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Libyan citizens who can afford private health care are opting out of the public health care system. They have a perception that the quality of public health care has deteriorated. The negative perceptions have resulted in a lack of trust by many of Libyan's citizens in the Libyan public health care system and consequently to unequal access to quality health care. The purpose of this study was to identify the factors that have led to the negative perceptions and mistrust. The conceptual support for the study was based on a construct of trust that defines trust as the state of readiness for unguarded interaction with someone or something. Key research questions examined the role Libyan cultural values and privatization of healthcare might have played in creating the negative perceptions and mistrust of the healthcare and its delivery and whether the perceptions and mistrust varied between the patients and healthcare providers. The research methodology used for this study was a qualitative exploratory single-case study. Fifty participants were interviewed during a one-month period. Responses were coded using ATLAS.ti. Study results provided an understanding of the cultural considerations, the impact of privatization, and the respondents' perceptions of Libyan public health care. Results indicated that respondents demonstrated the capacity to trust but did not consistently have positive perceptions of competence and intention of administrators of the public health care system. The findings suggest that patients view the behavior of providers as an indication of their level of skill. Additionally, respondents perceived that they will have a higher level of service if they have a personal recommendation. The social change implication for this study is that overcoming these negative perceptions and improving trust can lead to equal access to quality health care.