I am aware that the concept of a single payment by an insurer to cover both hospital and consultant costs in relation to individual patients has been advanced in a recent discussion paper on health insurance in Australia. The principle of a single payment has a number of obvious attractions, particularly the greater transparency which it would offer to the consumer in terms of overall medical costs. It can also reduce administrative complexities for an insurer. It may also have potential as a cost containment measure but this needs further evaluation.