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The problem with long processes is that you risk the world changing in the interim. The reforms to our health system put forward in the draft National Health Insurance (NHI) Bill were designed in what feels like a different era.

There are several reasons why we need to revisit our chosen reform pathway. We find ourselves in altered circumstances, entering a period of austerity accentuated by Covid-19. The reform pathway as now conceptualised requires substantial reorganisation of a fragile system in a relatively short time-frame. This big bang approach poses several risks, the biggest being that our system may never be reformed because of resistance from across the political spectrum...

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