感性的官僚：健保署人員的行政實作與倫理

Abstract

以往人類學甚少關注具體實施政策的行政官僚，也少有直接將政府機關作為田野場域，導致官僚機構始終如同黑盒子一般讓外人難以理解。為了打破此一侷限，本研究以中央健保署分區業務組的承保科為田野地，進入行政人員的辦公室，實際了解其業務日常，從具體的過程細節中來探討行政官僚如何施作才能讓政策制度徹底實行。在健保署人員的工作過程中，我發現，相較於官僚高度理性的冷漠印象，這群承辦人員們更多是發揮感性的一面在應對民眾，而這反而能更加完善制度所預設的目標。

為了理解這樣的工作樣態，我透過三方面來進行分析：第一，從承保科的工作內容切入，解說業務類型與處理技巧，並論述為了達成制度目標，承辦人員實際上進行了大量的詮釋與想像，並高度仰賴這些認知與理解上的勞動，來獲取更高的工作績效。我將這一連串官僚在工作中衍伸出的詮釋與想像行為稱為「想像勞動」，並將整個過程分成三階段來討論其如何發生。第二，探究承辦人員在應對民眾時展現的特殊態度，我將其稱之為「服務倫理」，並論述這套倫理是如何由政府提升服務的改革計畫以及官僚思考後主動「多做一點」的個人選擇所混合而成，強調這讓健保作為社會保險的益處能真正跨越制度隔閡落實於民。第三，來看到這群人員的真實工作空間，嘗試透過描繪他們日常上班生活，來討論甚麼樣的環境與氛圍才能容納與支撐前述的充滿詮釋與想像的行事以及願意主動服務他人的倫理。重點放在客觀環境、感官經驗、支援網絡三部分，來突顯承保科工作特性與職場環境兩者之間既是彼此助力也是映照。

最後作為總結，我以健保署的案例來跟以往官僚研究進行對話，並重新根據田野整體進行討論，從而釐清承保科的組織定位及所展現的特點，再基於研究成果，來討論官僚治理以感性形式所發揮的新可能。

In the past, anthropology paid little attention to the administrative bureaucrats who implemented policies, or seldom used government departments as fields, which made bureaucratic institutions always like black boxes that were difficult for outsiders to understand. To break through this limitation, I took the National Health Insurance Administration (NHIA) as a field, entered the offices of bureaucrats, learned about their daily business, and discussed how administrative bureaucrats work to make policies come true. During the working process of NHIA staff, I found that they often use their emotional side to deal with the public, and this further improves the goals set by the system.

In order to understand this kind of work, I will analyze it from three aspects: first, start from the content of bureaucratic work, explain the business types and skills, and discuss that in order to achieve policy goals, bureaucrats actually carry out a lot of interpretation and imagination, and rely on these cognitive labors to achieve higher work performance. I use "imaginative labor" to call this series of interpretation and imaginative acts and divide the whole process into three stages to discuss how it occurs. Second, I explore the particular attitude that bureaucrats display toward citizens, which I call the "service ethic." I argue that this set of ethics is a mixture of government reform programs to improve services and bureaucrats' personal choices to "do more", emphasizing that this allows the benefits of National Health Insurance to be truly delivered to the public across institutional barriers. Third, I pay attention to the working space of bureaucrats to discuss what kind of environment and atmosphere can support imaginary labor and service ethics. I focus on three parts: objective environment, sensory experience, and support network, to highlight that job characteristics and workplace environment both support and reflect each other.

Finally, as a conclusion, I use this research to engage in dialogue with previous bureaucratic research, point out the special findings of this case, re-clarify the organizational positioning of this department, and discuss the new possibility of bureaucratic governance in affective form.