It is also questionable whether efficiency in the actual care of the care provider would be welcome. “Many of us would love to get cheaper drugs, but will we be happy to get a cheaper doctor?” said Kaplan. “Many people don’t want an efficient doctor who takes five minutes. They want someone who listens to them and knows them. In the world of efficiency, it may be more difficult to get the same doctor.”
Then there are ethical issues. “Will Business Ethics Affect Medical Ethics?” said Kaplan. “Just because you’re good at shipping carpets within 48 hours doesn’t mean you can take care of people’s health.”
Medical Equipment
A little-known source of high healthcare costs is non-prescription equipment and supplies. Because Amazon is closely associated with suppliers, your doctor may be able to request crutches, Donovan said, not to mention wheelchairs, splints, tongue depressors, thermometers, hearing aids and syringes.
This could lead to conflicts of interest, Caplan said. Amazon may give you a discount on its thermometer and not tell you about the other nine. It is a healthcare consumer’s right to know all options, he said.
Ease
One area where Amazon undisputedly excels is the user interface. Let’s face it, it made buying very, very easy. This convenience and simplicity could extend to healthcare, which is a rat maze right now,” Donovan said.
Convenience is a big part of Amazon’s brand, Farr said, adding that it could make it easier to get drugs in the mail, a growing business.
Access to healthcare
Thanks to Amazon’s lead in just about everything, it’s in a good position to expand One Medical’s telehealth options, Caplan said. Retail healthcare is already trading convenience for people who need the ability to meet doctors from home.
“It’s extremely difficult to quickly get an in-person appointment with a primary care provider,” Caplan said. “I saw Amazon build something like nurses to help you with advice, faster access to a pharmacist if you have a question. They could even have people answer questions that are not in this country, although that would create legal problems.”
Privacy
Probably the biggest concern here is privacy. If you get a prescription for the diabetes drug metformin, will you get ads for glucose meters or sugar-free candy? If you’re prescribed statins, what if you start seeing ads for treadmills?
“This is a company that mines data as a core part of its business,” Caplan says. “Privacy is not one of the things Amazon is fully committed to with sensitive healthcare information.”
Farr is less concerned about medical privacy. “It would be a huge, huge deal if they violated HIPAA,” she said. “I’m much more concerned about consumer health information. There are far fewer laws protecting that information, such as using a wearable device to track your period.”
Amazon’s HIPAA policy, posted online, “is very standard in a good way,” Donovan said. An Amazon spokesperson said: “If the deal closes, One Medical customers’ HIPAA Protected Health Information will be treated separately from all other Amazon companies, as required by law.”
Healthcare inequalities
Amazon Pharmacy and primary care companies have the potential to equalize healthcare, but they can also achieve the opposite. “Some people won’t be able to access this world because they’re not that handy with the Internet and computers,” Caplan said. “It could introduce a new form of inequality and inequality in health care. You’re either too old or you’re in the country or you don’t have a computer because you’re poor. Amazon doesn’t serve everyone.”
Meanwhile, retail healthcare providers such as CVS, Walgreens and Rite Aid tend to cluster in affluent urban centers such as New York, San Francisco and Seattle, Farr said.
And expect to see more of the same as other companies expand their healthcare presence. CVS Health has already partnered with insurance giant Aetna. “There could be submissions from other major internet slash social media companies in this space,” Caplan said. “I couldn’t predict who, but maybe Google, Facebook.”