There is too much sustain, there is too much damage.
Do you know why all of these mages with absurd base damages are balanced? Because all of these AD champions have absurd amounts of sustain. Can you imagine what bot lane would be like if ADC's couldn't just heal through all of the stupid damage of kill lanes? It'd be a complete slaughter fest. Adding all of this sustain (with dorans items/masteries) to the pre-existing sustain on champions and items results in boring gameplay (examine ad champions with built in sustain: Nasus, Trundle, Renekton). How can you fix that? Give everyone tons of damage! Now it's become a game of mana, will you trade enough to run out of mana? If you do... and they don't have mana, they can just sustain you out of lane!
The entire game feels gimmicky, I'm tired of getting one shot, I'm tired of one-shotting. Not everyone has to be a burst mage.
sustain down

getting one shot?
Mana? 