Australia’s health care system needs comprehensive reform to ensure taxpayers and patients get a better bang for their health buck. In this detailed submission to a Senate committee inquiry into private health insurance and out-of-pocket media costs, Grattan Institute’s Health Program Director Stephen Duckett calls for a crackdown on any public hospitals found to be giving admission priority to privately-insured patients, questions the value of the health insurance rebate, urges the Federal Government to encourage medical specialists to establish their practice in rural and remote parts of Australia, and recommends changes to Medicare’s fee-for-service payment system so GPs have a financial incentive to reduce unnecessary patient visits to their practice.