Amazon’s dangerous ambition to dominate healthcare


PPatient privacy has been inviolable since the time of Hippocrates, 400 BC. It may be about to end. Last week, Amazon announced it would acquire One Medical, a healthcare provider with more than 700,000 patients.

Big Tech has flirted with health care for years. Amazon’s direct entry into primary healthcare is a turning point. This will increase the perils of surveillance capitalism, with implications for everyone.

Amazon knows our guilty pleasures, what we buy, what pills we buy, and what we watch, read, and listen to. Its devices listen in our homes and come out of our doorbells (Amazon Ring). Amazon’s “Kuiper” satellites will soon connect our Internet.

Recent scandals have revealed that Amazon uses data collected for supposedly innocent reasons in ways that betray our trust. Amazon staff say there are no limits to how Amazon uses this data internally. According to Amazon’s former information security manager: “We have no idea where our fucking data is.”

One Medical receives information on the health of children, families, the elderly and vulnerable people. This includes information about drug addiction, mental health issues, and other intimate conditions. We can’t be sure Amazon will handle this new data any better than it has handled its existing trove of data.

Our secrets are not safe inside Amazon. And it’s not just consumers who are at risk. Other businesses that compete or sell through Amazon will almost certainly be harmed. Amazon uses data collected from one part of its business to help other parts. For example, it competes with retailers who sell on its platform by exploiting its privileged data about their businesses. More data — especially intimate data — increases Amazon’s market power over consumers and competitors.

If we allow Amazon to operate our medical clinics, are we also allowing Amazon to operate health insurance services? We face a dark future where an all-knowing behemoth exploits our intimate vulnerabilities not to provide us with care, but to appropriate income.

This concern is not hypothetical. The economic model employed by the internet giants, surveillance capitalism, is defined by the extraction of data from all sources, the creation of models of collective and individual human behavior and the use of global applications – such as Facebook , Instagram, YouTube or Amazon – to direct users to desired behaviors. We have already witnessed massive damage from surveillance capitalism, including the undermining of elections in the United States and other countries, the amplification of disinformation during a pandemic, and ethnic cleansing in Myanmar.

Like Amazon, Google and Microsoft have sought and won major contracts with the federal government, including the Department of Defense. Google has built a stronghold in public education. To date, policymakers have failed to act on warnings about threats to civil liberties that could result from surveillance capitalists running government databases and education systems.

What makes Amazon’s acquisition of One Medical particularly troubling is that it would expand surveillance capitalism beyond real-world advertising platforms into healthcare. health, one of the most sensitive categories of data. Amazon is not alone.

Amazon’s acquisition of One Medical requires regulatory approval. This transaction gives the Federal Trade Commission the opportunity to exercise not only its obligation under antitrust law, but also its new mandate to protect consumer privacy. Past efforts to protect consumer privacy under the Health Insurance Portability and Accountability Act (HIPAA) have proven insufficient as data from medical tests, prescriptions, wellness apps, etc. are not protected. There is also ambiguity about how HIPAA applies to patterns created from protected data.

We don’t know that Amazon will misuse the data it collects from One Medical, but there’s no reason to take that risk. Consumers today are poorly protected from surveillance capitalism. The few congressional initiatives barely scratch the surface of the problem. That leaves the FTC as the best hope for protecting consumers from potentially predatory behavior.

Consumer protection was once a core function of government. It should be again. The harms of unregulated use of personal data are well known and understood. There is no excuse for further delay. Blocking Amazon’s proposed acquisition of One Medical won’t solve the problem, but it will send a vital message that the government will finally use the tools at its disposal to protect Americans.

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