low-income country, with prospective clients who are simultaneously characterized by having low-income, low-education, low-numeracy, rural, and with little or no experience with insurance. Premiums must be low for the poor target population. However, low premiums impose limited coverage, or rationing of benefits. The testing took place in India. As the target population has no access to a national health insurance scheme and rarely buys commercial health insurance products, any attempt to upscale demand for HI among grassroots groups (in India and elsewhere) would require establishing the specific benefits that clients prioritize within a defined, very low, budget. The CHAT simulation exercise had to be changed to give participants choices reflecting the reality prevailing in rural India. Thus, fewer benefit types were offered in India compared to those offered in the US version of CHAT. The levels of benefits had to be reduced as well (basic-or-high, versus the basic-or-medium-or-high options in the US) and the service levels had to be redesigned to reflect only differences in the degree of reimbursement (in the Indian version) while excluding qualitative aspects of healthcare services such as choice of provider (referred to in the US version). And, obviously, the actuarial estimates of the costs of benefits, and consequently also the overall limited cost of the premium payable, were adapted to context. The exercise in India involved a number of persons who were new to the topic of giving prospective clients choice. Some of the persons who were involved, or observed the CHAT experimentation in the field, offered their impressions of the impact of the CHAT exercises in India: “… [I] have personally experienced / observed that participants – illiteracy notwithstanding – come to an understanding of the concept of insurance… and would like insurance to be available in their villages… The CHAT tool can facilitate the best community choice through consensus… CHAT enhances clients’ awareness of the link between premiums they pay and benefits they can reasonably expect from the insurance… This learning culture of CHAT can clear misunderstandings and, consequently, people will have confidence in the scheme… Only by consulting the people themselves can one break away from the current traditional method of designing insurance solutions based on biased information… [and overcome] the prejudice that the illiterate (poor) are unable to decide their own lives and that health insurance is too complicated for them” (see the Changemakers Forum: ) The salient point is that