We trust health assets like “medical advice” to exist. That is, we trust that public medical information describes reality such that it may be applied to measurably improve health. This is a challenge because medical advice, especially preventative medical advice like genomics, is a trust asset: an abstract idea with value applied to the indefinite future. However, that trust is under attack, and as the immediately profitable but eventually catastrophic erosion of the term “insurance” now jeopardizes the financial industry, the meaning of term “medical advice” is now being eroded by greedy companies. Why is the meaning of “medical advice” so important to medicine, and why is this trusted label so vulnerable in America when other types of asset labels are so well protected?

Immediate reality enforces the existence of a physically realizable asset like a good or service. The owner enforces the existence of an abstract asset like a brand or copyright. But who enforces the existence of a socially understood trust asset like medical advice? Apparently, nobody.

The value of physical asset like a steel rail is obvious because its meaning is self evident. The value of an abstract asset like a brand is generally obvious because its meaning is generally self described. Most products in a marketing economy are meant only to please, and if they do not, they may be returned for a refund. But if its meaning is ambiguous, who can judge the value of a trust asset like medical advice? Apparently, since products purported to improve health are not held to any rational standard to improve health, nobody.

Finally, to mislabel a physical asset like a steel rail as “this is not a steel rail” is of little threat because that is absurd. To mislabel an abstract asset like “Pepsi” is extremely illegal because that could be believed. The meaning of an abstract asset is self described, and if a label is allowed to be ambiguous, then meaning of that label is destroyed. But when a label of trust is arbitrarily applied —derivative, insurance, medicine— nobody knows what to believe, and all trust assets of that label are destroyed. No trust, no value, no asset.

Does “medical advice” exist, or does it not? Does “medical advice” mean “information to be applied for better health,” or does “medical advice” mean “I have or have not explicitly labeled this information as medical advice”? Does medicine describe physical reality, or is medicine an arbitrary legal term to be ignored when commercially convenient? Are you using medical science to predict future health, or are you making money now because in the future… well, “that’s business”?

It happened in finance, it is happening in medicine, and now we have allowed the most promising new field of medicine, genomics, to be predicated by it.

Is this what we want? For genomics to be the “credit swap” of medicine? We allowed words like “insurance” to become nothing more than an optional label of legal liability, and the resulting disaster now threatens the very meaning of finance itself. And now that Old Wall Street is rubble, companies like Navigenics want to found genomic medicine as New Wall Street. Is that what “medical advice” is? An optional label of legal liability? And who is trying to stop them? You? Anybody? Nobody. Have a brochure. Invite everybody to your conference. Revel in the celebrity! Woopie! You don’t want to miss the foundings and fortunes of new Wall Street! Just wait until “health” can be traded as an asset! Oh boy!

It’s not enough in science —it is not enough in medicine— to “do no harm.” The meaning of medicine must be defended. When we are convinced that cleaning solutions will make our bathrooms “sparkle” because “cute animated scrub brushes fly around on TV,” we can forgive that. When the leading American industry is the ability to convince ourselves in 15 seconds to our spend per capita GDP on a car because “explosions,” we let that slide. These are obvious, physical assets, and they are either purchased, or they are not, and “no harm is done.” In fact, you might feel better about cleaning your bathroom, and your improved apparent socioeconomic status may help you date more attractive people. Congratulations.

But medicine is trust, and when preventive health care is labeled, marketed, and sold like branded “insurance that is not insurance,” that must not be tolerated.

Truth is not a marketing expense. If you are a physician or a scientist and you would like to someday use medical science to compete for the attention of the public with others wielding cartoons and explosions, ignore me. If not, then act.