Objective :To analyze the fairness of health financing and its change in the western China. Methods:Data survey based on the comprehensive reform of grassroots health of residents family health in the typical areas of western China in 2014 and 2016, the direct tax and indirect tax of consumption expenditure were calculated by combining the various consumption expenditure tax rates of each province in the relevant year of China Statistical Yearbook; the direct tax, indirect tax, social health insurance, commercial health insurance, out-of-picket health expenditure payment and Kakwani index, were calculated to reflect the fairness of five health financing channels. Results :The concentration index of direct tax, indirect tax, social medical insurance, commercial health insurance and cash health expenditure in the west typical areas in 2016 were 0.615, 0.366, 0.285, 0.423, 0.262, Kakwani index were 0.256, 0.007, -0.074, 0.064, -0.097, compared with 2014, direct tax and commercial health insurance concentration index increased by 0.120 and 0.118, cash health expenditure decreased by 0.028; direct tax and the commercial health insurance Kakwani index increased by 0.106 and 0.104, cash health expenditure decreased by 0.042, other financing concentration index and Kakwani index changes were not obvious. Conclusion :The fairness of health financing in the typical areas of western China has improved, and the progressive degree of the direct tax and commercial health insurance has been further increased, which is beneficial to the poor, and the fairness of cash health expenditure is getting better