What Amazon's push into health care means for patients

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Amazon wants to be your doctor’s office and your pharmacy.

"You can imagine a scenario where in the future someone you know doesn't feel well and they turn to Alexa," Stacy Mitchell, co-director of the Institute for Local Self-Reliance, says.

"Then, the prescription that the doctor prescribes through that office visit or the telehealth just shows up on the front door through Amazon."

First step, prescription drugs. But that's not all. The company also plans to buy some 200 medical clinics.

"This is the thing that basically puts Amazon ahead of like, Apple, ahead of Google, ahead of all of its other competitors," health tech reporter Erin Brodwin says. "Just because that physical footprint is going to be so much bigger."

Today, On Point: Amazon’s push into health care, and what it could mean for you, the patient.

Erin Brodwin, health tech reporter at Axios. (@erinbrodwin)

Joey Mattingly, associate professor at the University of Utah College of Pharmacy. (@joeymattingly)

Maurice McKinnon, data engineer in Charlotte, North Carolina and Amazon Pharmacy customer.

Stacy Mitchell, co-director of the Institute for Local Self-Reliance. (@stacyfmitchell)

Matt Day, Amazon reporter at Bloomberg Technology. (@mattmday)

What is RXPass?

Erin Brodwin: "RXPass is a Prime service. ... It enables you, as long as you're a Prime member, to get as many generic medications as you want. And those are generic to be clear, not specific brands. For $5 a month. Now that sounds huge and big, but I have a few caveats that I'm sure we'll get into about the deal. For starters, though, it's not available to people who use Medicare or Medicaid. Frequently those are the people who need it most. And it's also only for about 50 generic drugs. So before you get too excited, I'd make sure your generic drug is already on the list."

On Amazon taking a page out of Elon Musk's playbook 

Erin Brodwin: "I think they're taking a page out of Elon Musk's playbook here and trying to set up so that they have tentacles in every inch of the business. And then eventually they can kind of unite them all, press a magic button and there you go."

On Jeff Bezos's goals to disrupt the market

Joey Mattingly: "If you followed what Jeff Bezos has been saying publicly for 20 years, he looks to disrupt the market. He focuses on the customer, not his competitors. That seems to be something that they've always done in every market. And so when you think about the pharmacy market or specifically the retail or community pharmacy market, like your Walgreens, Walmart, CVS. These companies, they've found an opportunity where maybe some customers aren't as happy with their current service in those pharmacies and maybe looking for a different opportunity.

"And they've been very successful in other areas. And I don't see why they couldn't be really successful here. My real question is going to be, are they going to be focusing solely on the customer as just a retail customer or are they going to be involved in patient care and actually really working with the patients? Making sure that they are on the most appropriate medications, not just the cheapest?"

On mail-order prescription drugs

Joey Mattingly: "Pharmacies are absolutely involved. Now, the challenge with mail-order or any pharmacy in particular ... the service between the patient and the pharmacist, that relationship can vary. And if you only have, you know, your prescriptions coming in the mail and you have no direct communication with a single pharmacist or a pharmacist that you get to know and they get to know you, without that relationship, which may develop, I think, a little easier in a normal, single pharmacy environment in your hometown, you may lack some of that other context.

"Have you ever called a help center and it's like you call one day and they take all your information and then you follow up the next day and then they have to take all your information again, because no one took notes the first time. Like, that's what I feel like you might get if you don't have any relationships. Whereas it's one thing if you just know me as a generic pharmacist, and it's another thing if you know me as Joey and you're like, Hey, my pharmacist is Joey. I go to him for my questions and things like that. So I'm a big proponent of that relationship."

On Amazon disrupting market power

Stacy Mitchell: "You could look at this and say, well, you know, Amazon coming in and sort of disrupting the health care space is maybe a pathway to sort of disrupting that entrenched market power. But I think it's worth being skeptical about that, mainly because I look at a bunch of other industries where Amazon has come in, consolidated industries, like book publishing is a good example.

"You know, Amazon came in and at first there was this idea of like, Oh, there's somebody that's going to kind of shake this up and this bottleneck of these dominant publishers. Maybe that will go away. And instead, what we found is that the publishers were sort of frightened by Amazon's market power, actually underwent a whole series of mergers, and now there are even fewer publishers."

On Amazon's impact on American health care

Joey Mattingly: "My optimism is that this disruption will hopefully force the other players in the market to step it up. I think you mentioned earlier that, you know, it's not always like the greatest experience in some of the pharmacies you've visited. And I think that we owe our patients better. And we also owe it to our pharmacy technicians and our pharmacists ... a better experience. Because they went to school and got trained to help patients with their medications. And so, yeah, let's reform the system so that they can actually do that."

On big tech's embrace of the health care industry

Erin Brodwin: "I think if the majority of the American medical system hadn't been set up for many, many reasons, to be primarily focused on the chief experience being billing, you know, you have electronic health records being set up specifically for this purpose. And people are wondering why those kinds of systems don't actually help improve patient care. ... Then I think it wouldn't be inevitable. I think it wouldn't be inevitable if we had existing interests interested in improving the experience for the patient, for the provider.

"You know, we've talked about pharmacists here, but clinicians also really important, nurses. To point out their experience here isn't great either. I mean, I don't know how recently you've gone to the doctor, but every visit I've had recently. You sit there and the clinician is spending the vast majority of the visit sitting, typing behind a computer screen. They don't want to be there. I don't want them to be there.

"But, yes, to answer your question in a very long-winded way. I would say it is inevitable for someone to come in and disrupt. Do I think it's overall a positive that Amazon is the one doing it? I'm really not sure. But I do think disruption of some form, it was inevitable here. And then just to put this into some additional context, because there are other health care plays that Amazon has here that we haven't really talked about that much. It also has the Alexa for voice base commands.

"And then, of course, that diagnostics division I mentioned, retail presence and in Whole Foods. But then it also has a very powerful cloud presence. And this is very, very important to all health care entities with us. So I think taken as a whole, Amazon does have humongous potential here. Whether that's a net positive or negative, I think the jury's still out."

Axios: "Unboxing Amazon's health care play" — "Amazon's health care efforts have hit a fever pitch as the announcements roll in — but while its One Medical deal has clear advantages, its pharmacy and telehealth plays currently appear less substantive."