This decade, genomic health care is for people with thousands of  dollars of disposable income. Let’s not mince words: experimental health care is for the rich. But genomics is an information technology, and information technologies scale. A sequenced genome is a mere CD’s worth of data — data that can be freely transferred over the internet. No doctors or insurance middle-men required. Outrageous? An album of music is also a mere CD’s worth of data. Remember Napster? The music industry does.

But will there be a Napster of medicine? Indie medicine is quackery, not creativity, and sticking it to the man in a medical context seems… unwise.

It’s not only coming, it’s here.

We’re in the hobby kit stage of personal genomics now, and you can do your own crude genomic test if you buy a $1000 SNP array from a company like 23andMe. I’ve done one myself (here’s how). Like the first personal computers, for some time, personal genomics will seem erudite and absurd — until it’s not.

Let’s pretend that I’m building the Napster of medicine.

If I want to compile my own genomic database from public information and run tests on genome sequences submitted over the Internet, who’s going to stop me? Nobody. Data is data, and having an MD or PhD doesn’t magically make a computer run better [1]. SNPedia is a start, but I can scrape patents, public research, and services like 23andMe, too.

And if I wanted to run my own genetic tests, what would I need?

• Oragenes or Swabs
• Primers (oligonucleotides) which I can design at Primer3 and verify with BLAST
• a PCR machine
• various common reagents and general lab equipment

Will patent lawyers or legislative orders deter some self-righteous geek running, say, illegal at-cost BRCA tests? Here’s how successful the music industry has been prosecuting music sharing sites. And here’s a question, one that I’d like to pose to a patient advocate like Jessica Queller. If I could save a life from breast cancer with an illegal but perfectly valid free genetic test that was otherwise unobtainable, am I morally obligated to run that test?

It’s still too expensive for amateurs to sequence entire genomes or run SNP chip tests, but like mainframe computers, that technology is rapidly approaching, and single gene tests are already achievable. Genetic testing isn’t magic, and it will be everywhere.

I’m not advocating some trainspotter anarchist genomic revolution, I’m being realistic. The best way to get this technology to doctors to help patients is to help nurture responsible startups like 23andMe and Helix Health, not crush them under legislation and certification. The law only hurts those with something to lose, and draconian enforcement will spawn a digital black market, setting back the genomic industry ten years, if not forever. The entertainment industry is STILL paying for its Napster mistake, because despite services like iTunes, people have tasted the forbidden fruit of free, infinite media. Today, users are deeply reluctant to pay for any media on the Internet. They’ll be deeply reluctant to trust or pay for genomic medicine, too, if you nuke the market and leave the cockroaches to rule.

Medical Industry: don’t piss off computer nerds. You don’t want to fight vaporous, smart people whose religion, hobby, and self-appointed career is to destroy you… especially if they can get venture capital to do it.

[1] Unless you’re Navigenics. Their doctors make computers run 250% better.