Abstract: Pay on fee is a widely used way of settlement in the medical security system of China. This paper analyzes the objectives and action choices under dif ferent reimbursement patterns taken by hospitals, patients and medical security organizations. Further analysis shows that different reimbursement patterns take n by the medical security organizations will lead to different interrelationship s, different satisfied degrees and utilization levels of medical resources. Lack of business insurance organizations and management experience and information a ccumulation, the settlement way of pay on fee in China has to be used for a long time. The key to utilize medical resources more properly is to modify object fu nctions and constraint conditions of hospitals.