**3.2 Comparison of options**

Four members of the project team and two additional Chinese health-care experts used the MCDA model to independently rate the two insurance policy options. Their answers were evaluated using the following rules:


Following this approach, insurance option 2 was rated with a total of 78.0 points as the superior policy as compared to insurance option 1 with a total of 53.95 points. The detailed results are shown in **Table 4**. Insurance option 1 scored better for the attributes relating to "financial impact and funding for the insurance," "access to pharmaceuticals," coverage for outpatient healthcare, "affordability/economic burden to patients," "timely interventions," "primary care utilization," "solidarity," and "equity." In the final two attributes "ease of transition" and "acceptability to stakeholders," insurance option 1 was rated higher.

This example shows that there is a trade-off in any decision-making process—in this case between the domain "likelihood of change" where option 1 scored higher and for the other four domains, where option 2 scored higher. The model highlighted these trade-offs and made them more transparent. Once policy-makers agree on their final decisions, they are also more aware of what resistance may be expected and therefore may be better prepared to consider preventive measures to minimize such resistance.
