It is difficult to implement medical insurance advance payment, mainly because there are some difficulties in system design and actual operation.

In terms of system design, the establishment of the medical insurance fund advance payment system aims to solve the problem that the insured person of basic medical insurance can get timely medical treatment under the irresponsible situation of the third party, which belongs to a rescue system in an emergency.

However, in practice, due to the unclear legal issues such as the determination of tort liability, the settlement of basic medical insurance benefits involving overall accumulation and personal account handling, accounting treatment after settlement, subrogation right and capital guarantee, it is difficult to implement the advance payment system smoothly.