20 September 2016 - Suppose your car plays up and you take it to the mechanic. It turns out what’s urgently needed is a new fuel pump, so you tell the mechanic to go ahead.

He sources a high-quality fuel-pump for $250, but the government sets a minimum price for fuel pumps of $500. So he invoices you $500 for the fuel pump.

None the wiser, you pay the bill and your mechanic pockets the $250 difference.

Does that sound fair? If you found out that happened, wouldn’t you feel ripped off? Of course. But in healthcare, this sort of rip-off happens all the time because of the way prostheses, such as artificial hips and knees, are paid for by private health insurance. That hypothetical fuel pump is your replacement heart valve.

When prostheses are required as part of a surgical procedure, the cost is passed on to the insurer.

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