Systematic health planning and needs assessments do not figure in the purchasing decision of the National Health Insurance Fund Administration (NHIFA). In addition, systematic performance measurements are also lacking, with accountability measures being restricted to audits that chiefly focus on legal and financial aspects of the operations of providers (Gaal et al., The authorities should allow the NHIFA to engage in selective contracting to avoid oversupply while building commensurate capacities in the NHIFA to enable it to perform the new tasks.