The Case for an Outright Ban on Facial Recognition Technology
Some experts worry that facial recognition technology is a dangerous enough threat to our basic rights that it should be entirely banned from police and government use.
[Editor's Note: This essay is in response to our current Big Question, which we posed to experts with different perspectives: "Do you think the use of facial recognition technology by the police or government should be banned? If so, why? If not, what limits, if any, should be placed on its use?"]
In a surprise appearance at the tail end of Amazon's much-hyped annual product event last month, CEO Jeff Bezos casually told reporters that his company is writing its own facial recognition legislation.
The use of computer algorithms to analyze massive databases of footage and photographs could render human privacy extinct.
It seems that when you're the wealthiest human alive, there's nothing strange about your company––the largest in the world profiting from the spread of face surveillance technology––writing the rules that govern it.
But if lawmakers and advocates fall into Silicon Valley's trap of "regulating" facial recognition and other forms of invasive biometric surveillance, that's exactly what will happen.
Industry-friendly regulations won't fix the dangers inherent in widespread use of face scanning software, whether it's deployed by governments or for commercial purposes. The use of this technology in public places and for surveillance purposes should be banned outright, and its use by private companies and individuals should be severely restricted. As artificial intelligence expert Luke Stark wrote, it's dangerous enough that it should be outlawed for "almost all practical purposes."
Like biological or nuclear weapons, facial recognition poses such a profound threat to the future of humanity and our basic rights that any potential benefits are far outweighed by the inevitable harms.
We live in cities and towns with an exponentially growing number of always-on cameras, installed in everything from cars to children's toys to Amazon's police-friendly doorbells. The use of computer algorithms to analyze massive databases of footage and photographs could render human privacy extinct. It's a world where nearly everything we do, everywhere we go, everyone we associate with, and everything we buy — or look at and even think of buying — is recorded and can be tracked and analyzed at a mass scale for unimaginably awful purposes.
Biometric tracking enables the automated and pervasive monitoring of an entire population. There's ample evidence that this type of dragnet mass data collection and analysis is not useful for public safety, but it's perfect for oppression and social control.
Law enforcement defenders of facial recognition often state that the technology simply lets them do what they would be doing anyway: compare footage or photos against mug shots, drivers licenses, or other databases, but faster. And they're not wrong. But the speed and automation enabled by artificial intelligence-powered surveillance fundamentally changes the impact of that surveillance on our society. Being able to do something exponentially faster, and using significantly less human and financial resources, alters the nature of that thing. The Fourth Amendment becomes meaningless in a world where private companies record everything we do and provide governments with easy tools to request and analyze footage from a growing, privately owned, panopticon.
Tech giants like Microsoft and Amazon insist that facial recognition will be a lucrative boon for humanity, as long as there are proper safeguards in place. This disingenuous call for regulation is straight out of the same lobbying playbook that telecom companies have used to attack net neutrality and Silicon Valley has used to scuttle meaningful data privacy legislation. Companies are calling for regulation because they want their corporate lawyers and lobbyists to help write the rules of the road, to ensure those rules are friendly to their business models. They're trying to skip the debate about what role, if any, technology this uniquely dangerous should play in a free and open society. They want to rush ahead to the discussion about how we roll it out.
We need spaces that are free from government and societal intrusion in order to advance as a civilization.
Facial recognition is spreading very quickly. But backlash is growing too. Several cities have already banned government entities, including police and schools, from using biometric surveillance. Others have local ordinances in the works, and there's state legislation brewing in Michigan, Massachusetts, Utah, and California. Meanwhile, there is growing bipartisan agreement in U.S. Congress to rein in government use of facial recognition. We've also seen significant backlash to facial recognition growing in the U.K., within the European Parliament, and in Sweden, which recently banned its use in schools following a fine under the General Data Protection Regulation (GDPR).
At least two frontrunners in the 2020 presidential campaign have backed a ban on law enforcement use of facial recognition. Many of the largest music festivals in the world responded to Fight for the Future's campaign and committed to not use facial recognition technology on music fans.
There has been widespread reporting on the fact that existing facial recognition algorithms exhibit systemic racial and gender bias, and are more likely to misidentify people with darker skin, or who are not perceived by a computer to be a white man. Critics are right to highlight this algorithmic bias. Facial recognition is being used by law enforcement in cities like Detroit right now, and the racial bias baked into that software is doing harm. It's exacerbating existing forms of racial profiling and discrimination in everything from public housing to the criminal justice system.
But the companies that make facial recognition assure us this bias is a bug, not a feature, and that they can fix it. And they might be right. Face scanning algorithms for many purposes will improve over time. But facial recognition becoming more accurate doesn't make it less of a threat to human rights. This technology is dangerous when it's broken, but at a mass scale, it's even more dangerous when it works. And it will still disproportionately harm our society's most vulnerable members.
Persistent monitoring and policing of our behavior breeds conformity, benefits tyrants, and enriches elites.
We need spaces that are free from government and societal intrusion in order to advance as a civilization. If technology makes it so that laws can be enforced 100 percent of the time, there is no room to test whether those laws are just. If the U.S. government had ubiquitous facial recognition surveillance 50 years ago when homosexuality was still criminalized, would the LGBTQ rights movement ever have formed? In a world where private spaces don't exist, would people have felt safe enough to leave the closet and gather, build community, and form a movement? Freedom from surveillance is necessary for deviation from social norms as well as to dissent from authority, without which societal progress halts.
Persistent monitoring and policing of our behavior breeds conformity, benefits tyrants, and enriches elites. Drawing a line in the sand around tech-enhanced surveillance is the fundamental fight of this generation. Lining up to get our faces scanned to participate in society doesn't just threaten our privacy, it threatens our humanity, and our ability to be ourselves.
[Editor's Note: Read the opposite perspective here.]
Breakthrough therapies are breaking patients' banks. Key changes could improve access, experts say.
Single-treatment therapies are revolutionizing medicine. But insurers and patients wonder whether they can afford treatment and, if they can, whether the high costs are worthwhile.
CSL Behring’s new gene therapy for hemophilia, Hemgenix, costs $3.5 million for one treatment, but helps the body create substances that allow blood to clot. It appears to be a cure, eliminating the need for other treatments for many years at least.
Likewise, Novartis’s Kymriah mobilizes the body’s immune system to fight B-cell lymphoma, but at a cost $475,000. For patients who respond, it seems to offer years of life without the cancer progressing.
These single-treatment therapies are at the forefront of a new, bold era of medicine. Unfortunately, they also come with new, bold prices that leave insurers and patients wondering whether they can afford treatment and, if they can, whether the high costs are worthwhile.
“Most pharmaceutical leaders are there to improve and save people’s lives,” says Jeremy Levin, chairman and CEO of Ovid Therapeutics, and immediate past chairman of the Biotechnology Innovation Organization. If the therapeutics they develop are too expensive for payers to authorize, patients aren’t helped.
“The right to receive care and the right of pharmaceuticals developers to profit should never be at odds,” Levin stresses. And yet, sometimes they are.
Leigh Turner, executive director of the bioethics program, University of California, Irvine, notes this same tension between drug developers that are “seeking to maximize profits by charging as much as the market will bear for cell and gene therapy products and other medical interventions, and payers trying to control costs while also attempting to provide access to medical products with promising safety and efficacy profiles.”
Why Payers Balk
Health insurers can become skittish around extremely high prices, yet these therapies often accompany significant overall savings. For perspective, the estimated annual treatment cost for hemophilia exceeds $300,000. With Hemgenix, payers would break even after about 12 years.
But, in 12 years, will the patient still have that insurer? Therein lies the rub. U.S. payers, are used to a “pay-as-you-go” model, in which the lifetime costs of therapies typically are shared by multiple payers over many years, as patients change jobs. Single treatment therapeutics eliminate that cost-sharing ability.
"As long as formularies are based on profits to middlemen…Americans’ healthcare costs will continue to skyrocket,” says Patricia Goldsmith, the CEO of CancerCare.
“There is a phenomenally complex, bureaucratic reimbursement system that has grown, layer upon layer, during several decades,” Levin says. As medicine has innovated, payment systems haven’t kept up.
Therefore, biopharma companies begin working with insurance companies and their pharmacy benefit managers (PBMs), which act on an insurer’s behalf to decide which drugs to cover and by how much, early in the drug approval process. Their goal is to make sophisticated new drugs available while still earning a return on their investment.
New Payment Models
Pay-for-performance is one increasingly popular strategy, Turner says. “These models typically link payments to evidence generation and clinically significant outcomes.”
A biotech company called bluebird bio, for example, offers value-based pricing for Zynteglo, a $2.8 million possible cure for the rare blood disorder known as beta thalassaemia. It generally eliminates patients’ need for blood transfusions. The company is so sure it works that it will refund 80 percent of the cost of the therapy if patients need blood transfusions related to that condition within five years of being treated with Zynteglo.
In his February 2023 State of the Union speech, President Biden proposed three pilot programs to reduce drug costs. One of them, the Cell and Gene Therapy Access Model calls on the federal Centers for Medicare & Medicaid Services to establish outcomes-based agreements with manufacturers for certain cell and gene therapies.
A mortgage-style payment system is another, albeit rare, approach. Amortized payments spread the cost of treatments over decades, and let people change employers without losing their healthcare benefits.
Only about 14 percent of all drugs that enter clinical trials are approved by the FDA. Pharma companies, therefore, have an exigent need to earn a profit.
The new payment models that are being discussed aren’t solutions to high prices, says Bill Kramer, senior advisor for health policy at Purchaser Business Group on Health (PBGH), a nonprofit that seeks to lower health care costs. He points out that innovative pricing models, although well-intended, may distract from the real problem of high prices. They are attempts to “soften the blow. The best thing would be to charge a reasonable price to begin with,” he says.
Instead, he proposes making better use of research on cost and clinical effectiveness. The Institute for Clinical and Economic Review (ICER) conducts such research in the U.S., determining whether the benefits of specific drugs justify their proposed prices. ICER is an independent non-profit research institute. Its reports typically assess the degrees of improvement new therapies offer and suggest prices that would reflect that. “Publicizing that data is very important,” Kramer says. “Their results aren’t used to the extent they could and should be.” Pharmaceutical companies tend to price their therapies higher than ICER’s recommendations.
Drug Development Costs Soar
Drug developers have long pointed to the onerous costs of drug development as a reason for high prices.
A 2020 study found the average cost to bring a drug to market exceeded $1.1 billion, while other studies have estimated overall costs as high as $2.6 billion. The development timeframe is about 10 years. That’s because modern therapeutics target precise mechanisms to create better outcomes, but also have high failure rates. Only about 14 percent of all drugs that enter clinical trials are approved by the FDA. Pharma companies, therefore, have an exigent need to earn a profit.
Skewed Incentives Increase Costs
Pricing isn’t solely at the discretion of pharma companies, though. “What patients end up paying has much more to do with their PBMs than the actual price of the drug,” Patricia Goldsmith, CEO, CancerCare, says. Transparency is vital.
PBMs control patients’ access to therapies at three levels, through price negotiations, pricing tiers and pharmacy management.
When negotiating with drug manufacturers, Goldsmith says, “PBMs exchange a preferred spot on a formulary (the insurer’s or healthcare provider’s list of acceptable drugs) for cash-base rebates.” Unfortunately, 25 percent of the time, those rebates are not passed to insurers, according to the PBGH report.
Then, PBMs use pricing tiers to steer patients and physicians to certain drugs. For example, Kramer says, “Sometimes PBMs put a high-cost brand name drug in a preferred tier and a lower-cost competitor in a less preferred, higher-cost tier.” As the PBGH report elaborates, “(PBMs) are incentivized to include the highest-priced drugs…since both manufacturing rebates, as well as the administrative fees they charge…are calculated as a percentage of the drug’s price.
Finally, by steering patients to certain pharmacies, PBMs coordinate patients’ access to treatments, control patients’ out-of-pocket costs and receive management fees from the pharmacies.
Therefore, Goldsmith says, “As long as formularies are based on profits to middlemen…Americans’ healthcare costs will continue to skyrocket.”
Transparency into drug pricing will help curb costs, as will new payment strategies. What will make the most impact, however, may well be the development of a new reimbursement system designed to handle dramatic, breakthrough drugs. As Kramer says, “We need a better system to identify drugs that offer dramatic improvements in clinical care.”
In today's podcast episode, law professor Gaia Bernstein talks about the challenges of keeping control over our thoughts and actions, even when some powerful forces are pushing in the other direction.
Each afternoon, kids walk through my neighborhood, on their way back home from school, and almost all of them are walking alone, staring down at their phones. It's a troubling site. This daily parade of the zombie children just can’t bode well for the future.
That’s one reason I felt like Gaia Bernstein’s new book was talking directly to me. A law professor at Seton Hall, Gaia makes a strong argument that people are so addicted to tech at this point, we need some big, system level changes to social media platforms and other addictive technologies, instead of just blaming the individual and expecting them to fix these issues.
Gaia’s book is called Unwired: Gaining Control Over Addictive Technologies. It’s fascinating and I had a chance to talk with her about it for today’s podcast. At its heart, our conversation is really about how and whether we can maintain control over our thoughts and actions, even when some powerful forces are pushing in the other direction.
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We discuss the idea that, in certain situations, maybe it's not reasonable to expect that we’ll be able to enjoy personal freedom and autonomy. We also talk about how to be a good parent when it sometimes seems like our kids prefer to be raised by their iPads; so-called educational video games that actually don’t have anything to do with education; the root causes of tech addictions for people of all ages; and what kinds of changes we should be supporting.
Gaia is Seton’s Hall’s Technology, Privacy and Policy Professor of Law, as well as Co-Director of the Institute for Privacy Protection, and Co-Director of the Gibbons Institute of Law Science and Technology. She’s the founding director of the Institute for Privacy Protection. She created and spearheaded the Institute’s nationally recognized Outreach Program, which educated parents and students about technology overuse and privacy.
Professor Bernstein's scholarship has been published in leading law reviews including the law reviews of Vanderbilt, Boston College, Boston University, and U.C. Davis. Her work has been selected to the Stanford-Yale Junior Faculty Forum and received extensive media coverage. Gaia joined Seton Hall's faculty in 2004. Before that, she was a fellow at the Engelberg Center of Innovation Law & Policy and at the Information Law Institute of the New York University School of Law. She holds a J.S.D. from the New York University School of Law, an LL.M. from Harvard Law School, and a J.D. from Boston University.
Gaia’s work on this topic is groundbreaking I hope you’ll listen to the conversation and then consider pre-ordering her new book. It comes out on March 28.
