After almost ten years construction, three basic social medical insurance system fitting for market economy system of socialism with Chinese characteristics plays an active role in solving economic and social contradiction, boosting urban and rural public health cause development and equalization and so on, meanwhile, to some extent, embodies the initial setup of the mechanism for all Chinese citizens to share economic development results. Currently, however, the three basic social medical insurance system still has the problems in equalization, management system, decentralized supply and so on, and medical service agencies urgently need reform. China should start pilot work for urban and rural integrated social medical insurance, combine three into two, impose related tax according to special demand, let all Chinese fairly enjoy social medical insurance service and treatment, realize management system reform for decentralized service, and deepen the reform of medical service agencies.