I don't know how many folks here have seen my recent postings on the subject and then have been able to spend some time looking at the World Trade Organization issues that I have been posting about. I hope that you will because addressing them is really important to affordable health care in the US.
Reading through the Presidential WTO Report, I keep coming back to the section (reproduced in the box below) that explains why the US taxpayer must be held responsible for buying out multinationals in the future if we decide we need single payer, after they have entered the market..
A GATS Primer from Canadians.org
Why would we be asked to compensate bad business decisions on the part of multinationals, the decision that they were charging us all too much, or simple social change.
Who gave them this insane "right" to be compensated when the US needs to make some change? US companies don't get that right. Its like asking the government to compensate all the businesses in a town when they make a decision to close a military base there. But, that appears what the GATS have done for multinationals, and this barrier will - if we don't act now, almost certainly become a de-facto brick wall that prevents affordable healthcare forever.
We need investment- both domestic and foreign, but but there must be a better way than via GATS!
We, the people of the United States, obviously, never 'decided - not in 1994, or now, to ban' single payer or public healthcare- but the WTO agreements do - many say, effectively could ban it!
And they have been there for a long time! Has anybody been discussing this with the American people? No- Practically nobody has!
The excerpt below is from the 2008 Presidential WTO Report - which is the best overview I have seen on this issue. If anything, there is more urgency to address this issue now than there was in 2008 when it was released during the campaign.
"In addition to the policy constraints found in WTO, NAFTA and seven U.S. "free trade agreements"101 based on the NAFTA model provide foreign investors operating within the 13 countries102 additional rights regarding how they may be regulated when operating within the United States. These investor rights apply top-down - they cover all sectors unless an exception is taken. They cover all foreign investors operating within these countries (including those from Europe and China, for instance), not only "domestic" firms from these nations.
Among the privileges the FTAs provide such a large category of foreign investors is a right to demand compensation from the U.S. government for policies and actions that undermine their expected future profits relating to an unimaginably broad set of possible investments within the United States.103 NAFTA allows the companies to equate domestic regulatory policies to an "expropriation" of their assets, or "takings." This broad provision for corporations to be compensated for "regulatory takings" does not exist under U.S. domestic law, and empowers foreign investors - including foreign subsidiaries of U.S. firms - to attack a broad array of policies that would not pass muster under U.S. law in U.S. courts. Such rights apply "pre-establishment" - that is to say if a domestic policy could keep a foreign investor from establishing or acquiring an operation within the United States, then the investor can demand compensation even before having established an investment here.
In NAFTA and six NAFTA-style FTAs,104 foreign corporations and investors are empowered to privately enforce these new rights in a closed-door arbitration system that operates outside the domestic court system and excludes public participation, even though U.S. taxpayers must foot the bill for any cash compensation that may be awarded.105 Moreover, if a state law is implicated in such a case, the state has no standing and must rely upon the federal government to defend its policy.
Since NAFTA's enactment in 1994, corporations in all three NAFTA countries have challenged a variety of national, state and local environmental polici es and even civil judicial decisions under this system. Over $35 million has been paid out in damages.106 While many NAFTA investor cases are still pending, some companies have succeeded with these challenges already. The mere threat of such a challenge has chilled governments from making policy innovations, including a threat under NAFTA against a Canadian province's single payer mandatory auto insurance program.
A variety of measures taken by state, provincial and municipal governments to protect the envir onment have been challenged by corporations as regulatory takings using NAFTA's Chapter 11. These include:
- Metalclad v. Municipality of Guadalcázar, Mexico: A Mexican municipality demanded that a U.S. company obtain the same construction permit that had been required of the Mexican company that previously owned the toxic waste facility. When the municipality insisted that the company obtain the permit before it could begin expanding the facility, Metalclad filed a NAFTA Chapter 11 complaint. The NAFTA panel ruled that limiting the company's use of its property was a NAFTA-illegal action tantamount to an "indirect" taking. The Mexican government was ordered to pay $15.6 million in damages.
- S.D. Myers v. Canada: In this case, a U.S. company sought compensation because its "right" to treat Canadian PCB waste in its Ohio facility was halted by Canada, which was acting in compliance with the Basel Convention, a multilateral environmental agreement that encourages nations to treat toxic waste domestically. Canada stopped the toxic trade before the United States did although both signed the treaty. S.D. Myers filed a NAFTA suit claiming discrimination. S.D. Myers was awarded $5 million in damages by a NAFTA tribunal.
- Glamis Gold v. U.S.: In 2003, a Canadian mining company, Glamis Gold, filed a notice that it intended to pursue a $50 million dollar NAFTA claim against mining regulations promulgated by the State of California meant to safeguard the environment and indigenous communities from the impacts of open- pit mining.107
The array of health care reform and climate policies that could be attacked under these provisions is virtually limitless. And, because private commercial interests - not governments - initiate these cases, there is no incentive for a firm in another country that may well have a policy similar to the one being attacked here to avoid setting such a precedent. In contrast, a government might decide not to pursue a challenge so as to avoid a counter challenge on its own similar measure.
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What do we need to do to change the probable outcome from bad to good?
Some long-overdue honesty on the various GATS and WTO-related issues nationally would be a good place for politicians and the media to start.
From the US:
Global Trade Watch (US NGO)
How the GATS (General Agreement on Trade in Services) Could Hurt Maine (PICA)
From other countries:
Trading Health Care Away?
GATS, Public Services and Privatisation (The Corner House, UK)
GATS, Privatisation and Health (The Corner House, UK)
Putting Health First: Canadian Health Care Reform, Trade Treaties and Foreign Policy (Maintaining Canada's public healthcare system while remaining a signatory of GATS and embracing free trade - presents some difficult challenges)
GATSwatch on Health
Exclude Health Care, Water, And Vital Human Services From GATS including health care, water, energy and education.. are treated as barriers to trade under GATS, which applies to all 145 World Trade Organization (WTO) ...
Papers on GATS and health care issues:
Legal fetishism and the contradictions of the GATS
The public health implications of world trade negotiations on the general agreement on trade in services and public services (The Lancet)
International trade and health policy : Implications of the GATS for US healthcare reform Journal of Business Ethics, by ARNOLD Patricia J. ; REEVES Terrie C. ;
Abstract for the Arnold/Reeves paper above:
This paper examines the implications of the General Agreement on Trade in Services (GATS), the World Trade Organization's agreement governing trade in health-related services, for health policy and healthcare reform in the United States. The paper describes the nature and scope of US obligations under the GATS, the ways in which the trade agreement intersects with domestic health policy, and the institutional factors that mediate trade-offs between health and trade policy. The analysis suggests that the GATS provisions on market access, national treatment and domestic regulation, which are designed to eliminate 'regulatory barriers' to global trade in health services, limit the range of options that state and federal regulators and legislative bodies can employ to regulate the health sector and implement healthcare reforms. As such, the paper identifies the broader social and ethical implications of free trade policy.