In recent years, the rapid development of universal health insurance has provided a beneficial supplement for the im- provement of the multi-level medical security system, but it also faces many problems. Through exploring the current development of universal health insurance, it summarizes the problems in the areas of participation and financing, operation and supervision, and claims and payment. The optimization suggestions are put forward from two aspects: clarifying the functional positioning of relevant government departments in benefiting the people and making commercial insurance companies actively play their market advantages as commercial entities.