Objective：To inspect the economic incentive of“the more premium, the more reimbursement" for the the Medical Insurance System for Urban and Rural Residents. Method: Based on the perspective of rational choice of the insured, the study builds the actuarial present value models for individual pay cost and compensation, using the index of compensation yield,we examine the financially encourage participation in insurance by different payment grades. Result: The rational choices of the insured is low payment grade and insured at the high medical consume age, that is , “the more premium, the more reimbursement" police have no economic incentive effect. Conclusion: this policy is a breach of the principle of fairness, is not conducive to benign operation of the system and stable development of the society. we should improve the long-term financing mechanism, implement compulsory insurance and eliminate the adverse selection.