I disagree. Insurance isn’t a bet. Bets are zero sum (or worse). Insurance isn’t zero sum. It’s a structured redistribution of risk bringing both an improved ex

I disagree. Insurance isn’t a bet. Bets are zero sum (or worse). Insurance isn’t zero sum. It’s a structured redistribution of risk bringing both an improved expected utility (if we assume risk aversion) And expected profits to the risk takers. (The funny economist would argue that a casino is the same if we assume the opposite of risk aversion (tolerance / seeking)). I agree with the point that for high chance, low impact events insurance is less efficient. Follows from the same basic utility theory. Insurance is not costless and costs will start to dominate benefits. The intergenerational aspects of health insurance are a good point. Inflation and medical-technological progress still make insurance a good solution in my book. You can save for a pension (still looking at most of the Western world for saving too little); it’s harder to save for unknown future costs whose height is dependent on where the medical risk falls.