In our market economy, we can buy what we want, as long as it’s available, and we have the money. And we normally expect the more expensive the product, the better the quality.

However, this is not the case in healthcare, simply because we just don’t know if a better-skilled doctor or surgeon, or hospital amenities, always means better care.

As a recent Grattan Institute report on private health insurance states, in this context it would be fair for “specialists with demonstrably better skills than their colleagues in the same specialty” to charge more.

But the Grattan report goes on to spell out the quandary over financing healthcare, saying: “Since the public has no access to information about relative skill, such as complication rates after taking account of the complexity of the patient, it is hard to justify the higher fees that are charged. Higher fees are … about what these doctors think the market can bear.”