The system of individual account of basic medical insurance for urban workers in china,since the day it was set up,has been in dispute.This paper theoretically proves that the basic assumptions of individual account are inherently defective and incompatible with the external medical system environment.In practice,the defects of the system are easily-seen and thus a reform is imperative.Among all the reform proposals,a joint-insurance on a family basis is the optimal path,which means the individual account will be abolished and the family members of the insured workers will also be included within the workers’ medical insurance,using the individual account funds.This reform path could enhance the compulsory administration of the basic medical insurance system so as to avoid multiple systems for urban households,thus reducing the risks of medical expenses for urban family.Meanwhile,it allows the government to focus on subsidizing all the rest citizens other than just workers and their family members,which could pave a way to solve the institutional predicament of the government’s long-term subsidies for most of the citizens.It could further encourage migrant workers and their family members to participate in workers’ medical insurance and propel the practice of national urbanization strategy.With the deepening practice of urbanization,the workers’ medical insurance on a family basis and the medical insurance system for urban and rural residents will achieve a natural integration in the near future due to the close convergence of funding and benefit levels.