憲政民主國家中，國家行使公權力的正當性來自民眾的同意。當行政國家的任務，日趨龐雜與專業，國會越來越傾向於授權行政機關基於其專業與效率，訂定具體的施行細則等行政命令，以因應行政機關動態的決策需求。不過，當立法機關將越來越多的重要決策，授予民意基礎與公開程度都不如自己的行政機關作成時，其正當性何在？如何提升行政決策的正當性？根據各國立法實務與理論的趨勢，強化公民參與行政決策，是一個可能的出路。本文以公民會議為例，試圖在全民健保的行政決策建立制度性的公民參與機制。本文首先檢視由行政機關行使立法權在學理上的正當性，以凸顯公民參與對於強化行政決策正當性的重要性，其次進一步就全民健保行政，探討強化公民參與既有的決策程序的必要性，最後，以公民會議為例，說明將公民會議納入健保行政決策可能的制度設計。

The legitimacy of the state exercising coercive power stems from the citizen consensus. However, with the administrative state shouldering increasing responsibilities, the Legislature is increasing by handing its decision-making power to administrative agencies with the expertise to make timely decisions. How can we justify administrative agencies exercising legislative powers? Based on theories and practices in administrative law, this article suggests that citizen participation can be cited as a justification. Using citizen conference as an example, this article seeks to strengthen citizen participation in Taiwan's national health insurance. This article begins by justifying citizen participation in the administrative agencies' decision-making, and then looks ínto the necessity of enhancing citizen participation in Taiwan's national health insurance. Finally, this article proposes a model to institutionalize citizen conference in the decision-making process of national health insurance.