A wounded healthcare system The US system of healthcare is rooted in a short-term focus on treatment of disease, rather than quality-of-life enhancement through prevention of chronic illness. With a US $1.5 trillion price tag last year [1], US healthcare costs accounted for 14.1% of the gross domestic product. These figures are expected to grow to US $2.8 trillion and 17.7% by 2011 if American medicine continues on its current path [2]. With uncontrolled costs, inefficiency and lack of satisfaction on the part of consumers or providers, our healthcare system is in danger of collapse. In the last decade, expenditure on chronic disease has grown to almost three-quarters of US healthcare spending [201]. Although medicine is currently preoccupied with late-stage treatment of high prevalence diseases, a coherent emphasis on practicing prospective care to avoid or reduce disease could help cure some of healthcare’s maladies.

Our healthcare system does not yet effectively customize ‘one-size-fits-all’therapeutic regimens for a patient’s specific disease phenotype. However, technologies emerging from the fields of genomics, proteomics, metabolomics and bioinformatics are now making it possible to distinguish amongst phenotypes that have been considered as one nominal condition [3, 4]. Many experts have suggested that genomics and pharmacogenomics will transform medicine and drug development [5, 6]. Others have argued that many current genomic tools are more hype than substance, and that decades will be needed before genomics has a significant impact on healthcare [7, 8]. We believe that genomics and pharmacogenomics are necessary pieces of a broader shift in focus for healthcare, from inconsistent reactive diagnosis and nonspecific disease treatment, to standardized prospective assessment, personalized health planning, and selective individual treatment.