President Cyril Ramaphosa’s trite quip at this year’s state of the nation address that he was just “looking for a pen” to sign National Health Insurance (NHI) into law is a joke no longer. On Monday night the presidency announced that Ramaphosa would on Wednesday sign the NHI Bill to “overcome the socioeconomic imbalances and inequities of the past” and “direct the transformation of South Africa’s health-care system”.

The legislation paves the way for universal health-care coverage, with medical professionals contracted to a state-run NHI fund through which all medical treatment will be disbursed. It’s a worthy ideal — but fundamentally unworkable in its current guise...

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