The characteristics that make a nudge a nudge, and a not-nudge a not-nudge, are too important to be assumed or left to economists and other analysts to determine. They warrant specific appraisal. Likewise, both nudges and not-nudges ought to be required to pass the same tests of effectiveness and acceptability to which all healthcare technologies ought to be subjected and through similar open and participative processes. In this sense, they are not to be differentiated.