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Glossary on free trade agreements and health part 1: the shift from multilateralism and the rise of ‘WTO-Plus’ provisions (2021)

The global trading system has undergone a shift away from multilateral trade negotiations to a ‘spaghetti-bowl’ of regional and bilateral free trade agreements (FTAs). In this two-part glossary, we discuss why this shift has occurred, focusing on how it poses new challenges for public health. Specifically, we introduce key terms that shape this new trading environment and explain them through a public health lens. Part 1 of this glossary focuses on provisions in FTAs that build on previous agreements of the World Trade Organization (WTO). These provisions are commonly designated as ‘WTO-Plus’. This approach continues into part 2 of the glossary, which also considers components of FTAs that have no precedent within WTO treaties. Following a broader discussion of how the current political context and the COVID-19 pandemic shape the contemporary trade environment, part 2 considers the main areas of trade and health policy incoherence as well as recommendations to address them. This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usage http://dx.doi.org/10.1136/jech-2020-215104

Glossary on free trade agreements and health part 1: the shift from multilateralism and the rise of ‘WTO-Plus’ provisions (2021)

The global trading system has undergone a shift away from multilateral trade negotiations to a ‘spaghetti-bowl’ of regional and bilateral free trade agreements (FTAs). In this two-part glossary, we discuss why this shift has occurred, focusing on how it poses new challenges for public health. Specifically, we introduce key terms that shape this new trading environment and explain them through a public health lens. Part 1 of this glossary focuses on provisions in FTAs that build on previous agreements of the World Trade Organization (WTO). These provisions are commonly designated as ‘WTO-Plus’. This approach continues into part 2 of the glossary, which also considers components of FTAs that have no precedent within WTO treaties. Following a broader discussion of how the current political context and the COVID-19 pandemic shape the contemporary trade environment, part 2 considers the main areas of trade and health policy incoherence as well as recommendations to address them. This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usage http://dx.doi.org/10.1136/jech-2020-215104

India's Lucrative Organ Trade

For a long time it was legal, now its not. But the organ trade is still flourishing in India. Because of the poverty which has only been worsened by neoliberal "reforms" there. People, especially those with large families, see selling their organs as the only way out of unpayable debts after sudden loss of jobs they expected to have their entire lives.

11 National Associations of Healthcare Workers Issue Letter demanding More protections for Health Workers.

To raise the "standard of care" (of how we treat) all professionals we need to stop the agenda that is embedding a trade agreement agenda of forcing all domestic regulations to the global least common denominator as a precursor to globalizing them. It aims to increase profits greatly by replacing our domestically grown professionals with ones from the developing world (taking them from countries that desperately need them) - One of the reasons they want to do this is is precisely to prevent them from having input on all sorts of things- including things like this.

Hidden Holocaust: Young Californian, turned away by urgent care facility because he was uninsured dies of cardiac arrest due to coronavirus

[WE HAVE GATS AND DISHONEST POLITICIANS AND MEDIA TO THANK FOR THIS] We still don’t know much about the 17-year-old who may have died of COVID-19 in California. He lived in the city of Lancaster; his father, also sick, is an Uber driver. He had no known preexisting conditions, and no health insurance either, according to a new Gizmodo report. In a YouTube video, Rex Parris, the mayor of Lancaster, suggested the teenager’s lack of insurance contributed to his death. When the sick teen reported to urgent care, staff allegedly turned him away. “He didn’t have insurance, so they did not treat him,” Parris said. Instead, they told him to go to a nearby public hospital. He tried. But the delay may have cost him his life. “En route to AV Hospital, he went into cardiac arrest. When he got to AV Hospital they were able to revive him and keep him alive for about six hours,” Parris continued. “But by the time he got there, it was too late.” Though the teen tested positive for COVID-19, the Centers for Disease Control and Prevention have launched an investigation into his death to rule out any other medical factors in his death. But he wouldn’t be the only COVID-19 patient to die partly because of a lack of health insurance. A Pittsburgh, Pennsylvania, woman died from the virus after she refused to go to the hospital for care. “She didn’t have insurance. She thought she might not be able to pay the bills,” her son told the Pittsburgh Post-Gazette. There are probably other cases like theirs, and behind each one, a person killed by our collective failure to protect them. About 45 percent of American adults were either uninsured or underinsured in 2018, the Commonwealth Fund estimates. Those people are uniquely vulnerable to the effects of any pandemic. They’re more likely to wait to seek care for fear of the expense, or to go entirely without it, and their ranks will increase over the next weeks and months. Because we tie health insurance to employment, a COVID-connected recession could potentially strand thousands, if not millions, without secure access to health care in the middle of a pandemic. Our health-care system is not the best in the world, as the New York Times credulously claimed a few days ago. It is failing. Heavily privatized, dependent on the whims of industry and the vagaries of insurance companies, it is collapsing under the weight of a crisis. Rural hospitals continue to close for lack of funds, and leave the communities they serve without quick access to care. Even in wealthy, urban areas, doctors and nurses don’t have enough masks, enough ventilators, enough protective shields, enough scrubs. In Philadelphia, city officials tried and failed to convince the millionaire owner of Paladin Healthcare, Joel Freedman, to lease them the public hospital he purchased and closed last summer. Sprawling corporations donate masks here and there. But charity can’t plug the gaps through which the poor and the dying fall. Health care is a public good. Policy-makers just don’t treat it that way, and now we’re reaping what they’ve sown.

ICU beds already near capacity with non-coronavirus patients at L.A. County hospitals

ICU beds at Los Angeles County hospitals are already at or near capacity, prompting worries of shortages ahead of expected coronavirus surge By MATT STILES, IRIS LEE MARCH 20, 20204:27 PM Intensive care beds at Los Angeles County’s emergency-room hospitals are already at or near capacity, even as those facilities have doubled the number available for COVID-19 patients in recent days, according to newly released data obtained by The Times. Fewer than 200 ICU beds were available Wednesday, with most ICU beds occupied by non-coronavirus patients, according to the data which covers the roughly 70 public and private hospitals in Los Angeles County that receive emergency patients. The figures, which haven’t been disclosed previously, offer the first real-time glimpse of capacity levels at hospitals from Long Beach to the Antelope Valley and raise fresh worries that the hospital system, which is already strained by shortages, could soon run short of beds. “I am very concerned. We have a limited number of ICU beds available in L.A. County,” said Supervisor Janice Hahn, who urged residents to heed social-distancing orders to reduce infection rates and strain on medical resources. “I would like to begin exploring every possible solution to increase the capacity of our hospital system, including building pop-up hospital sites.” The anticipated surge of coronavirus patients is setting off a scramble to increase capacity of all types of beds, some of which could be converted to ICU units, according to county health officials. To accomplish that, hospitals are halting elective services to open up more space, and are considering other plans to expand capacity, including converting existing space or erecting tents. That effort shows in the figures, with the number of beds overall nearly doubling in the last several days — from 624 on March 13 to 1,182 as of Wednesday. That change includes an increase of ICU beds, which have more equipment and a higher staff-to-patient ratio, from 85 to 191, according to the figures. Christina Ghaly, a physician who directs the county’s vast system of providers, clinics, and hospitals known as the Department of Health Services, said hospitals can add ICU beds by converting existing space. That entails equipping beds with special equipment and adding personnel and, in some cases, getting approval from state regulators. Rooms could also be opened in non-emergency room hospitals, which aren’t included in the current figures. “The hospitals across the entire county are working very hard to free up capacity, and also to create capacity,” said Ghaly. County officials stressed that the figures represent the current staffing needs by hospitals, which have a greater “surge” capacity as more patients get sick. She said they are also asking state officials to fast-track additional capacity. But despite the progress, as many as 90% percent of licensed ICU beds are already occupied with patients who have suffered other medical emergencies, such as heart attacks, car accidents and other cases, according Ghaly said.

Inside America's woefully ill-prepared health system

"by Jacob Greber: The US healthcare system, so expensive that people actively avoid hospitals, could become the defining political issue of a presidential election year." "One American every 30 seconds is bankrupted by medical bills."

A Miami man who flew to China worried he might have coronavirus. He may owe thousands.

You really must read this story, which shows how America's healthcare system is criminally deficient. The Trump Administration, in conformance with our extensive WTO (GATS) commitments, such as the standstill clause in the Understanding on Financial Services Regulation is rolling back all post 1998 changes in financial service regulations, (like health insurance and banking) leaving the financially unsophisticated poor wide open to exploitation by sellers of what we unfortunately frame as 'innovative financial services'. Its the official US trade position that governments cannot be allowed to interfere with even predatory forms of business. Even to protect people from the worst kinds of practices. Even to protect us from emergencies. Profit is Job #1.

Avoiding coronavirus may be a luxury some US workers can't afford

Stay home from work if you get sick. See a doctor. Use a separate bathroom from the people you live with. Prepare for schools to close and to work from home. These are measures the Centers for Disease Control and Prevention has recommended to slow a coronavirus outbreak in the United States. Yet these are much easier to do for certain people — in particular, high-earning professionals. Service industry workers — like those in restaurants, retail, child care and the gig economy — are much less likely to have paid sick days, the ability to work remotely or employer-provided health insurance. The disparity could make the new coronavirus, which causes a respiratory illness known as COVID-19, harder to contain in the U.S. than in other rich countries that have universal benefits like health care and sick leave, experts say. A large segment of workers are not able to stay home, and many of them work in jobs that include high contact with other people. It could also mean that low-income workers are hit harder by the virus.

A look at the "affordable" "health insurance" the global corporate state has in store for the poorer of us.

Surprised? The US health care system is literally on a very "fast track" to total and mandatory crapification, in the form of shedding by the government of all "moral hazard" by the pretext of irreversible services liberalization (total one way, binding privatization and globalization). Weve already been sold down the river - starting decades ago with GATS. Negotiations to pile it higher and deeper - until our hands look just like the sculpture on the beach in Punta Del Este where it all began, back in September 1986, are ongoing. And have been for all that time. This is not a little thing, its a global war on the very idea of a middle class. Far more thefts in the form of more "trade and investment agreements" are ongoing. Its an urgent race by the world's oligarchies to steal as much as possible before people wise up, and in the US, both Fast Track expires, and the November election. We could see announcements within the next couple of weeks. True to form, we and many other countries are being fed an endless pile of bullshit. This ad - from Hindu Business Line was actually more informative than many US ads for similar "crapsurance" -if you read between its lines. Read it.

Cafeteria Style Coronavirus Insurance Coverage, coming here soon?

These attenuated Third World health insurance plans that allow you to pick from a menu of diseases you fear most, are coming to the US soon. This kind of "GATS-legal" viciously attenuated coverage for the financially unsophisticated American may be the only future that is legal to offer the poor, under OUR pre-existing conditions, the WTO financial services rules and their standstill. Disclosure requirements may be one of the only restrictions that is still allowed under GATS.

Global trade in patients is ramping up, could have trade agreement implications

Because of the GATS agreement. See "the Scope of GATS and its Obligations" also linked, here for some more info on the legal aspects of what is now called euphemistically "patient mobility" - Its covered under the GATS. The Agreement may lock in international trade in patients when it occurs, and its "not more burdensome than necessary" provisions forcing governments to allow and pay for the offshoring of poorer patients (and possibly prisoners) and blocking "Medicare For All" like systems, which would keep patients in their home countries. (unless single payer pre-existed the GATS agreement, like in Canada) See "patient mobility" and "Medical tourism" keywords.

Health for some: death, disease and disparity in a globalizing era

By R Labonte, T Schrecker, AS Gupta. These vignettes show how recent, rapid changes in our global economy can imperil the health of millions. The first describes a real event. 1 The other three are composites, like those used in the World Bank's World Development Report 1995 (World Bank 1995), but in …