Abstract: The medical social security is an effective risk-dispersing system, during which government plays an important role. The problems of rural medical social security in China last for a long time, and the practical situation is not so optimistic. Chinese government takes a great responsibility in establishing the rural medical security system. In its reformative adjustment, the government should undertake some responsibilities, bring the effective function of supporting, promoting and advancing the system into full play, and adopt more pragmatic attitude and measure in the switch of conception, the investment of finance, the perfection of legal system, etc.