Prostheses accounted for more than 10 per cent of the real growth in benefit outlays by private health insurance in Australia in the past decade. Australian prosthesis prices are high by international standards, yet prosthesis pricing is stuck in an out-dated regulatory approach. It is not providing best value to taxpayers, health insurance members, or patients. In this speech to ARCS (the Association of Regulatory and Clinical Scientists), Grattan Institute’s Health Program Director Stephen Duckett identifies ways to improve the existing regulation. But he argues that they should be seen only as inadequate patch-ups of a rickety system. That system deserves to be consigned to the dustbin of history, and replaced by a fundamentally different approach to paying for surgical care which bundles prosthesis costs into a single price.