Technology has revolutionized healthcare over the past 50 years. From pacemakers and artificial joints to organ transplantation our patients have experienced care that has dramatically improved their quality of life. Genomic science offers opportunities for gene therapy as well as new drug development. These developments arise from “virtuous circles” of technology to science to technology that depend upon the physical sciences and mathematics, health sciences, and engineering. All of these components require adequate funding, people who can work at interfaces, and appropriate relationships of Academia to Industry. These advances raise major issues for health care costs, ethics, conflicts of interest, privacy and patient-physician interactions.