We Have Met the Enemy, and It Is...TikTok?

A few months ago I wrote about TikTok: marvelling at its rapid spread, noting how it was China's first big tech success internationally, even speculating on what it could mean for U.S. healthcare.  Now TikTok is back in the news, because -- and I'm not making this up -- experts fear it could be a threat to national security. 

The Treasury Department's Committee on Foreign Investment is investigating TikTok's parent ByteDance.  A Senate Judiciary Committee panel is holding hearings today (at which TikTok declined to appear).  Concerns were initially raised about apparent censorship of Hong Kong protests, but now are broader.  Some sources claim TikTok is sending user data back to China, possibly to the Chinese government. 

Senator Tom Cotton (R-AR) worries that "...the company is beholden to the Chinese Communist Party and will not secure the rights and privacy of its American users," while Senator Chuck Schumer (D-NY) expressed concern "...that apps like TikTok — that store massive amounts of personal data accessible to foreign governments — may pose serious risks to millions of Americans."  

And you thought it was just a platform for goofy videos.  

One former ByteDance manager told The Washington Post: "They want to be a global company, and numbers-wise, they’ve had that success.  But the purse is still in China: The money always comes from there, and the decisions all come from there."  A security expert added: "The leverage the government has over the people who have access to that data, that’s what’s relevant."

TikTok denies that it censors political content, claims that U.S. data is stored "locally," and maintains that it does not send any user data to China, but we're grappling to deal with a tech company having such a U.S. footprint while overseen by another country.  Mark Zuckerberg, whose own company has faced plenty of criticism about its values, said in a speech at Georgetown University:

Until recently, the internet in almost every country outside China has been defined by American platforms with strong free expression values. There’s no guarantee these values will win out.  A decade ago, almost all of the major internet platforms were American. Today, six of the top ten are Chinese.

It would be naive to think that TikTok and its parent company ByteDance aren't collecting user data, and using it to analyze and target users.  What that targeting looks like, or might look like in the future, is less clear, as is whether or not the Chinese government is or will be involved. 

Credit: Internet of Business

But let's be clear: TikTok may be an example of the problem, but it is not the problem.  Natasha Singer wrote a great op-ed in The New York Times: The Government Protects Our Food and Cars. Why Not Our Data?.  She noted:

Why are Americans protected from hazardous laptops, fitness trackers and smartphones — but not when hazardous apps on our devices expose and exploit our personal information?

and:

In fact, the United States is virtually the only developed nation without a comprehensive consumer data protection law and an independent agency to enforce it. Instead, Americans have to rely on the Federal Trade Commission, an overstretched agency with limited powers, to police privacy as a side hustle. The regulatory void has left Americans at the mercy of digital services that have every reason to exploit our personal information and little incentive to safeguard it.

Whatever we're afraid China might do with our TikTok data, other entities -- including actors for foreign countries -- are already doing with our Facebook, Google, or Twitter data. 

As I'd expressed in my previous TikTok article, U.S. healthcare should be worried about China's ambitions in healthcare.  Very worried.  Bloomberg says, "Pressured by its growing middle class, the Chinese government has set itself an ambitious target: first-world health outcomes at a fraction of the cost that other countries, especially the U.S., pays." 

Ping an Good Doctor "one minute" AI clinic

China is, in particular, planning to use A.I. in healthcare.  As China news site Sixth Tone put it, "Chinese healthcare is betting big on AI.  China Daily reports AI Reshaping healthcare system.  In a recent paper about China's healthcare system, the authors boldly predict: "artificial intelligence will overturn the existing medical model. Artificial intelligence technology will transform the medical sector and trigger an estimated $147 billion market during the next 20 years." 

People like Eric Topol, MD, are urging that the U.S. and China collaborate on bringing AI to healthcare.  "Chinese academics and companies already have unfettered access to personal health data," Dr. Topol and Kai-Fu Li, PhD write. "To compete in AI health, U.S. companies will need access to clinical data on a similar scale. How will that be possible if the current isolationist policy continues?"

And we're back to data.  Did I mention that ByteDance sees itself as an AI company? 

Unlike the U.S., China has a strategy on AI  and on healthcare (not to mention (and quantum computing and 5G).  They're acting like it really is the 21st century, while we're still debating things like whether Facebook should run false political ads.  Right now China's healthcare ambitions may be limited to China, but TikTok's success should be fair warning that at some point they are going to want to export them. 

We still believe healthcare respects borders - not just national, but also state and local.  We still allow data to be siloed, yet also to be shared for purposes that primarily benefit people other than whose data it is.  We still think our hugely expensive, highly dysfunctional healthcare system is the envy of the world. 

None of that is going to survive the oncoming tsunami of healthcare innovations from abroad. 

So worry about TikTok all you want, but it's what comes next that we should be worrying about.  Even in healthcare.