Health care has evolved in response to the development of medical science. Health policy has reacted to medical practice. The outcome of this reactive approach has been the current high-cost rescue medicine. Metaphor is interactively and inextricably woven into our cognitive processing and has become inherent to our decision making. The basis for the force of metaphor is that it implies meanings at a subconscious level and thereby recruits the driving power of emotion. I will review the mechanisms by which metaphor becomes normative, and analyze health care metaphors which have been operative in the past. I will then construct a health policy metaphor focusing on the opportunity provided by the advent of genetic science. It is my thesis that a proactive health policy metaphor will direct the reorganization of health care policy which, by taking advantage of genetic science, will satisfy social needs at a sustainable expense. (Richard Homan)