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A major environmental tragedy of modern times is the widespread arsenic contamina-tion of shallow drinking water wells in rural Bangladesh, which went unrecognized for years. Large numbers of people are now starting to show a range of symptoms long asso-ciated with chronic arsenic exposure. Rural families in Bangladesh, one of the poorest countries in the world, face financial risks from major illness both from the cost of medical care and from the loss of income associated with reduced labor supply and productivity. Because of the lack of comprehensive government assistance programs and formal insurance markets, most of these households have to rely on private, informal, insurance mecha-nisms. For the poor these typically take place at the household level. While arsenic-related health problems in Bangladesh have long received considerable attention (eg, Smith, Lingas, and Rahman 2000 …