Charitable healthcare is a social system that utilizes social resources to provide healthcare security for members of society, restoring and maintaining their health. It is an organic component of multilayer healthcare security system. The impact of charitable healthcare on China's multilayer healthcare security system includes three aspects: direct impact of enhancing the foundational security level of the healthcare security system, the indirect effect of promoting the improvement of this system, and the diffusion effect of fostering solidarity and mutual assistance among social entities. This article adopts an analytical approach of "subject-resource-mechanism-impact, and focuses on five aspects of cost compensation, service provision, collaborative sharing, negotiation and feedback, and integration mechanisms, examining how three types of participants—donors, organizers, and recipients—utilize economical resources, information resources, organizational resources, technological resources, and moral resources. While charitable healthcare plays a positive role, it also faces several challenges, including imbalance in cost compensation structure, vague boundaries in service provision, barriers to collaborative sharing, and behavioral irregularities leading to integration failures. To enhance the effectiveness of charitable healthcare, it is essential to update concepts and build consensus, ensuring that the mechanisms operate on the right track; to introduce polices and optimize resource allocation, promoting precise alignment of charitable resources with needs; and to optimize technology and improve service efficiency, ensuring the smooth operation of the mechanisms.