The research is a methodological study to design anevaluation procedure for selecting a health insurance scheme forrural areas of Guangxi,P.R. China. There is an urgent need to implement some kind of healthinsurance scheme in Guangxi to finance the consumption ofessential health care by most of the peasants. But given theneed, how should an appropriate health insurance scheme bedesigned or selected? In the research an attempt has been made to developanalytical and evaluation procedures which can be used to supportdecision making about a health insurance scheme. In the first stage broad social objectives, to be achievedthrough implementing health insurance, and the operational andfeasibility constraints which could impede achievement of theobjectives were identified. Objectives and constraints wereanalyzed and efforts made to identify one or more specificindicators by which assessment could be made of effects. The main elements which contribute to insurance schemeswere then identified and the alternatives for each elementlisted. The effect of each element on each objective wasassessed, based upon economic principles, using the indicator ofeach objective for the analysis. The relation of elements toconstraints was also explored. The possible effect of eachalternative within each element set was then scaled. The trade off between the efficiency of each alternative(performance in meeting objectives/performance in meetingconstraints) was then evaluated using a Multi Criteria Analysis.Since objectives and constraints will have different priorities(determined by political and economic concerns) three alternativesets of weights were assigned so that the effects of such weightscould be assessed. The selected alternatives, within each elementset, are then combined into a scheme and the relative performanceof the selected alternatives compared to determine the mostimportant alternatives. The final stage of the process, Multi Criteria Analysis,facititates choice but requires that decision makers make cleartheir priorities before that choice is made. The approach followed is very challenging but is useful inrevealing the many uncertainties which, at the moment, arebroadly ignored when deciding on insurance schemes. The approachshould be further developed.