期刊
MEDICINE HEALTH CARE AND PHILOSOPHY
卷 25, 期 3, 页码 531-539出版社
SPRINGER
DOI: 10.1007/s11019-022-10098-9
关键词
Intergenerational solidarity; Intergenerational equity; Sustainability; Health system; Long-term care system
This paper discusses the challenges faced by welfare systems as the assumptions of perpetual growth are challenged, and how caregiving responsibilities can be reallocated in aging democratic countries. It explores how the interests of future generations can be included in procedures, noting the biases towards the current generation in both representative and deliberative democratic systems, suggesting that benevolent representatives may be needed to represent future interests.
As the assumptions of perpetual economic and population growth no longer stand, the welfare systems built on such promises are in peril. Policymakers must reallocate the responsibility for providing care between generations. Democratic theories can help establish procedures for finding solutions, particularly in ageing democratic countries. By analysing existing representative and deliberative democratic theories, this paper explores how the interests of future generations could be included in such procedures. A hypothetical social health insurance scheme with the pay-as-you-go financial arrangement is selected as an illustrative case. This paper argues that due to the intrinsic bias towards the current generation, both representative and deliberative democratic health policymaking are limited in making decisions that account for future generations. Instead, their interests could be at best represented by benevolent representatives.
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