including susceptibility to disease), what good is presupposed by human existence and flourishing; why it is the family that serves as the primary locus of bearing and realizing this unique good; and what kind of society might possess the structures necessary to achieve the good thus conceived. All these questions lead to a revision of the theory of justice required in health care, in favor of family health saving accounts as an important institutional guarantee.

Families, dependencies, and the moral ground of health savings accounts.

Health Savings Accounts have been marginalized in the West. In Singapore, however, they are foundational to the financing of health care. In this brief essay, I shall begin to sketch a justification for Health Savings Accounts. The family has always been thought of as a mere prolegomena to the polis and to be primarily about securing the goods of material life: food, shelter, intimacy. I shall first explore the recent scientific literature on the communal nature of human thriving and follow it with a phenomenological account of human dependency. I shall claim that in securing the material means to sustain life, the family is also involved in the creation of the life-world of the child. That means that the bare necessities of life met in families are not merely about sustaining bodily life but are also part of the meaning-making aspects of life. The family then should have recourse to the material means of life-and-death decisions, because it is in these life-and-death decisions that the families' life-world of values is to be deployed.

Toward a Confucian family-oriented health care system for the future of China.

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 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.