全民健保實施至今已逾十年，雖然民眾對於健保維持相當的滿意度，但制度本身仍有諸多需要改進之處。行政院認為應就全民健保政策進行全面性的檢討與重建，故自2001－2004年於行政院下成立「二代健保規劃小組」，並分為五個次組，分別是「政策評估組」、「經濟財務組」、「醫療分配組」、「公民參與組」、與「統計分析組」。本文所探討的保費改革方案預評估，即為上述「政策評估組」就「經濟財務組」所提出的保費改革方案，預先進行政治可行性評估。本文主要就政治可行性評估步驟之一，著重於瞭解政策參與者對於全民健保之保費改革方案的認知與偏好為何；以及探討不同政策利害關係人，如一般民眾與健保菁英，對於議題的看法有無差異；並預先提出可能引起爭議之焦點，以供方案規劃者與決策者參考。根據當時規劃的二代健保保費改革方案的基本原則，研究小組分別於2002年進行一般民眾的電訪調查與2003年進行健保菁英的問卷面訪。研究結果發現：一般民眾與健保菁英在於健保知能方面的差距甚大；在政策偏好方面，一般民眾與健保菁英的看法亦有所差異，例如對於醫療費用上漲的財務責任分擔；但在於設定保費負擔上下限與取消被保險人職業分類方面，則有較高的共識。

The National Health Insurance Program has been implemented for more than 10 years. According to recent statistics, the public satisfaction rates with theProgram have often been above 70%. Nevertheless, the NHI Program is not that successful in terms of other aspects. For example, the medical expenses haveexceeded the insurance revenues and therefore created huge deficits. Moreover, it is difficult to raise the NHI contribution rate due to political pressures from the Legislative Yuan and the general public. On the face of the aforementioned problems, the Executive Yuan launched a massive re-planning project from 2001 to 2004 (the so called Phase II NHI Program or P2-NHI), which attempted to thoroughly study the problems encountered by the Program and to proposesystematic solutions.This paper is based on a pre-evaluation of the P2-NHI financing scheme with special reference to a comparison of the perceptions and preferences of the NHI elites and the general public. This paper begins with a literature review on pre-evaluation and political feasibility analysis as well as an introduction to the new NHI financing scheme. It is followed by an empirical study on the perceptions and preferences of policy stakeholders toward the reform scheme. A comparison of the views of the general public and the elites was drawn on a telephone survey (n1=1,069) and an elites interview (n2=52) with a semi-structured questionnaire. According to research findings, the general public was not so familiar with the NHI issues in comparison with the elites. Moreover, the general public and the elites had different preferences toward certain issues, such as the share of additional medical expenses among stakeholders and the calculation of premiums based on individuals or households. In conclusion, we identified a big gap of NHI literacy between elites and the general public, as well as their consensus and conflicts towards the reform scheme. These findings could be fed back into the policy making process.