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Crowd-Out Ten Years Later: Have Recent Public Insurance Expansions Crowded Out Private Health Insurance?

This concept is important in countries like the US (and UK as part of the EU) who have made GATS and similar commitments, because whatever it does, any public option is not supposed to cut into a co-existing insurance industry's core customers, if it does, the country's laws are subject to challenge by any interested party. (typically a country, like the US) under GATS rules, which are very broad and designed to create and support new rights of corporations, as protected by countries. If a country feels its insurance industry could do better if the other country was forced to "discipline" its domestic regulations to comply with WTO rules. In the case of health care and health insurance, this key gotcha would not apply in a country where there was a single payer system like Canada's - Don't confuse a system like England's (whose NHS, despite its dominant position, is only a 'public option' therefore quite vulnerable to external challenges) with Canada's (totally single payer+exempt) . See discussions elsewhere on here of "GATS Article I:3" and the "Governmental Authority Exclusion" - use the keyword/tag interface - currently in the left hand column, you may need to scroll down, to find them.

Medicaid Expansion in Health Reform Not Likely to “Crowd Out” Private Insurance

"Contrary to claims by some critics, the Medicaid expansion in the new health reform law will overwhelmingly provide coverage to people who otherwise would be uninsured, rather than shift people who already have private coverage to Medicaid." --- comment: This concept of "crowd-out" was literally created by the GATS and it's concept of minimal trade restrictiveness which requires that all government-subsidized measures be the most minimal possible - as well as possibly time limited, for example, only available to either an individual for only a few years, or possibly a country - for only a short period, perhaps a decade or less, (or perhaps only if they are and remain an LDC) . In this case, Medicaid is kind of a loan, not an insurance program, as it is subject to repayment, and only available to the destitute, and near destitute with assets that will only become available at their deaths, such as a home - after their other options have been used up. This "prevents healthcare prices from falling", and "preserves the profit in selling insurance", and "the value of the insurance companies investment". These are the most important things in a for-profit healthcare system. Especially as it becomes "The one bright spot in a dismal economy"

How the World Trade Organisation is shaping domestic policies in health care

David Price, Allyson M Pollock, Jean Shaoul, THE LANCET - Vol 354 - November 27,1999, pp. 1889-1891 "Multinational and transnational corporations, including the pharmaceutical, insurance, and service sectors, are lining up to capture the chunks of gross domestic product that governments currently spend on public services such as education and health. The long tradition of European welfare states based on solidarity through community risk-pooling and publicly accountable services is being dismantled. The US and European Union governments are aggressively backing this project in the interests of their business corporations. But the assault on our hospitals and schools and public-service infrastructure depends ultimately on a promise from one government to another to expand private markets. Such promises can be kept only if domestic opposition to privatisation is held in check. We need to constantly reassert the principles and values on which European health-care systems are based and resist the WTO agenda"