The Senate bill represents an endorsement of the privatization/globalization/trade liberalization model of HCR, it proposes new laws restricting health insurers which could be invaidated by the WTO as barriers to trade.
From the 2008
Global Trade Watch Report: (Discussing urgent changes that are needed in HCR proposals to avoid triggering irreversible changes in our ability to choose what kind of health care we pursue, as GATS's
makes privatization irreversible)
"Among the needed changes is the withdrawal of certain key health- and environment-related sectors from WTO coverage. Redressing WTO limits on U.S. health care policy space could not be more urgent. Currently there are very few foreign insurance firms or health care providers in the U.S. market, thus a withdrawal of existing U.S. GATS commitments in this area - which requires compensation under WTO rules - will be less costly now than when there are more foreign firms operating here in the future. Additionally, specific provisions of WTO agreements that limit domestic policy space and flexibility regarding non-trade policies must be modified. And, elements of U.S. offers to commit new policy space to WTO jurisdiction in the WTO Doha Round negotiations that would impose new limits on non-trade policies must also be withdrawn. Finally, while not a central focus of the report, we also identify as requiring renegotiation the North American Free Trade Agreement (NAFTA) and other "Free Trade Agreement" (FTA) foreign investor rules that empower companies to directly sue governments in foreign tribunals for taxpayer-funded compensation if health, environmental or other domestic policies interfere with their future expected profits."
Now we have a new law which - at some point- will irrevocably finalize the United States's endorsement of globalization and liberalization of trade in health insurance and health services, a rejection of public plans, a stance that historically, in truth (treaties supersede local laws) in the very real world of global trade, not the TV world of politics,
endorses in spirit, the eventual elimination of all restrictions on trade, including laws on safety and laws that restrict financial service providers like insurance firms from selling products of whatever quality they desire.
It continues the de-facto, 'under the radar' privatization of health "monopoly service providers" begun in 1994. It makes progress towards our committments to privatize Medicare and Social Security- started in 1994, and avoids creating any new
monopoly service providers
(i.e. Medicare, Social Security) or expanding existing ones. That is REALITY. What you see on TV is an act. Our other choice is to, like Canada is attempting, (or
was attempting in 2002), to be careful and examine every move ten times before taking a step. Even though Canada has signed the same treaties as we have, they are being much more honest and careful.
I hope that folks realize that the Obama administration stands for nothing globally as much as free trade. We are undeniably leaders,
but we have NOT been leaders in a good sense.
Foreign investment is truly a double edged sword, and we have already, in a sense, sold our nation's soul to the devil for access to foreign markets. We are the market that is being traded. Our people simply have not been informed. After a decade of US banks gambling with our money, they lost. Additional taxpayer money is important to maintaining multi-nationals global profitability. There is little or no profit margin in public healthcare. In a dangerous sense, the bankers view Americans lives as their property, to exploit at will. The rights to us - to Americans and to our market, our money have already been sold. It is truly their way, or nothing, today. UNTIL WE CHANGE THE WTO COMMITTMENTS WE HAVE MADE AND MAKE OUR PRIORITY PEOPLE ABOVE PROFIT, AND MAKE THAT CRYSTAL CLEAR- Until then, we are on record with Bush era policies. We continue Bush era policies. Why? Is it because..
Have they already spent that money!?
The Democrats should not have promised "coverage" and "access" when they have been giving away cost control. Single payer, which could be made impossible by GATS, offers cost control. Their desperate use of empty promises that they cannot fulfill to achieve the final click of the ratchet - activating GATS is not acceptable behavior for politicians trusted with a nation's health policy. Perhaps they never had the power to change anythng because of the huge gambling debts of the banks? Would they have been elected, had they told us the truth? Neither party is telling the truth on GATS as it could potentially impact HCR.
If triggered, GATS regulations will likely supersede, in other words, INVALIDATE many of the so called protections being used to sell the HCR bill that impede free trade.
They are the ideological purists. Its free trade purism or nothing, even if that choice throws affordability out the window. Thats irresponsible. They force our free trade agenda on other nations, even when they cannot pay. Knowing this, in the international arena, can we expect mercy, or Tit for tat if our banker/actor/politicians "accidentally" trigger GATS trapping us in a commercial insurance spiral of increased prices and decreased quality until we all convulse in death? Once GATS is triggered in health insurance by allowing in multinationals like the one in Mr. Kristof's article - we will
If "markets" here can be traded for profitable, unregulated foreign ones what is safe?
We seem to already be committed to giving foreign firms eventual COMPLETE ACCESS to many different market categories, including health care/financial services -which Single payer may be stronger, if GATS is not triggered- and if its free- noncommercial. But as soon as some commercial private firms are involved, GATS attempts to ratchet away public healthcare- Then single payer can be prohibited because of its need to be the single, only payer and buyer of services to save money-(Or in WTO-speak, a "monopoly service provider") the method by which single payer makes health care affordable is villanized, as are public employee unions and government owned healthcare facilities in general- How can we then make healthcare affordable? We can't. Where is the profit in that? (for them)
HERE is one important reason GATS bans single payer:
In 2005, WTO Appellate Body ruled in the U.S.-Antigua-Gambling case that a regulatory ban in a GATS-covered service sector constitutes a "quota of zero" - in violation of GATS market access rules that prohibit numerical limits on service operations. Thus, policies criminalizing certain acts or banning certain activities, even if they treat domestic and foreign companies alike, are now presumptively WTO-illegal if a government has made unconditional GATS commitments in a particular service sector. This implicates not only the complete and partial gambling bans held by some states and localities, but also the regulatory bans in other service sectors that the United States has signed up to the GATS including health care. The United States so far has made no effort to review its past commitments to protect regulatory bans in covered areas, implicating innumerable policies.
Single Payer then becomes physically impossible. No wonder so many people with very questionable intentions keep trying to muddy that ALL-IMPORTANT distinction!!
If I were a legislator, I would be voting NO today. For that reason. Without careful consideration, and changes to GATS, first, WE could easily lose control- Do you trust politicians and their contributors the insurers and drug companies to do the right thing? To preserve your choice? Well soon-you may have NO "CHOICE".
Globalization/Trade "Liberalization"/Health Reform Links
- The General Agreement on Trade in Services (GATS): Implications for regulation of financial services in the United States (MS Word .doc format)
- Global Trade Watch
- Report: Presidential Candidates' Key Proposals on Health Care and Climate Will Require WTO Modifications (Best description of the triggering issue, but the danger is understated)
- GATS information database Search by Sector then choose "Health" to see all the committed sectors that impact health care delivery in the United States including insurance, hospitals and distribution services.
- Summary of WTO Dispute Rulings 1995-present
- Public Citizen's GATS directory (including the Schedule of Specific Commitments, GATS/SC/90 April 15, 1994 and related supplements. The text of the U.S. schedule, along with a glossary of terms and other materials to help decipher often inaccessible trade jargon)
- Backgrounder on WTO service sector liberalization and deregulation (PDF) (Global Trade Watch)
- Unions and Health Care Reform (quote:"GATS "already prohibits Single Payer health care")
- GATS 2000 Request From the EC and Its Member States (Hereinafter The EC) To The United States Of America
- "Putting Health First" (policyalternatives.ca) How Canada's system is faring in the era of globalization, with lessons for the USA's health care system
- Centre for International Public Health Policy
- The Antigua-US online gambling case - (Or how we could easily end up having GATS-restrictions on health insurance triggered by a 'mistake')
- Forum for Democracy and Trade- US-Antigua web page
- Canadian Centre for Policy Alternatives analysis of US-Antigua
- USTR's 2010 Trade Policy Agenda: The Good, The Bad, and the Bizarre (Global Trade Watch- March 1, 2010)
- SSRN (Social Science Research Network, search for abstracts by category)
- The Impact of GATS on Women: "Liberalization" of Health Services - Women Pay the Price
- Korea FTA Negotiations on Medicines Will Harm us Too (Crucial drug affordability issue- US on wrong side- Huffington Post, July 12, 2006)
- How the GATS (General Agreement on Trade in Services) Could Hurt Maine "The GATS could undermine Dirigo Health because it receives public funding. Additionally, it would be GATS-illegal for Maine to create a single payer universal health insurance system that covers everyone. The GATS does not allow the creation of new government monopolies and a universal health insurance system would be just that."
This is what Policy.ca had to say
about the 2006 report Bad Medicine, which analyzed the potential threat to Canada's health care posed bt GATS and other trade treaties like NAFTA- From the analysis on a leading Canadian political analysis site.. Follow the link at the top to download the report "Bad Medicine"
"Canada's medicare system is at odds with the principles of so-called free trade treaties. By establishing a public sector health insurance monopoly, the Canada Health Act cuts against the grain of trade and investment liberalization. According to Grieshaber-Otto and Sinclair, Canada's health care system is only partially shielded from the force of free trade treaties, despite assurances that it is not at risk. They identify many risks to Canadian health care, and conclude with recommendations for more secure health care reform, including halting any privatization of health care services."
"Unions and Health Care Reform"
By Katherine Sciacchitano - (Dissent Magazine)
"In the wake of these technological innovations are the General Agreement on Trade in Services (GATS), the North American Free Trade Agreement, the proposed Free Trade Agreement of the Americas, and the various hemispheric trade agreements. Conceived as one-way streets to privatization, the treaties commit governments to open domestic markets to global competition by eliminating "barriers to trade" (for example, licensing standards, safety standards, higher reimbursement levels for public providers), even when the "barriers" treat foreign corporations exactly the same as domestic corporations. The bottom-up approach of GATS allows countries to commit sector by sector to its provisions. The United States hasn't agreed to open professional health care services to global competition, but it has opened management of hospitals and other health care facilities as well as health insurance. Theoretically, single-payer national health insurance is already prohibited under GATS. Under NAFTA's provisions for investor-to-state suits, single-payer could be challenged either by a foreign insurance company or a U.S. insurer incorporated off-shore that wanted to recapture a share of the U.S. market. Under any of the pacts, the state attorney general's charitable trust authority that SEIU relied on in the CHW and Tenet campaigns might be severely restricted. Strategies such as those SEIU used to organize home care workers-winning creation of a public employer of record for privately contracted home care workers-might be considered an illegal monopoly and outlawed."