If the cross state sales proviso activates the health care sections in GATS, as it is intended to do, irrevocably - and then if even one international insurance firm states its intention to enter our market, which they already have, requesting that we allow cross-state line sales, GATS will be triggered and we will be prohibited from having a single payer or indeed, any public "option" forever!
That is because of the investor vs. state lawsuits that any investor could bring against a state for blocking its "right" to sell in the market. These lawsuits, based on POTENTIAL, not actual sales, can be huge.
That is what happened to Ontario in 1993 when they tried to offer a "public option" in auto insurance. They were brought before a NAFTA tribunal for unfairly competing with the multinationals, and they lost.
Noam Chomsky has written about this.
(GATS) Could Force Nations Plans Into "US Style" Disasters. This is an excerpt from a paper by an Australian doctors group describing the potential ways in which a signatory could inadvertently kill its ability to have public healthcare. Health and GATS: the DRS submission to DFAT
"The Doctors Reform Society (DRS) was formed in 1973 to support the introduction of universal health insurance in Australia, then called Medibank, now Medicare. The DRS has fought long and hard to improve equity and access to healthcare for all members of Australian society. There is sound international evidence that universal health insurance schemes, such as Medicare, with risk pooling across society in both funding and service delivery, provide the most effective and efficient health systems. The situation seen in the USA indicates the failure of market provision of health services backed with government subsidies."
"The DRS believes the Agreement on Trade in Services (GATS) threatens the existence of public healthcare, the Pharmaceutical Benefits Scheme (PBS) and mandatory universal health insurance schemes such as (Australian) Medicare."
They are telling us- we need to walk carefully! The Senate bill was written with an eye to forcing America - sneakily using GATS, a treaty big US based multinationals who wanted access to Third World markets wrote themselves- to give up all dreams of a public healthcare service that allows all Americans to get affordable health care. Public option advocates, single payer backers, this means you- This bill prevents both from being implemented, and directly threatens your hopes if its allowed to trigger the relevant sections of GATS, which it will!
Beware!
This is what was explained to us in the previously discussed WTO report.
It applies. Without any doubt, it applies. We already signed GATS years ago, BUT, it still has not been triggered, it does not apply to health care in the US YET, only because foreign providers have expressed a need for permission to sell their products nationally, not state by state- first, thats ALL. By triggering the GATS provisions that apply to the provision of health insurance and the distribution of drugs, described in my previous diaries on this issue, we will end up walking into a trap, triggering the so called "ratchet effect" and making future adoption of public healthcare schemes and public drug purchasing pools impossibly costly, That inability to enact public plans of any kind, would make affordable quality healthcare and bring drug prices down to international norms, (a fraction of the prices in the US) impossible! If you don't believe me, read what Sarah Sexton has to say about GATS, Privatisation and Health an essay from the UK.