The way the National Health Insurance (NHI) is being formulated is a classic example of how to condemn a policy to failure before it’s even been implemented. Most people can readily agree that healthcare, for rich and poor alike, should be affordable, accessible and of acceptable quality; and that it should be based on clinical need, not the ability to pay. How to achieve this is the issue.

Years of state capture and public-service incompetence have undermined trust in the government. If it is not perceived to be credible, trustworthy and effective, many ordinary citizens will view any policy, no matter how good, with suspicion; as yet another lucrative opportunity for corruption, patronage and failure.

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