Int. J. Environ. Res. Public Health 2009, 6 518 Medicine Advisory Boards, akin to the Technology Advisory Boards used by basic research institutions in the technology industry, to facilitate translational medicine. Consumers are uniquely positioned to tackle some other key health care industry issues. Just as patients are the only ones who can avoid HIPAA privacy regulations and open source their own data to the benefit of the greater community, patients can skirt the social taboos that other health care ecosystem members may encounter regarding economic issues. Patient-driven health social networks could promulgate cost rationalization by demanding price lists from health service providers and backing consumer credit programs for health care debt such as those envisioned by Criterion Ventures [41]. Much of preventive medicine may continue to be non-reimbursed; one positive aspect of this is that providers would be forced to develop consumer-presentable health service offerings and pricing. Finally and on a more speculative note is one of the other major advancing fields of life sciences, synthetic biology, also known as bioengineering (http://openwetware.org). Essentially, synthetic biology is printing synthesized sequences of DNA after designing them by computer, possibly using the open source biological parts database (http://partsregistry.org). This could be relevant to the future of patient-driven health care if individuals or health social networks were to promote the do-it-yourself home synthesis of test substances, for example printing measurement chemicals for blood and saliva tests used in the self-monitoring process. 3.5. Changing Legal, Economic and Regulatory Institutions Legally, non-discrimination laws such as the Genetic Information Nondiscrimination Act (GINA) passed in May 2008 in the U.S. (http://www.genome.gov/24519851) exist but many people may still be worried about potential genetic discrimination from employers and insurance companies. Given the rate of advancement in DNA sequencing technology, it might be possible that whole genome scans become as normal as blood tests in the health system before laws like GINA are tested and a legal precedent is set regarding genetic discrimination. Economically, a trend is underway for employers to switch from traditional health plans to health savings accounts (HSAs) (http://en.wikipedia.org/wiki/Health_savings_account) as a means of lowering their health care costs. More than half of U.S. large-company plans will offer an HSA as an insurance option in 2008-2009 [42]. HSAs make end-users of health care services more aware of pricing and there is an ongoing debate about whether they produce better or worse health outcomes, but it is possible that consumers would be more efficient in their consumption of services behaving directly as rational economic agents. To the extent possible, consumers may choose to put their HSA dollars to work in new ways, focusing on preventive medicine and other emerging patient-driven health care solutions. Employers could benefit by implementing HSAs together with employee health rebate incentives. Regulatory controversy, the struggle between the old medicine and the new medicine, has already been part of the emerging patient-driven health care landscape in that many direct-to-consumer products and services are unregulated. Opined as initiated by the traditional medical establishment, in June 2008, California served cease and desist orders to direct-to-consumer personalized genomics companies [43]. As of early July 2008, apparently only five of thirteen such companies in California had complied with the order, arguing that they were not in infraction of any laws [44] and in August