中文摘要：

各级政府从2007年开始进行城镇居民医疗保险制度的试点，期望以此来解决城镇困难群体的就医问题。文章首先以我国东部地区某市的数据分析了老年城镇居民医疗保险制度运行，筹资额与所花费医疗费用的比例低，按照制度设计的原则，政府不对制度运行补贴，则报销比例低，影响人们的参保意愿。第二部分，国际上大多数实行医疗保险制度的国家为被保险者家属提供医疗保险待遇。从以上两部分的分析来看，城镇居民医疗保险制度未来的发展方向：第一，与城镇职工基本医疗保险制度逐步融合起来，以便分散风险；第二，加强对公共卫生和社区医疗服务的投入。结论是：如果没有遏制医疗费用上涨的有效手段，医疗保险制度对解决城镇困难群体的就医问题作用不大。

英文摘要：

The government is now working to incorporate the olds and children gradually in the basic medical insurance system. Most country which carry out social insurance system, provide the dependents＇ the same MedicalBenefits as the Insured person. The author analyze the Adverse Selection from the high risk of the ensure group and the form of unconstraint attend. The methods of avoiding the system risks is coming into the Employees＇ Medical Insurance System in Towns and Cities by step. So the system have the compulsive character, this will reduces the systematic foundation risk. Then the author suggested to issuance the Nation＇ s Integrated Guiding Opinions, advance the administrative level of overall planning. The government should increase input in public health and community medical treatment service.