On 26 February 2008, Victorian State Opposition Leader Ted Baillieu described as a ?blow out? the increase in average elective surgery waiting times from 202 days in September 2007 to 235 days in February 2008. Likewise, the Australian Medical Association is concerned that 800 000 Australians will leave private health insurance now that the federal government has increased the income threshold for the Medicare levy. They warn of ?further pressure? on public hospital waiting lists. Public hospital waiting lists are frequently used for political point scoring and are portrayed by the media and politicians as indicators of health system performance. Alarmingly, governments often develop policies in response. This paper presents the current evidence to see whether waiting lists are valid indicators of health system performance and presents some advice for policymakers.