Examines the impact of genetic testing and therapy on health care in light of the development of the system in the USA since the turn of the twentieth century. Genetic testing and therapy have the potential to create a great advance in health care but also to become a business of multi‐billion dollar proportions. If present trends of investment and long‐range plans mature, health care will be adversely affected in terms of its distribution, access and economy. Developed and sold as commodities in a free‐market economy, genetic advances will economically stress health care and fail to meet the ethical and legal standards demanded by voluntary informed consent and counseling. Without abandonment of the marketplace approach to health care and thorough reform, many will find themselves excluded from the benefits and vulnerable to discrimination.