Insurance is a mechanism of sharing risk that has been used for centuries, for example via Lloyds of London to protect cargo shipped from India back to England.

American health insurance, because of various government subsidies, has evolved into a hybrid system of covering rare catastrophic events, while also financing health maintenance. The latter is not a real insurable risk.

Bayat discusses his efforts fighting with state insurance commissioners to give consumers better insurance. He proposes distinct processes for what is being insured, and the vehicle for helping individuals pay for their healthcare needs. Doing so will respect choice in care while reviving affordability.