Not to argue with you, Ed.
  But my interpretation of "self-certifying" is grounding yourself when
your physical/mental condition prevents SAFE flight.  Like when you're
feeling depressed.  Or have a rauchous head cold that could prevent you
from climbing over the weather that you know is along your route.  
  I personally look upon the Ultralight and the GPS as the ONLY saviors
of private flying.  Medical alievation is the only way that the aging 
population will be able to stay in the cockpit.  That, or hiding your
condition to keep that piece of paper in your pocket.
  As to the insurance.  IMHO, that is the only "enforcer" of the FAR's
with real teeth.  Scenario:  You crash into some ones property => The
insurance company finds a descrephancy in your paperwork (no, it does
not have to be responsible for the accident) => The person whose 
property was involved strips you, your estate and your family of all
assets that can be converted to cash for the lawyer and the plaintif.
  And flying without a current medical in a certificated airplane is only
one (of many, many...) ways it happens.  
  Don't forget:  insurance companies have staff, paid for eight hours a
day, to look for things.  Since most of us carry medical insurance through
our employers, it is real easy to find out who has what.  
  So there you have it, sports fans.  Make something a monopoly and it
goes that way.  The FAA is the only one issuing flying tickets.  They
"giveth and taketh away."
       Percy in POrtland

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