To compare the changes of Harbin city in the full implementation of relevant indicators before and after the payment of medical insurance expenses in the total prepaid amount, total prepaid amount payment effect evaluation method, put forward reasonable suggestions to the Medicare payment policy better. Methods: using SPSS software for data collection, statistics, descriptive analysis, compare the city medical insurance before and after the implementation of the total medical insurance system before and after the implementation of the relevant indicators of health care inpatient. Results: two years after the implementation of the prepaid medical insurance system, there were significant changes in the amount of medical insurance, the amount of inpatient care, and the average hospitalization expenses of patients. The overall city health insurance, the average hospitalization expenses and the medical insurance payment were negative growth. Conclusion: the implementation of the total amount of prepaid health care system, the control effect with the cost of all time significantly, but also exposed some problems, need to have the appropriate adjustments in the policy and the way and the method, in order to adapt to the national health care reform in depth, to alleviate the current situation of people’’s "difficult and expensive".