The orientation，framework and goals of the essential health care system has been defined in the new round of health reform. With development in three stages，the task of establishing the framework of essential health care system has been basically completed. The policy framework for the essential health care system has been upgraded into a legal framework. Systems，schemes and mechanisms under the essential health care system have been improved day by day. In the meantime，key schemes such as hierarchical health care，modern hospital management，universal health insurance，pharmaceutic supply and comprehensive supervisor have achieved breakthroughs，as well as essential health care services enhanced and the increasing health demand met steadily. However，there is a lack of consensus over the connotation of the system. Along with the deepening of the health reform，imbalance and in-coordination in the essential health care system emerged. There is still a gap between the true effectiveness of the essential health care system and the ideal situation. The changing of external and internal circumstances proposed new requirements for the system. The essential health care system to achieve tangible results by becoming more mature and well-established，there should be consensus built over the connotation of the system，key schemes further developed and well implemented，prominent weakness addressed and clusters of schemes formed to tackle critical problems so as to grantee people’s physical and mental health and public health security.