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Intergenerational contract in Ageing Democracies: sustainable Welfare Systems and the interests of future generations

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Abstract

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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Notes

  1. This presupposition sets the scope of this paper. One could rightly challenge the legitimacy of the intergenerational-transfer-welfare-arrangement as described in this paper and propose that a just social arrangement must remove welfare systems of this kind. While challenges of this sort have their merits, they are not the ethos in most of the developed countries (and even developing ones) and hence have fewer implications in the practical term. The legitimacy problem of welfare system is indeed worth comprehensive analysis. However, for the purpose of this paper, the analysis is limited to the scenarios where some degree of sustainability of the welfare system is ethically demanded.

  2. However, for those immigrants who were naturalised as citizens (and typically lost the nationality of their countries of origin), the scene of signing a contract is more imaginable and not simply metaphoric.

  3. The members of a democracy could opt out of such a contract by leaving the polity and being naturalised as a citizen of another. Should the contract be ethically unjustifiable to an extent, members could initiate a revolution to overthrow the illegitimate government. This is an extreme way of opting out of a contract.

  4. While many of which are actually predictable by the mere fact regarding the ageing population structure and the transitioned mode of production and economy.

  5. In the case of paternalistic constituents, they might also put their own concerns for the future generations into agendas and hold their representatives accountable.

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Acknowledgements

The author thanks Dr. Benjamin Hertzberg for his comments.

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  1. Institute of Health Policy and Management, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei, Taiwan

    Ming-Jui Yeh

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Yeh, MJ. Intergenerational contract in Ageing Democracies: sustainable Welfare Systems and the interests of future generations. Med Health Care and Philos 25, 531–539 (2022). https://doi.org/10.1007/s11019-022-10098-9

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