The vaccine rollout in the United States has been a national embarrassment. A doctor in Houston was fired for using ten doses of vaccine that would have otherwise expired and gone to waste. Local and state sign-up portals are impossible to navigate, even for tech-literate adult children trying to enroll their elderly parents. There is seemingly unending confusion about overall supply, which states are desperately low on shots, and when the country can expect vaccine production to scale up to meet the urgency of the demand.
This disastrous patchwork of delivery systems, and the crisis of inequity that flows from it, resembles nothing so much as our underlying health care system. Anyone who has ever tried to get an insurer to talk to a provider, or questioned why a Band-Aid might cost $629, knows that it’s a herculean task. It is our system’s proximity to, and dependence on, the private sector that makes it so unwieldy, costly, and miserable at providing care.
Despite this, the Biden administration is apparently looking to partner with Amazon, Airbnb, and other tech giants to assist in vaccine distribution. Politico reported on Tuesday that the Biden administration is “taking Silicon Valley up on its latest offers to help fight the pandemic,” including potentially tapping Amazon’s “expertise in IT and operations to help in vaccine distribution.” Perhaps even more confusingly, Airbnb is pitching its capacity to provide “vaccine depots”—presumably the vacant vacation rentals of small-time landlords—which sounds like a solution in search of a problem if ever there was one. The story is light on details, but a Biden spokesperson acknowledged the ongoing talks.
There’s a trope that tech bros love inventing a thing that already exists—a bus, a library, vending machines. As American Prospect Executive Editor David Dayen pointed out, if the tech companies get involved, maybe the country could “get 3 million vaccines delivered every day, which hasn’t happened since … the flu vaccine a few months ago.” The Centers for Disease Control and Prevention numbers for flu vaccines back that assessment up. In other words, there’s no obvious benefit to Amazon’s involvement in vaccine distribution, but plenty of reasons to be skeptical of the monster Jeff Bezos created absorbing yet another function of our public infrastructure.
There’s an interesting running intra-left debate about monopolies that is directly relevant to this issue. Many on the left, such as Elizabeth Warren, have called for Amazon—or Facebook or Google—to be broken up into smaller, discrete companies. But there are others who don’t see centralization as a problem and openly acknowledge the awesome power of a firm like Amazon. They just believe Amazon should be nationalized. That group is not opposed to bigness per se but to the fact that bigness results in huge transfers of wealth to a very small group of people and allows firms like Amazon to exploit their workers, write laws, and generally distort democracy in the workplace and in electoral politics.
Given that Amazon already relies extensively on the United States Postal Service for its distribution, it’s not immediately clear what value it brings to the table for a vaccine rollout. (The socialist Mike Davis has also argued that nationalizing Amazon would help save the Post Office, a huge side benefit.) What is immediately clear, though, is the upside for Amazon itself. In an earlier report, also from Politico, public health law professor Laurence Gostin raised this exact concern. Gostin argued that Amazon would likely use its access to pad its bottom line “because they’re very well known as a company to try to literally dominate the market and force out any competition.”
This kind of dystopian trade-off—a successful vaccine rollout in exchange for granting Amazon the status of the de facto state—might be worth more serious consideration if these partnerships actually worked, but there is no reason to think they would. West Virginia has one of the highest-risk populations in the nation, as well as logistical hurdles that come from poor and geographically isolated communities. Despite these challenges, the state has one of the best vaccine distribution records in the country. “A key part of the strategy, health officials say, was the decision not to activate a federal partnership with the CVS and Walgreens pharmacy chains and instead rely on independent drugstores,” NBC news reported in late January.
Instead of focusing on big brand name stores, local officials partnered with local pharmacies, which were often much closer to hard-to-reach populations than the large franchises were. As a result, local officials knew the needs and limitations of the communities they needed to reach. One persistent weakness of large humanitarian relief efforts, epitomized most clearly by the Red Cross, is their inability to assess needs in a coherent and timely manner.
In New York City, in the aftermath of superstorm Sandy, the networks that emerged from the Occupy movement were significantly more plugged into their local communities than the Red Cross workers who parachuted in with little local buy-in. Local community groups and mutual aid networks often proved more effective than the City’s official emergency officers. And yet we’ve seen disrespect for local knowledge during the pandemic, for instance when New York Governor Andrew Cuomo “declined to use the longstanding vaccination plans that the State Department of Health had developed in recent years in coordination with local health departments,” and instead “relied on large hospital systems to coordinate vaccinations,” according to The New York Times.
Even if Amazon were a paragon of ethical capitalism—bear with me, really—it would be unfit for this task. Amazon is already trying to corner the market on prescription deliveries, a $500 billion domestic market that would make the company even more of a political juggernaut than it already is. But the fact that the firm is an avatar for steroid-level worker exploitation makes this proposed partnership all the more grotesque. The corporate behemoth has been a singular force for reproducing violent inequity; it’s jarring to see such a company embraced as a partner in resolving the disparities of the pandemic.
Amazon is currently waging war against union organizers in Alabama, who are pushing to cover nearly 6,000 workers in the union. Amazon’s representatives tried—and failed—to force an in-person vote for the union, which could have turned into a superspreader event. The company has also taken to such time-honored traditions as intimidating its employees by coercing contract employees (some of whom are formerly incarcerated) to wear “no” buttons, even though those contract employees would not actually be eligible to vote. “You got these guys just getting out of being incarcerated, so it’s hard for them to find employment,” union organizer Michael Foster told The American Prospect earlier this month.
Back in October, Amazon buckled to public pressure and announced that nearly 20,000 of its workers had tested positive for the coronavirus. One reason that number was so high is that, unlike many companies that have struggled since last March, Amazon’s profits (and Bezos’s net worth) have soared. Amazon, which went on a mid-pandemic hiring spree, became a $2 trillion company in August and, by the end of the year, had added almost $6 billion in additional profit over its prior year, according to a report from Brookings Institute.
If Amazon is so big that the U.S. can’t handle matters of public health without it, that sounds like a persuasive argument for why it should be converted into a public utility. (Or a persuasive argument to build out already existing public infrastructures that have been weakened by decades of austerity.) And if the U.S. can handle the vaccine rollout without Amazon, then by definition there’s no reason for it to be involved. Tech giants aren’t looking for a public-private partnership—they’re looking for an easy mark. There’s no reason we need to play along.