我国从2000年以后在县市基层普遍建立起城镇职工基本医疗保险制度,取得了较大进步和社会认可的成就,创新出一些成功经验。然而县级医保工作也存在一些共性和个性问题,从问题性质看有阶段性问题、结构性问题和管理性问题并存。本文从系统内和系统外的对策探讨,兼作一些本质问题对策分析。 Since 2000, China has generally established a basic medical insurance system for urban workers and staff members at the grassroots level in counties and cities, and has achieved great progress and social recognition. Some successful experiences have been innovated. However, there are some common and individual problems in the work of county-level medical insurance. From the nature of the problem, there are phased problems and structural and managerial problems co-exist. This article from the system and outside the system to explore countermeasures, both as a number of essential problems and countermeasures.