Correct, you can get it closer to an iceberg without worries of shorting things out.
The final barrier would seem to be, how close do you think your assemblers can get? Hand assembly, you could butt all these components (transistor, jumper and heatsink) together and let them all get real friendly, but some clearance will be needed on automated assembly. Or for strain relief, since these are rather brittle ceramic parts and they won't be so happy to have big metal parts and thick solder fillets hanging off them.
Upside, even if you're doing a thermal pad-enclosure heatsinking approach, you can spread the heat out with a thick-ish copper (or other metal) tab. Far, far more heat spreading than the foil alone can do, so you can get your 5 or 10W out of the thing, even with fairly obnoxious materials like an ABS enclosure or something. Well, if it's big enough, heh, ABS sucks...
Also neat for fast switching: they make HIP* pure-alumina heatsinks now! Sounds crazy or ridiculous. Well, however they manage to make 'em, yeah they're a lot less conductive than metal, but when you're only dissipating a dozen or so watts over a few inches of sink, that doesn't matter very much. Meanwhile, you have
no worry about isolation, just grease and go! (They usually use spring clamps, no screws needed.) Very attractive for high dV/dt.
*Hot Isostatic Pressed. They use an extrusion die (apparently also made out of alumina, but it manages not to weld and erode for some reason), feed in powdered alumina under pressure, heat the middle to just shy of the melting point, and pull out a perfect extrusion from the far side. Very high density and strength is obtained, as well as apparently almost any shape!
Tim