Political parties are gearing up for the general election in 2019, and the EFF’s race-baiting is bang on schedule. Yesterday, whites were to blame; today Indians, coloureds tomorrow. Somewhere around February 2019, EFF national chairman Dali Mpofu will explain, in twisted Marxist dialectic, that Chinese South Africans are continuing their wicked imperial plot to subjugate the African masses. Because, you know, those foreigners have been doing it ever since Ytcho Wancho’s arrival in the Cape in 1660.

The DA’s media releases will be copied and pasted from Revelation. Unless Mmusi Maimane wins the election and casts the ANC into the abyss, plague and war will blight the country. Nothing like a bit of apocalyptic terror to get the base out: worked the last time, the time before that and the time before that. The DA might, however, want to leave out the part about a river running dry.

The ANC can’t run around screaming that the sky will fall down or start brushing off The Protocols of the Elders of Zion: there’s a history of governance to defend. Jacob Zuma’s presidency is something of a problem in that regard. Government debt has rocketed while jobs remain in scarce supply. PetroSA and Denel are broke despite having two products, oil and weapons, that are always in fashion.

Corruption has become so endemic that business schools might as well start offering degrees in it. And then there were the former president’s personal follies. Given those shenanigans, the rumours that his second wife, Nompumelelo Ntuli-Zuma, plotted to poison him are at least plausible.

The NHI, which boils down to a large government-run medical aid with price-fixing committees, is the latest incarnation of the ANC’s strategy of providing hope.

Moreover, the goodwill generated in the body politic from the ANC’s pivotal role in the liberation struggle is fading. Simply pointing to the past isn’t enough these days. After almost 25 years, voters can quite rightly ask why poverty is now on the increase. Put another way, why are 30.4-million South Africans living on less than R992 a month? Why have the ANC’s policies failed?

The ANC needs an election strategy, and quick. Enter the "new dawn".

If the "new dawn" is to be a viable election strategy, the ANC needs to do two things. It has to first convince the electorate that the New Dawn isn’t the Old Sunset. The people currently running the show are largely the same folks who implemented and supported Zuma’s catalogue of disasters. Number Two is now Number One. Bathabile Dlamini has a new portfolio to screw up. Ace Magashule and David Mabuza were promoted. Convicted fraudster Tony Yengeni is the head of the ANC’s working group on crime and corruption. Et cetera, et cetera.

The counternarrative is that President Cyril Ramaphosa is a patient and methodical politician. He is slowly but surely setting up the groundwork to get rid of the incompetent and corrupt. Given time, the government will be cleansed of the bad and the good shall govern. This story bleeds into the second requirement of the ANC’s electoral strategy: provide hope.

Giving hope is something the ANC is remarkably good at. The Reconstruction and Development Programme, the National Development Plan and any one of the South African Airways recovery plans all say the same thing: yes, times are bad but we now have the right policy. Be patient and at some future date all will be well.

Enter Health Minister Aaron Motsoaledi and National Health Insurance (NHI). Quality medical care for all is a good thing. In fact, with education, security and the enforcement of contracts, universal healthcare is a significant reason for having a state in the first place. The Freedom Charter and the Constitution enshrine universal healthcare as not only desirable but a fundamental part of the social contract between the state and the body politic.

The NHI, which boils down to a large government-run medical aid with price-fixing committees, is the latest incarnation of the ANC’s strategy of providing hope. Never mind your current illness, in 2020 or 2025 or 2030 the NHI will be up and running. All will be well then … as long as the ANC is voted back into power.

Motsoaledi’s recent presentation of the enabling legislation for the NHI was somewhat bizarre. When asked how much the NHI will cost, he waved his hand and said that was the Treasury’s business. Didn’t the Treasury and the Department of Health have, like, a meeting about that before introducing the legislation?

In response to the objection that the public health system should be fixed before introducing the NHI, Motsoaledi said the NHI couldn’t wait. Well, nor can patients in places such as Charlotte Maxeke Academic Hospital wait to be treated.

SA does have a system of socialised medicine, which 84% of South Africans rely on and is financed through progressive taxation. The problem is that the system is mismanaged. If the public health system were a patient, a priest would be hovering around to administer last rites. Only 89 out of 1,427 public health facilities are up to an acceptable standard, according to the Office of Health Standards Compliance. There aren’t enough beds for patients with mental health problems. Parliamentarians use the medical aid Parmed, administered by Medscheme, instead of relying on the public health system.

Public health is a matter of implementation rather than policy or legislation. Providing the populace with medical attention is a matter of bricks and mortar, staffing, financial management, quality control, preventing corruption and the procurement of medications, equipment and consumables at reasonable prices. In other words, all the difficult things Motsoaledi should have made happen since he took up his position in 2009 and not kicked down the road until some glorious new future arrives.

No matter how you look at it, for the NHI or something similar to work, a functioning and well-managed public health system is a necessary first step. Shifting contributions from private medical aids to a government-run medical aid can’t work if the underlying healthcare infrastructure is a shambolic mess.

But due to the ANC’s political necessity of an electoral campaign based on hope and the pretence that the new order is not the old order, reality needs to be sacrificed.

There is one positive thing that can be said about a campaign based on hope, no matter how slender or desperate: hope is better than fear or hatred. However, that’s a pretty low standard.

• Taylor, a former project co-ordinator at Earthlife Africa, is a Mellon Foundation postdoctoral fellow in philosophy at Stellenbosch University.