“House-for-pension”exposed a lot of problems in the development of the city’s current old age social security system. This paper is based on the study of the level of the old age social security system and the basic needs of aged people ,to discuss the dilemma of health pension of urban and rural people,the paper found that there are many obstacles faced by aged people in the respects of eco-nomic support,service security,and spiritual solace,incomplete security projects of economic security,insufficient coverage and limited level of current security projects, imperfect service system are important reasons. For this reason,we should establish and improve the “health pension”security system,set up long-term care insurance,and improve the existing social insurance system;establish health pen-sion service system combined health care,pension;improve the old people’s spirit level to meet their basic needs of health pension.%“以房养老”反映出我国现行老年保障发展中存在许多问题。本文以保障的层次性和老年的基本需求为研究视角，探讨了我国城乡居民健康养老的现实困境，发现老年人在经济供养、服务保障、精神慰藉等方面存在许多障碍，分析认为，经济保障中保障项目不完整、既有保障项目覆盖不全与保障水平有限、服务体系不健全是困境产生的重要原因。为此应从建立健全老年“健康养老”保障体系；建立长期护理保险以完善现有社会保险制度体系；建立医养结合的健康养老服务体系；提高老年人精神生活水平等方面来满足老年人健康养老的基本需求。
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