Abstract: This paper, from the "dichotomy" phenomenon of good policy environment and obstruction of actual operation in the development of palliative care service in China, introduces the current laws and regulations and system construction of palliative care service, and analyzes the causes, paths and behaviors of the underlying operation mechanism of China's medical and health care system that objectively hinders the development of palliative care service. It also presents how medical institutions of different natures respond differently to palliative care service. We believe that with the reform of China's health care payment method, the original mechanism will change accordingly and promote the development of palliative care service in many ways.