Hindle's analysis of past and present initiatives with regard to casemix classification review is perceptive (Hindle 2001). The issues he raises are important. It is clear that Australia has been innovative and led the world recently in casemix development and application. That is why other countries are using the Australian system. Involvement by federal and state governments, administrators and clinicians has led to a system broadly accepted as a lexicon for acute hospital admission classification and a means of payment.