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From the beginning, the Senate bill has been marketed to progressives as a "first effort", a unfinished project. Only pass the bill, we are told, despite its many problems and lack of affordable options for the middle class and poor, and we can improve on it "later".

However, the more I find out about the multilateral treaties we have signed over the last few years, the more I realize that the writers of this bill have inserted traps in the bill that absolutely must be removed in order to preserve future options to "improve" the Senate bill and health care-

The traps need to be removed and any ambiguities - for future reference clarified BEFORE we accept ANYTHING.

In this case I am specifically talking about things like selling across state lines that TRIGGER the WTO and GATS treaties, a subject few Democratic voters know much about.

Senators do, but DON'T EXPECT THEM TO TELL US.

As far as I can tell, if the bill is passed we will not be able to ever have a public option or single payer. Is this coincidental? Or is this another PhRMA deal - even worse than the PHRMA deal?

In WTO court, under the exact set of circumstances being thrust upon us in the Senate Bill, we wont have a chance. I think its obviously NOT SOMETHING WE WANT TO HAVE TO TEST.

Provisions of the Senate bill have the potential to derail all further progress on AFFORDABLE health care by triggering GATS  on health care, irreversibly locking the United States and its market, into the use of (potentially multinational, like in the Third World) commercial, for profit insurers, (and likely of even lower quality than we have now.)

Provisions limiting insurers in any way, or especially, undercutting them with affordable services of any kind could be forbidden in WTO tribunals. All rules would be subject to GATS rulemaking which would supersede laws written here.

This is because of the GATS treaty obligations which encourage investment and free trade by multinationals and prohibit would be regulators. (or public plan competitors)

Sorry, no appeal is possible. Treaties supersede local laws!

This would be triggered by allowing multinationals to sell insurance in the US, something they have avoided up till now, because the US has over 50 separate jurisdictions. Now, having petitioned the US government to make sales across state lines legal, they are waiting for action, and now waiting several years, for us to make that change- That change, allowing multinationals, the same firms that sell insurance throughout the Third World, to SELL INSURANCE NATIONALLY WITH ONE SET OF LAWS (presumably those of a state with few regulations) ie "SELLING ACROSS STATE LINES" is imminent, its in the Senate bill.

One does not have to go far in the report to see what triggering the health care section of GATS would limit - it would prevent any kind of government-run insurance plan. It would prevent any kind of government purchasing of drugs for resale, in competition with private drug companies, and it could potentially prohibit any kind of backing out of this mess without huge payments to multinational insurers for loss of potential, not actual business.

This seems to me like a hidden trap in the Senate bill.

GATS considers government efforts to replace or supplant for-profit firms to be potentially dangerous to private trade. They are sometimes considered to  to be...


Article VIII
Nations must assure that any monopoly
supplier of a service in its territory does not
compete in the supply of a service outside
the scope of its present monopoly rights and
which is subject to the nation’s specific
commitments. If a Member grants new
monopoly rights regarding the supply of a
service covered by its specific commitments,
it shall notify the Council for Trade in
Services no later than three months before
the intended implementation

Public health and health insurance
systems are monopoly suppliers
of health insurance services and
in some cases also supply health
care services. Since the US has a
specific commitment in GATS for
health insurance, any legislation
or other action to create a
nationally funded or state-funded
health insurance system would
have to be reported three months
in advance to the WTO, which
could take action to assure the
program is not preventing
competition among private
insurance companies.

(That could mean filing a suit in WTO tribunal to stop it, as happened in Canada in 1993 when they tried to offer a public automobile insurance. The NAFTA court said "No".)

Let me be blunt, if this isn't a trap. If this deception to prevent affordable healthcare is not acting in bad faith, WHAT IS?

I have found a lot of material relating to GATS effects in other countries There are many groups fighting internationally, to preserve democratic ability to determine policies - (The treaties like WTO, GATS, NAFTA, etc, supersede laws) in Europe, for example- but few groups here in the US. The best resource is this report published in 2008 about the potential dangers posed by GATS to proposals for health care reform and climate change by the Presidential candidates then. All of these cautions still apply.

You can read the full press release, or the entire report (both PDF downloads).

WHO page on GATS
"Will GATS Reduce Government Services" and other questions at Third World Traveler

Originally posted to Andiamo on Sun Mar 14, 2010 at 04:33 PM PDT.


The GATS treaty appears to be activated by certain actions which could involve multinationals in the US market, preventing important flexibility on healthcare. Should we be concerned?

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