美国家庭的衰弱:对卫生保健制度的一些启示

The Decline of the Family in the United States: Some Implications for Health Care

传统社会的人并不孤单,当他们生病、衰老时会得到家庭成员的照料。在美国,越来越多的孩子出生在婚姻之外,家庭正在逐步消失。在那些经济和社会资源来源极少的人群中,传统家庭消失得最为迅速,预示着日益增加的社会反常状态。即使对于卫生保健极为重要的非正式支持网络没有丧失,传统家庭也一样正在衰弱。因此,医疗改革必需重视家庭医疗保健储蓄账户,以阻止家庭完整性的剧烈衰弱。

In traditional societies, people rarely suffer alone. They are sick and infirm within a web of care provided by their families. In America, along racial, but more significantly along economic and educational class differences, the family is disappearing in the sense that ever more children are born outside of marriage. The traditional family is disappearing most rapidly among those with the fewest economic and social resources, portending an increasing anomie, as well as the weake ning if not disappearance of informal webs of support that have been important for health care. Any attempt to achieve fi nancially and socially sustainable health care reform will need to give emphasis to Family Health Savings Accounts （FH SAs） that can counteract the dramatic decline of family integrity.