The problems of the public health system were explored due to the unpredicted SARS accident in 2003 and the problems were more seriously in western China because of the backward of economic under development. This paper analyses the deeply reasons of the problems based the field investigations in investment and management system in those areas. The shortage of public finance is one of the most important reasons and the behavior jungle of the health service providers played another important role during the reform period. At the end，the paper gives some policy suggestions how to perfect the public health system in western China.