At present, China is the country with the largest number of elderly population in the world, and it is also one of the countries with the fastest aging speed. In the traditional medical treatment, people are often in a passive position, with relatively low consciousness and autonomy for self-health management, and large medical expenditure. For the elderly, the treatment cost is not only high, but also the physical fitness has not been fundamentally changed. By using the method of literature and comparative analysis, this paper studies the dilemma and suggestions of the change of physical exercise consciousness of the elderly when they change from “passive medical treatment” to “active health”. The results show that the current dilemmas from passive medical treatment to active health include fuzzy concept, unestablished idea, imperfect top-level design, imperfect talent training system, etc. Suggestions are put forward to strengthen concept guidance, enhance ideological consciousness, improve top-level design, and perfect talent system.