1. Uneven cost sharing: The total payment mode of county-level doctors' medical insurance fund is to allocate the total budget of medical insurance fund to county-level medical institutions in a set proportion, which has the problem of uneven cost sharing among different medical institutions. Some medical institutions will get more medical insurance funds because of their scale and ability, and some may get less medical insurance funds for various reasons, thus affecting the operation and service quality of medical institutions.

2. Influence of diagnosis and treatment behavior: The total payment method of county medical insurance fund may affect the doctor's diagnosis and treatment behavior. Because doctors' income is related to the use of medical insurance funds, doctors may prefer to choose some higher-priced medical services and ignore some relatively lower-priced medical services, which may lead to waste of medical resources and unreasonable medical behavior.