From Babylon to Baylor: How Insurance Went Off the Rails

About this episode

Anish and Dr. DiGiorgio explore the historical evolution of insurance and its implications on modern healthcare.

Anish and Dr. DiGiorgio trace the history of insurance from ancient Babylonian bottomery contracts through Egyptian workers' guilds, Greek risk-pooling societies, Lloyd's of London, and the birth of actuarial science — then walk forward into the Great Fire of London, the 1929 Baylor hospital plan, Henry Kaiser's vertically integrated care, the World War II wage-freeze tax subsidy that chained health coverage to employment, Medicare in 1965, and the ACA in 2010. Along the way they unpack why the insurance model breaks down when applied to events with a 100% chance of happening (like primary care visits), why government-imposed price controls force low-risk payers to subsidize high-risk ones, the role of reinsurance and moral hazard in disaster-prone regions, and how the cultural argument against socializing risk has been quietly losing ground in the West since the Great Depression. Chapter markers 00:00 Cold open — blizzard vs. backyard burgers 01:45 Why physicians need to understand insurance 02:11 Babylon, bottomery contracts, and the Code of Hammurabi 05:29 The birth of actuarial science 07:16 When insurance stops making sense (the 100% problem) 07:42 Egyptian guilds and Greek…

People in this episode

Guests: Anish, Dr. DiGiorgio

Topics covered

• history of insurance
• healthcare policy
• actuarial science
• risk management
• government regulation
• socialized risk

Keywords

• insurance history
• healthcare
• actuarial science
• risk pooling
• government regulation
• Baylor
• Medicare
• ACA

Mentioned in this episode

Organizations: Baylor, Lloyd's of London, Medicare, ACA

Places: Babylon, London

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