Is Singapore's Health Care System Congruent with Confucianism?

Abstract

All countries face the task of implementing a health care system that is financially sustainable and morally defensible. In “Confucian Health Care System in Singapore: A Family-oriented Approach to Financial Sustainability,” Kris Su Hui Teo argues that Singapore’s health care system has done well in balancing and executing these dual tasks, having developed a three-tier model that is both economically sound and defensible within a larger framework of Confucian values. In particular, it has been claimed that Singapore has developed a health care system that limits: (1) the moral hazards involved in health care entitlement systems (e.g. governmental as well as private insurance schemes); (2) the political hazards involved when governments establish a health insurance scheme which allows politicians to promise further entitlements that will need to be funded (if possible) in the future and (3) the demographic hazard of making the fundability of health care dependent on sufficient young workers to pay for the health care of the unemployed and the aged. This short essay does not attempt to examine whether Singapore’s health care is as economically successful as many have claimed. Rather, I explore whether Singapore’s system is, in fact, as consistent with Confucianism as Teo argues. This essay examines whether Singapore’s approach to health care is contrary to the Confucian view of an ideal society. In addition, I will show that even if Singapore’s health care system does conflict on some points with this ideal, if such a health care system serves an overriding or higher Confucian moral concern, such as the harmony of the state and the universe, then such measures might nevertheless be justified according to Confucianism. However, prior to addressing this issue directly, it is necessary first to lay out some of the central tenets of Confucianism in order to better understand both the possible moral shortcomings as well the positive features of Singapore’s health care system.