Under the influence of concerns about sustainability, health system reforms have targeted institutional designs and have overlooked the role of socio-political factors like solidarity—a concept that is generally assumed to underpin the redistributive health system. The purpose of this research is to investigate users’ perceptions of the National Health Insurance as a system, their senses of solidarity and their views on the sustainability of the system in Taiwan. Using the descriptive ethics approach, qualitative in-depth interviews were conducted with typical case (...) sampling of 17 participants in the Taipei Metropolitan. The framework approach was used to analyze the interview transcripts. The research finds that despite great differences between users’ perceptions of the NHI, most users could share a notion of mutual relationship among each other. Three types of reasons are used to justify the obligations of mutual aid imposed by the NHI. These reasons are embedded within divergent conceptions of solidarity. The research also finds that government’s performance, the stability of decision-making and users’ personal experiences engaging with the system are important conditions for the users’ supportive attitude toward the system. Solidarity is a plausible concept in sustaining a non-Western social health insurance such as Taiwan’s NHI. (shrink)

This article defends ‘relational theorizing’ in bioethics and public health ethics and describes its importance. It then offers an interpretation of solidarity and care understood as normatively patterned and psychologically and socially structured modes of relationality; in a word, solidarity and care understood as ‘practices.’ Solidarity is characterized as affirming the moral standing of others and their membership in a community of equal dignity and respect. Care is characterized as paying attention to the moral being of others and their needs, (...) suffering, and vulnerability. The wager of relational theorizing in health care and public health is that substantive ethical visions of solidarity and care will provide support for more just and egalitarian health care and public health policies. (shrink)

This article argues that the liberalism of fear provides a useful theoretical framework for public health ethics in two fronts. First, it helps reconcile the tension between public health interventions and liberal politics. Second, it reinforces the existing justifications for public health interventions in liberal political culture. The article discusses this in the context of political emotions in the COVID-19 pandemic. Fear plays a central role in the experiences of pandemic politics, and such fear is extended to the concern that (...) post-pandemic government would normalize emergency politics and threaten the political culture of liberal democracy. The article proposes that the liberalism of fear provides a theoretical solution not only to alleviate such fear, but also to reconcile the long-established tension between liberal politics and public health intervention. This is particularly so if the liberalism of fear’s characteristic of political realism is taken into account. The article makes two points about this, and discusses their pragmatic implications in the case of compulsory vaccination. (shrink)