After creating one of the world’s most profitable companies1 and moving into the online food space just last year,2 Amazon CEO Jeff Bezos’s latest move is into the healthcare industry. In an announcement made at the end of January, Amazon, JPMorgan Chase, and Berkshire Hathaway announced a new agenda to create a “fully independent” healthcare company that is “free from profit-making incentives and constraints.”3 As a starting point, these companies intend to create a healthcare company that serves their employees and their families,4 but Jamie Dimon, CEO of JPMorgan Chase, has already expressed hopes to cover “potentially, all Americans.”5
The potential for this new venture to disrupt the market is already a topic of discussion in the healthcare industry. Although UnitedHealthcare Group, Inc. is disclaiming that Amazon will be a “competitive threat,”6 the New York Times has surmised that Amazon, JP Morgan Chase, and Berkshire Hathaway are likely to serve as a model for other large corporations—if their venture is successful.7 Further, Amazon is not new to healthcare and likely has a substantial knowledge base of medical trends and data, given that the federal government starting utilizing Amazon web services in 2014 to collect medical data from insurers under the Affordable Care Act.8 Despite this, Bezos is not blind to the “degree of difficulty” a venture of this kind will take; rather, he believes his two-part goal of “reducing healthcare’s burden on the economy [and] improving outcomes for employees and their families [will] be worth the effort.”9
This new venture and new approach to healthcare appears to be a product of a dysfunctional healthcare industry, as defined by the questionable stability of the Affordable Care Act and the ever increasing costs of healthcare nationwide.10 But tech companies are taking advantage of these issues and finding opportunities where they already have large amounts of consumer healthcare data, an abundance of capital, and the potential for new partnerships with existing healthcare providers.11 Moreover, tech companies are not limiting their opportunities to break into this market as healthcare providers. For example, Google hosts one of the world’s largest databases,12 collecting and analyzing trillions of data entries.13 Unsurprisingly, a large number of searches, at least five million per day,14 are health-related questions. The ability to turn this data into a value-added commodity for consumers is already being demonstrated, from Google Home’s ability to provide pollen count and allergy forecasts15 to Google-acquired, artificial intelligence company DeepMind’s partnership with the Royal Free London National Health Service to provide “real time clinical analytics, detection, diagnosis and decision support” to doctors.16
The growing amount of medical data collected by technology companies also raises questions of HIPAA’s legal sufficiency to regulate the collection and use of medical information. While the new Amazon, JPMorgan Chase, Berkshire Hathaway venture falls squarely within the definition of a covered entity under17 the HIPAA Privacy Rule,18 which sets standards regarding consent and disclosure for both covered entities and business associates,19 many other tech companies and services will not fall within the scope of HIPAA’s protection. Rather, two major limitations of the law give rise to concerns about blindly sharing healthcare data: (1) HIPAA does not provide a private right of action for individuals affected by breaches in privacy,20 and (2) the innovations in technology by various companies that are not covered entities and perform functions that do not support covered entities escape the governance of HIPAA’s privacy rule altogether.21 Thus, although HIPAA provides some semblance of protection for healthcare data when it is held by a covered entity or business associate, the gap is widening between who has access to healthcare data and how much of that data is protected from disclosure by the emergence of tech companies in the healthcare industry.