Amazon Acquisition of One Medical Should Be Rejected Without Robust, Legally Binding Safeguards

Amazon's proposed acquisition of health care provider One Medical should be rejected unless Amazon commits to robust, legally binding safeguards that protect consumers, competition, and the integrity of the health care system, Public Citizen said today in a letter sent to the Centers for Medicare and Medicaid Services, the Federal Trade Commission, the U.S. Department of Justice, and leaders in Congress.

"The risks to competition, patient privacy and the delivery of quality health are evident. This merger should not be permitted to proceed unless and until strong public interest protections are imposed that will demonstrably address all of those grave dangers," the letter reads. Public Citizen raised the following concerns:

1. Amazon may gain an unfair competitive advantage in the health care market. There is good reason to fear that Amazon will leverage its dominant role in the online retail market to gain unfair advantage in health care delivery, for example, through bundling Amazon Prime and One Medical memberships.
   
2. Amazon may misuse patients' health data. The personal medical data that One Medical routinely accumulates would be of enormous value to a marketing company such as Amazon, which will have an undeniable and inherent interest in trying to gain access to that most personal of data. Moreover, there are good reasons to worry that Health Insurance Portability and Accountability Act protections will be inadequate to prevent Amazon from vacuuming up One Medical patients' data.
   
3. The merger may exacerbate health care inequalities. Amazon-One Medical is likely to disproportionately serve healthier and wealthier patients. This will leave other health care providers with sicker and less profitable patients - raising overall costs, and worsening health care disparities already experienced by vulnerable populations.
   
4. The merger could worsen Medicare overbilling. Amazon, through its acquisition of One Medical, would likely build out a primary care network across the country that inflates Medicare payments as part of its business model.
   
5. The merger may undermine the quality of health care. Amazon's online business model could deeply erode the quality of primary health care - including preventative, acute, and chronic disease management care. While some virtual visits can enhance consumer access, overly aggressive substitution of in-person medical encounters with virtual visits can work directly against the proper provision for needed in-person care. Relatedly, Amazon's demand for robot-like efficiency among its employees may well conflict with the imperatives of providing quality health care. And finally...
   
6. The merger may undermine worker rights at One Medical. Amazon has a well-documented history of hostility to workers exercising their right to form unions. Similarly, One Medical workers have reported being rushed, pressured, stretched out, and unable to deliver the quality of care they believe patients require. Amazon seems likely to worsen these issues.

"The American health care system is broken, but Amazon's entry as a major health care provider only threatens to make it worse," said Robert Weissman, president of Public Citizen. "We may get marketing instead of medicine, data harvesting instead of privacy protections, robotic care instead of bedside manner, and more health care disparity instead of more quality. The problem of American health care can be summed up as too much greed and not enough patient care. The Amazon acquisition of One Medical will only deepen that problem."