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Amazon's 'affordable' health care service has a hidden cost: your privacy


Amazon launched a low-cost health care service last year to provide virtual care for more than 20 common health conditions including allergies or acne. But as Geoffrey Fowler reported this week in The Washington Post, the service called Amazon Clinic comes with a hidden cost - your privacy. Geoffrey Fowler joins us now. Thanks so much for being with us.


SIMON: A reader asked. You signed up. What did you find out?

FOWLER: Before you're allowed to officially become a patient of Amazon Clinic, they make you click one of those little buttons that says continue or I agree. And there's a whole bunch of legalese that you're agreeing to there. At the top, it says, a HIPAA authorization. And I think a lot of listeners, anybody who's been to a doctor's office in the last couple of decades, might think, oh, yes, yes, HIPAA, that's normal. But this case turns out to be different. What Amazon is asking patients to do is to essentially give up some of their federally protected privacy rights. And that really should raise the eyebrows of anybody who wants to understand what big tech is doing getting into health care.

SIMON: I gather they said it indicated your information, quote, "may be re-disclosed." What does that mean?

FOWLER: It means that Amazon is essentially grabbing the right to take your data and give it to itself and then do we don't know exactly what with.

SIMON: Sell you something, I'm assuming.

FOWLER: Possibly, yeah. Part of the problem here is Amazon's language about what it is doing with this data and why it wants it is extremely vague. So, for example, Amazon has a giant retail business. It now has a pharmacy business. It has a really big advertising business that we don't talk a lot about. Amazon also has other kinds of health care businesses it wants to get into. It's increasingly getting into artificial intelligence. It could take our data and analyze it and try to predict risk scores about different kinds of people. So there's a lot of potential uses for our data, which are usually off limits to health care providers.

SIMON: We should, of course, note that Amazon is among NPR's underwriters. I believe they have a small relationship with The Washington Post, too.

FOWLER: The Washington Post is owned by Jeff Bezos, who is the founder of Amazon. But I am the tech columnist at the Post, and I review all tech with the same critical eye.

SIMON: Is this legal, what Amazon is doing?

FOWLER: When I talked to lawyers and privacy advocates, they said it's up for debate. There are two issues, really, that could come up. First of all, the law says you are not allowed to ask somebody to sign away their HIPAA rights as a requirement of getting service. In this case, Amazon says if you don't click that agree button, you can't really become their customer. Instead, they tell you, here's some contact information for clinics that are our partners, and they'll treat you if you arrange it directly. So I tried to do that, and getting the exact same treatment that normally would have cost me 30 bucks through Amazon Clinic was going to be over a hundred going directly. So that hardly seems like a comparable service offering.

The other question here is - and this is one that would be in front of an organization like the Federal Trade Commission - you know, are consumers really informed about what they're doing in this case? Is Amazon essentially misleading people and making them think that - you know, that they are covered by HIPAA? I mean, their website for Amazon Clinic makes lots of promises about HIPAA, but then asks you to sign a document that says you're no longer covered by HIPAA.

SIMON: When you contacted Amazon, what did they say about your reporting?

FOWLER: Amazon says that it only needs this authorization because of a peculiarity about its role in the health care process, that it is not the doctor itself. It is merely a marketplace for doctors, and it wants this data so that it can better serve its customers. That said, the language that they use and the authorization, it is worryingly vague and gives Amazon a lot of potential power to do stuff with our data in the future. So that's why I think it's worth raising the alarm.

SIMON: Geoffrey Fowler, technology columnist at The Washington Post, thanks so much.

FOWLER: Thank you. Transcript provided by NPR, Copyright NPR.

Scott Simon is one of America's most admired writers and broadcasters. He is the host of Weekend Edition Saturday and is one of the hosts of NPR's morning news podcast Up First. He has reported from all fifty states, five continents, and ten wars, from El Salvador to Sarajevo to Afghanistan and Iraq. His books have chronicled character and characters, in war and peace, sports and art, tragedy and comedy.