This has the potential to lead to low prices, presuming there is no monopoly producer. Private sector medicine prices are determined using external reference pricing. Generic substitution is required in the public sector, although in the private sector there are no incentives for doctors and pharmacists to prescribe generics. There are also clinical guidelines to discourage overprescribing, although no formal auditing system is in place to monitor compliance. There have been many reasons for delays, including a lack of political wilL In addition, there has been stakeholder resistance at times among public sector workers not wanting to lose their civil servant status, private sector workers concerned about income losses, private insurers wanting to be included as part of the new system, and employers and employees unhappy about their proposed contribution rates. For example, the basic goal of the new national health system is to bring together the public and private sectors under a single, competitive system.