I entirely agree with the conclusion drawn by Jed Friedman and in the last version of my paper with Darwin Ugarte it is actually featured almost word by word! Where I partly disagree, however, is with the statement that CBHI suffers the fatal flow of adverse selection. In fact, our paper shows that this is NOT a problem in the program that we have studied. The main, hard-to-remedy problem is the understanding failure. Here is another, entirely different reason why voluntary insurance schemes may fail.