Professional and policy discussions about the appropriate funding and allocation of health cares services are an essential part of the management of public and private health care insurance plans. However, the ability of governments and health professionals to equitably decide on the distribution of health care is being challenged by the increasing drive to patent health care technologies. Referring to the case of genetic testing for hereditary breast cancer (and Myriad Genetics' patenting of the BRCA1 & BRCA2 genes), this paper applies some concepts from moral philosophy to think through the effects of the commercialisation of genetic technologies, and what would constitute a more just and rational approach to health care decision-making, in the context of the Canadian health insurance system.