政策利害關係人指認的理論與實務：以全民健保改革為例

The Theory and Practices of Identifying Stakeholders: A Case Study of National Health Care Reform in Taiwan

相對於經濟可欲性的評估，政治可行性評估（political feasibility）是政策分析過程中重要但一直被忽略的領域，在民主社會當中，政治可行性是政務人員從事政策考量的核心，也是政策專業能否實踐的關鍵。本文就是在這樣一個認知之下，藉著作者們參與「二代健保」政策規劃，應用近年逐漸受矚目的政治可行性分析法—「政策利害關係人分析」（stakeholders analysis）的機會，聚焦在政治可行性分析初期最重要的挑戰—「利害關係人『指認』（identification）」的問題，以文獻與實作來回答政治可行性分析資訊來源指認的問題。本文從理論發展與實務分享兩個角度，以二代健保的實際規劃過程為例，討論政策利害關係人的指認議題。其一，相關的理論的討論，是先從企業策略管理的理論出發，討論利害關係人的定義與起源、分類與指認問題，接著進入公部門的用用；其二，實務操作的分享，主要討論網絡治理與策略規劃等相關理論，找出利害關係人指認與分析在理論上的困難與解決方式。接著，本文詳細整理與紀錄利害關係人分析的決策與時機，特別關注在利害關係人指認的問題上，並從結果資料當中討論指認利害關係人的方法與原則；本文歸納出四點建議，提供學界與實務界參考，包括：利害關係人的指認必須是倫理性以及策略性的，它的運作事在政策制度網絡的環境中，而在操作上，應該注意有限資源的問題、其基本架構最好簡約可行、以及判斷的工作可以專家與內部人員的調查與訪談得知。最後，無論如何，以利害關係人分析來進行政策的政治可行性評估，雖然理論與實務的問題很多，但是仍然值得繼續發展之。

For a long period of time the attention paid to political feasibility analysis has been considerably smaller than that focused on economic feasibility. Despite this imbalance, political feasibility is nearly always the deciding factor in governmental decisions. In this article, authors try to present a real world case of accessing political feasibility by way of so-called 'stakeholder analysis.＂ Especially, the focus of this paper is on the issue of stakeholder 'identification,＂ which involves constructing both theoretical framework as well as empirical methods to categorize and recognize related groups and individuals in the analyzing process. A review of the relevant literature first looks at the management theory usage of the term 'stakeholder＂, in which it is refers to a strategy used to ensure corporate survival. This is then contrasted against its usage in the public sector, where the term refers to theories of policy networks, strategic planning and ethics.The third section of this article presents in detail our real world example of stakeholder analysis on the national health insurance policy. Conclusions are that: (1) The issue of stakeholder identification is both ethical and strategic in actions; (2) These actions can only be realized in an institutional networks environment; (3) The analysis should be economically oriented, with inside knowledge being required when conducting object tive surveys. Lastly, the process of identifying stakeholders is imminently worthwhile, regardless of the fact that it is fraught with problems and unresolved issues.