Urban and rural medical assistance system is important for alleviating difficult medical problems and ensuring poor people enjoy health care. As an important aspect of multi-level medical security and health service system, urban and rural medical assistance system has made great achievements. However, there are some flaws and inadequacies. The problems still remain, such as the deviations of policy guidance in the urban and rural medical assistance system, incomprehensive rescue coverage, single financing mechanism, lack of scientific in the low limit of pay line and the upper limit on salvage amount. In order to improve medical assistance system, all kinds of unreasonable restrictions should be abolished, the financing channels should be broadened, medical assistance management should be operated independently, the legal system construction of medical assistance system should be accelerated.