It's considered one of the nastiest cards to resolve in Commander, but it does require a massive 10 mana the first time, and then 12 the next, and not in the colors of ramp (Black, Cabal Coffers
The drawback of losing 1.5 life per turn is not a significant deterrent in a game which ends within 5-6 turns and starts with 40 life
Multiple instances of the mechanic on a single creature would trigger separately, but thats really only possible with Un-cards right now
But it does allow you to play beat down and then use this to grab a board wipe when the plan goes south
Lao takes a different approach
You can dump a bunch of mana into Taii Wakeen's activated ability, then go absolutely wild with cards like Goblin Bombardment or Pyrohemia, which get the damage boost on each individual activation for that turn