Desirable results do not necessarily come from good intentions alone. It is particularly so with the complicated reform of healthcare service. The embarrassing situation a county government faces after the implementation of its new medical bill reimbursement program in March is a case in point.

The program, launched by the county government of Shenmu, Northwest China's Shaanxi province, stipulates that all its citizens, both rural and urban, can have their medical expenses reimbursed if they spend more than 200 yuan in township clinics, 400 yuan in county-level hospitals and 3,000 yuan in hospitals outside the county.

The county ranks first in economic performance among all counties in the province. With per capita gross domestic product of 68,700 yuan ($10,000), the county government believes that its finance is strong enough to support such a program.

It drew up detailed rules to avoid possible problems such as excessive use of healthcare resources by doctors or patients and doctors conniving to get extra medical expenses reimbursed. Supervisors were sent to local hospitals to oversee if hospitals forge medical records, invoices and medical certificates to get money from the county treasury.

However, all seven hospitals in the county have been unexpectedly crowded in the past two months. There have been hardly any vacant beds for patients who needed emergency hospitalization. Some patients refused to leave even after doctors assured them that they have fully recovered. It was reported that over 2,000 people were hospitalized in March alone in the county's seven hospitals, and the total expenses to be reimbursed is 9.6 million yuan.

Obviously, the situation is beyond the control of the local government. Some people apparently consider it as foolish to not take advantage of this policy to have whatever their ailments treated or even their chronic diseases completely cured by staying in hospitals.

Rich as the county is, local finances will not be able to afford such a program for long if more and more patients continue to require scarce medical resources. In addition, a lot of public money will be wasted in unnecessary medical tests and medication, which will quite likely drain resources that need to be conserved for patients with serious health problems.

It is good for the county government to come up with the idea of providing medical care to all its residents. Good intention is all very well. To actualize the intention in a reasonable manner for the best possible result is another matter.

A program to guarantee that all residents should receive the healthcare service they need should never be turned into the one that is stretched to provide whatever medical service residents want regardless of the doctors' opinion.

It is imperative for the county government to provide inexpensive healthcare in a manner that curbs waste of resources and increases efficacy of treatment.

(China Daily May 18, 2009)