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Facing Facts

Both proponents and critics agree that the scope of the GATS is very broad. Its extraordinary breadth derives from the incredible diversity of services, the architecture of the agreement, and the expansive way the GATS defines key terms. The subject matter of the GATS—services—is almost unimaginably broad. Services range from birth (midwifery) to death (burial); the trivial (shoe-shining) to the critical (heart surgery); the personal (haircutting) to the social (primary education); low-tech (household help) to high-tech (satellite communications); and from our wants (retail sales of toys) to our needs (water distribution). The GATS applies to all measures affecting “trade in services,” broadly defined. It covers measures taken by all levels of government, including central, regional, and local governments. It also applies to professional associations, standards-setting bodies, and boards of hospitals, schools and universities, where these bodies exercise authority conferred upon them by any level of government. In other words, no government action, whatever its purpose - protecting the environment, safeguarding consumers, enforcing labour standards, promoting fair competition, ensuring universal service or any other end—is, in principle, beyond GATS scrutiny and potential challenge. --- As a former director general of the WTO has correctly noted, the GATS extends “into areas never before recognized as trade policy.” Not limited to cross-border trade, it extends to every possible means of providing a service internationally, including investment. While this broad application does not mean all services-related measures violate the treaty, it does mean that any regulatory or legislative initiative in any WTO-member country must now be vetted for GATS consistency or risk possible challenge. The treaty covers “any service in any sector” with only limited exceptions; no service sector is excluded a priori. This all-inclusive framework binds member governments to certain GATS rules that already apply across all sectors—even those where no specific commitments have been made. It also means that all service sectors are on the table in ongoing, continuous negotiations."

A/RES/44/232. Trends in the transfer of resources to and from the developing countries and their impact on the economic growth and sustained development of those countries

Note Paragraph F, which refers to the meeting in Punta Del Este, Uruguay that established the process that led to the creation of the WTO and begun a "standstill" during which time Member nations were to stop making regulations of any kind which impeded this goal (thats how they frame the expansion or especially creation of what we call public services.) So after that point, we were legally bound not to create a public healthcare system, a problem that continues to this day. So, all around the world, often politicians promising changes that are blocked by these treaties. Instead, a great many countries including (especially) the US and the other countries that made commitments in those areas are bound.

GATS Annex on Financial Services

This document potentially endangers the US's Social Security, Medicare and other safety net programs if they are partially privatized and compete with commercial entities. It is part of the GATS and its explained well by Patricia Arnold in her essay on GATS and Financial Regulation (Public Citizen). It contains a slightly different definition of 'services supplied as an exercise of governmental authority' than GATS Article 1:3 does, which applies in certain situations. To understand it you should also read Nicholas Skala's 2009 paper in the International Journal of Health Services and the Understanding on Commitments in Financial Services. You can also find a bit more material online if you search on the phrase "Fu Lung" or "Fu Lung Group" in the context of financial services+WTO or the Uruguay Round. It seems an effort is made to make information on FTAS difficult to find for outsiders.

The drug pricing policy web site of pricing expert Donald W. Light.

Opposition in International Law – Alternativity and Revisibility as Elements of a Legitimacy Concept for Public International Law - by ISABELLE LEY

As international law is widening in regulatory scope and intensity, it arguably suffers from a legitimacy deficit. This article conceives of this deficit as a deficit in possibilities to politicize, criticize, and contest international law-making proposals in the way a loyal opposition does in a domestic constitutional context: through the representation of relevant societal interests, the voicing of critique, and the safeguarding of alternative proposals for the future. The author of this article tries to bring together the current debate in political theory on the value of legitimate disagreement and dissent in political institutions and the ongoing discussion on the legitimacy of international law. Therefore, a concept of an institutionalized opposition for international law-making processes is developed, referencing authors such as Hannah Arendt and Claude Lefort. Next, the author analyses whether one can already find instances of an institutionalized opposition in international law – in parliamentary assemblies and in international agreements which are designed to present a legal–political counterweight to specific legal concepts and institutions.


This is the declaration -made on September 20, 1986 - in Punta Del Este, part of the Uruguay Round, where services were officially inserted into the GATT talks that were to become the WTO. So its when the US began to lose its regulatory autonomy. Despite its brevity, in retrospect, this became in every sense a deal between the world's oligarchs to put aside democracy and lock down the future. Note that this meeting and document were also referenced in UN document A/RES/44/232 "Trends in the transfer of resources to and from the developing countries and their impact on the economic growth and sustained development of those countries"

USCIS Appeals Panel Rules on L-1B Employment

Story about "Matter of I- Corp., Adopted Decision 2017-02 (AAO Apr. 12, 2017)" a USCIS adjudicative decision where a company's decision to pay a Malaysian engineer less than US minimum wage resulted in a rejection of the non-immigrant work visa they were applying for. It was determined that companies applying for non-immigrant work visas, must plan to pay _at least a 'legal' US wage, ideally a wage that reflected the special skills posessed by the proposed visa recipient. This is a reasonable requirement so that engineers working for minimum wage don't depress the job prospects of engineers generally.

Multinational Corporations and Health Care in the United States and Latin America: Strategies, Actions, and Effects

"In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector."

What is FastTrack

by Maine Fair Trade Campaign - What Fast Track is is DANGER, because IMHO these deals are a scam, that no legislator or member of the electorate in their right mind would ever vote for.

GATS and Congress

These are the services that are regulated by GATS. "Health insurance" and many more. "These are the hot button issues of our time".

"Achmea: The Beginning of the End for ISDS in and with Europe?"

"The Achmea case essentially concerned a preliminary reference by the German Federal Court of Justice over whether EU law precluded the application of an arbitration clause in an IIA between EU member states. Slovakia had challenged before German courts the jurisdiction of an investment tribunal constituted under the Dutch–Slovak bilateral investment treaty (BIT). A Dutch investor (Achmea) had seized that investment tribunal over a partial reversal of the Slovak government’s decision in 2004 to privatize the health insurance market. In 2007 Slovakia had prohibited the distribution of profits generated by private health insurance activities. The investment tribunal considered this a breach of the BIT and awarded Achmea damages of EUR 22.1 million."

Video: GATS- What is it?

Concise, very fast video cram course on GATS by an expert in it. Don't blink or you might miss something important. For example, at 5:55 Prof. Stumberg describes why the two US parties never seem to compromise any more, everything done in dozens of services must only deregulate, not re-regulate. Basically, it's a GOP wet dream. thats Locked in.

TISA - The Really Good Friends of Transnational Corporations Agreement by Ellen Gould

Highly secretive talks began in 2012 to establish a new trade agreement, which adds to and builds upon the existing General Agreement on Trade in Services, GATS. The new agreement is plurilateral and is currently named the Trade in Services Agreement (TISA). The group of countries negotiating TISA have given themselves an insider joke for a name, the 'Really Good Friends of Services' , to signal how truly committed they are to promoting the interests of services corporations. But there is nothing funny about the sweeping, permanent restrictions on public services and regulation that could be the impact of their work. Because TISA is basically a global war against what were once known as public services. See the material on "governmental authority exclusion" to see how that definition has been changed by FTAS.

Public Services and the GATS - International Centre for Trade and Sustainable Development

Rashad Cassim & Ian Steuart, School of Economic and Business Sciences, University of the Witwatersrand, Johannesburg - (3rd Draft) "The strength of a society depends unequivocally upon a foundation that ensures the provision of a range of quality public services to all who need them, regardless of their ability to pay for them. It is perhaps perplexing then that the provision of public services, even those thought of as essential or basic services, is increasingly in the hands of private companies, leading inexorably to their commercialisation, threatening their reach to those that need them most, and potentially eroding the sustainability of their provision from both a social and environmental perspective. This subchapter aims to achieve the following: to provide an overview of the role and relevance of public services, and to examine the link between the provision of public services and the General Agreement on Trade in Services (GATS); the primary vehicle of the liberalisation of services within a multilateral, rules-based system of international trade and therefore an area of specific concern. Consequently, with respect to the first aim, this subchapter will examine the evolution of “public services” and why it remains important to retain an element of government intervention in their provision. With respect to the second, the chapter will focus on the scope of the GATS and the tensions inherent in the interpretation of Article 1:3 of the GATS, which deals with the “public services” carve-out from the agreement. This subchapter is divided into 5 sections. After this Introduction, Section 2 will examine what is meant by “public services”, including the usefulness of the more restrictive conception of “essential” or “basic” services. Section 3 focuses on the role of public services in addressing sustainable development concerns, particularly the relationship between public services and their privatisation. Section 4 is devoted to the relationship between public services and the GATS. Much has been written on public services and the liberalisation of trade and this section aims at synthesis of arguments on both sides of the divide, which have become increasingly more vocal and passionate as the services negotiations in the WTO proceed as part of the Doha Development Round. Section 5 concludes."

Topic- Carve-outs

Americans need to get broad carve outs in existing FTAs as well as future ones written into laws so legislators and executives cannot use trade agreements to do an end run around the voters wishes. Or they will. Making elections meaningless. This "carve-outs" category broadly defines alterations to trade agreements to modify their terms, so that countries can gain needed policy space back from trade agreements that attempt to hijack it forever. Note many FTAS also have an explicit procedure for modifying existing commitments. Like GATS Article XXI that must also be followed.

The politics of the private finance initiative and the new NHS

"This is the last of four articles on Britain's public-private partnership in health care We began this series by arguing that the private finance initiative, far from being a new source of funding for NHS infrastructure, is a financing mechanism that greatly increases the cost to the taxpayer of NHS capital development. The second paper showed that the justification for the higher costs of the private finance initiative—the transfer of risk to the private sector—was not borne out by the evidence. The third paper showed the impact of these higher costs at local level on the revenue budgets of NHS trusts and health authorities, is to distort planning decisions and to reduce planned staffing and service levels."

Global Trade and Public Health

"Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications". (This basically means they have stolen the right to regulate, or are in the process of stealing it.)

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

(The Lancet) "The previous round of WTO ministerial talks (the Uruguayan round) allowed governments to protect health and social services from GATS treatment by defining them as government services. According to GATS Article 1.3, a government service is one “which is supplied neither on a commercial basis, nor in competition with one or more service suppliers”. Article 19 of GATS is, however, intended to end this protection. “Members shall enter into successive rounds of negotiations . . . with a view to achieving a progressively higher level of liberalisation.” The WTO secretariat has argued that for services to be classified under Article 1.3 they should be provided free. Many governments initially protected health services from GATS treatment by defining them in this way. But the WTO has highlighted the inconsistencies in this approach. 12 “The hospital sector in many counties . . . is made up of government-owned and privately-owned entities which both operate on a commercial basis, charging the patient or his insurance for the treatment provided. Supplementary subsidies may be granted for social, regional, and similar policy purposes. It seems unrealistic in such cases to argue for continued application of Article I:3, and/or maintain that no competitive relationship exists between the two groups of suppliers of services.” In addition, Article 13 of GATS calls for the end of subsidies that distort trade and requires members to negotiate procedures to combat them. Therefore, according to the WTO, wherever there is a mixture of public and private funding, such as user charge or private insurance, or there are subsidies for non-public infrastructure, such as public-private partnerships or competitive contracting for services, the service sector should be open to foreign corporations. Health-care systems across Europe are vulnerable on all these counts."

State Capture

The classical definition of state capture refers to the way formal procedures (such as laws and social norms) and government bureaucracy are manipulated by private individuals and firms so as to influence state policies and laws in their favour. State capture seeks to influence the formation of laws to protect and promote influential private interests. In this way it differs from most other forms of corruption which instead seek selective enforcement of already existing laws.[3] State capture may not be illegal, depending on determination by the captured state itself,[4] and might be attempted through private lobbying and influence. The influence may be through a range of state institutions, including the legislature, executive, ministries and the judiciary, or through a corrupt electoral process. It is similar to regulatory capture but differs in the scale and variety of influenced areas and, unlike regulatory capture, the private influence is never overt. The private influences cannot be discovered by lawful processes, since the legislative process, judiciary, electoral process, and/or executive powers have been subverted.

US involvement in India demonetization - Big US companies behind the Indian "cashless cities " movement.

One worry I have though is, what happens if there is a strong solar storm, which could wipe out the energy grid and also, telecommunications for some time. (possibly years, as transformers that carry electricity are expensive, manufacturing capacity is limited, and they are difficult to replace) Another risk is multiple nuclear meltdowns due to loss of the ultimate heatsink. Cashless could mean no way to purchase food for an extended period of time.

OECD Services Trade Restrictiveness Index - Regulatory database

This is the index hosted by the OECD (one of several indices of trade restrictiveness) that countries can use to consult if their services regulations comply with "Minimal Trade Restrictiveness" rules that limit what a country can regulate. For example, WTO rules require that measures (basically all national laws, regulations or policies, at the federal, state or local level ) be 'not more burdensome (on corporations) than necessary to ensure the quality of the service'.

Good cop/bad cop

"Good cop/bad cop" routine, also called joint questioning or friend and foe, is a psychological tactic used in negotiation and interrogation. "Good cop/bad cop" tactics involve a team of two interrogators who take apparently opposing approaches to the subject. The interrogators may interview the subject alternately or may confront the subject at the same time.

The Good Cop, Bad Cop Negotiation Strategy

The good cop, bad cop negotiation strategy is common in sales negotiations and other competitive contexts. Learn to identify and defuse this persuasion ploy when it’s tried on you.

The General Agreement On Trade In Services: Implications For Health Policymakers (Health Affairs)

The General Agreement on Trade in Services (GATS), created under the auspices of the World Trade Organization, aims to regulate measures affecting international trade in services—including health services such as health insurance, hospital services, telemedicine, and acquisition of medical treatment abroad. The agreement has been the subject of great controversy, for it may affect the freedom with which countries can change the shape of their domestic health care systems. We explain the rationale behind the agreement and discuss its scope. We also address the major controversies surrounding the GATS and their implications for the U.S. health care system

The General Agreement On Trade In Services: Implications For Health Policymakers (Health Affairs)

The General Agreement on Trade in Services (GATS), created under the auspices of the World Trade Organization, aims to regulate measures affecting international trade in services—including health services such as health insurance, hospital services, telemedicine, and acquisition of medical treatment abroad. The agreement has been the subject of great controversy, for it may affect the freedom with which countries can change the shape of their domestic health care systems. We explain the rationale behind the agreement and discuss its scope. We also address the major controversies surrounding the GATS and their implications for the U.S. health care system

LOOTING:The Economic Underworld of Bankruptcy for Profit.

NBER Working Paper No. R1869 During the 1980s, a number of unusual financial crises occurred. In Chile, for example, the financial sector collapsed, leaving the government with responsibility for extensive foreign debts. In the United States, large numbers of government-insured savings and loans became insolvent - and the government picked up the tab. In Dallas, Texas, real estate prices and construction continued to boom even after vacancies had skyrocketed, and the suffered a dramatic collapse. Also in the United States, the junk bond market, which fueled the takeover wave, had a similar boom and bust. In this paper, we use simple theory and direct evidence to highlight a common thread that runs through these four episodes. The theory suggests that this common thread may be relevant to other cases in which countries took on excessive foreign debt, governments had to bail out insolvent financial institutions, real estate prices increased dramatically and then fell, or new financial markets experienced a boom and bust. We describe the evidence, however, only for the cases of financial crisis in Chile, the thrift crisis in the United States, Dallas real estate and thrifts, and junk bonds. Our theoretical analysis shows that an economic underground can come to life if firms have an incentive to go broke for profit at society's expense (to loot) instead of to go for broke (to gamble on success). Bankruptcy for profit will occur if poor accounting, lax regulation, or low penalties for abuse give owners an incentive to pay themselves more than their firms are worth and then default on their debt obligations.

The Scope of GATS and of Its Obligations by Bregt Natens, Jan Wouters

Bregt Natens, Jan Wouters - KU Leuven - Leuven Centre for Global Governance Studies Date Written: August 1, 2013 Abstract The GATS preamble already highlights the inevitable conflict between on the one hand achieving progressively higher levels of liberalization of trade in services in order to expand trade in services and promote growth, and on the other hand the right to introduce new regulation to meet national policy objectives. Hence, it was clear from the outset that the balance between trade liberalisation and domestic regulatory autonomy would be key in interpreting the constructively ambiguous GATS. The outcome of this exercise depends on three factors: the interpretation of (i) GATS’ overarching objectives, (ii) of the general scope of GATS and of the obligations arising from it (and the exceptions to them) and (iii) of the inherent individual flexibility of GATS. Whilst also touching on the first, this contribution mainly focuses on the second factor by addressing the scope of GATS, of its unconditional obligations, of obligations applying to sectors for which specific commitments have been scheduled and of obligations in GATS Annexes. Additionally, it provides an overview of the structure of GATS obligations. The third factor is mainly addressed throughout textboxes which provide an illustrative insight into how the European Union has used the inherent GATS flexibility to shape its obligations. Keywords: WTO, World Trade Organization, GATS, General Agreement on Trade in Services, services, scope, obligations, governmental authority exception

Adapting to a Highly Automated World

This is a very good paper that asks hard questions about what may happen in the near future as we get better and better at saving more and more labor. Its quite old but its very well done so it ages quite well, as a longtime amateur futurist I think more honest than many newer explorations of the same issues.

"Pre-Established" (status) and Financial Services Regulation in the GATS agreement

The status of whether a domestic law or regulation pre-existed the GATS agreement is an important status under WTO law. If an instrument or measure pre-existed the GATS it has far more lattitude to break GATS rules. This is why if we wait much longer, it may be very expensive, (based on the value of the lost business) perhaps nearly impossibly so, to establish a new "Medicare For All" (which does break GATS rules in a number of ways, for example, see Skala's paper) unless we immediately start the process of exiting and seeking carve outs from the GATS as far as this service sector. We should also start consulting experts so we can do that without destroying Medicare or Social Security's protection from GATS.

TISA Troubles

This study, co-published with the Rosa Luxemburg Foundation, examines the adverse impacts on public services and public interest regulation of the little-known Trade in Services Agreement (TiSA), quietly being negotiated in Geneva by a group of 23 governments, including Canada. Senior CCPA trade researcher Scott Sinclair argues that under the guise of expanding international trade in services, TiSA will make it much harder for governments to regulate vital services such as energy, water, banking, transport and online services. The agreement is also designed to pry open public services to commercial involvement. While this agenda may suit the commercial interests of the transnational corporations behind the secretive TiSA negotiations, it will not serve the broader public interest.

Higher social class predicts increased unethical behavior (PNAS)

Seven studies using experimental and naturalistic methods reveal that upper-class individuals behave more unethically than lower-class individuals. In studies 1 and 2, upper-class individuals were more likely to break the law while driving, relative to lower-class individuals. In follow-up laboratory studies, upper-class individuals were more likely to exhibit unethical decision-making tendencies (study 3), take valued goods from others (study 4), lie in a negotiation (study 5), cheat to increase their chances of winning a prize (study 6), and endorse unethical behavior at work (study 7) than were lower-class individuals. Mediator and moderator data demonstrated that upper-class individuals’ unethical tendencies are accounted for, in part, by their more favorable attitudes toward greed.

GATS Backgrounder from Public Citizen (2005)

“Governments are free in principle to pursue any national policy objectives provided the relevant measures are compatible with the GATS.” –WTO, Oct. 1999 “GATS provides guarantees over a much wider field of regulation and law than the GATT; the right of establishment and the obligation to treat foreign services suppliers fairly and objectively in all relevant areas of domestic regulation extend the reach of the Agreement into areas never before recognized as trade policy.” Good intro to/overview of GATS-

Maine CTPC Health Care Subcommittee Draft Report on GATS barriers to state health care reforms

US states thought they could just implement a statewide single payer system, many seem to still think that. But they were wrong. This report to the state of Maine shows what they found out! This report was prepared for the state of Maine by trade experts from Georgetown University. It shows some of the hidden traps faced by states that attempt to make it possible for the working poor to afford health care. The Health Care Subcommittee of the Maine Citizens Trade Policy Commission asked the Forum on Democracy & Trade to look at Maine’s health insurance programs in relation to U.S. commitments under international trade agreements, and specifically to identify potential conflicts or issues regarding Maine’s Dirigo Health Program with provisions of the WTO General Agreement on Trade in Services (GATS). Here we focus specifically on Dirigo and GATS in order to enable the Maine CTPC to: Understand potential trade conflicts serious enough to bring to the attention of U.S. trade negotiators and the Congress Raise questions about the meaning of vague GATS provisions on coverage and trade rules that could improve the quality of state-federal consultation on trade policy Identify potential safeguards for Dirigo and similar state-level health programs.

WTO - legal texts - Understanding on Commitments in Financial Services

"As of 2009, the 33 countries whose current schedules reference the Understanding include: Australia, Austria, Bulgaria, Canada, Czech Republic, Finland, Hungary, Iceland, Japan, Liechtenstein, New Zealand, Norway, Slovak Republic, Sweden, Switzerland, and the United States, as well as the European Communities members as of 1994 (Belgium, Denmark, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain and the United Kingdom.) The only developing nations that utilized the Understanding were Aruba, Netherland Antilles, Nigeria, Sri Lanka (for banking not insurance), and Turkey. Additionally, eight countries (Cyprus, Estonia, Latvia, Lithuania, Malta, Poland, Romania, and Slovenia) were in the process of revising their commitments to match the EC schedule" (from the commentary by Jane Kelsey on TISA Financial Services text) -- This document regulates government regulation of financial services like banking and insurance, including health insurance, greatly limiting what we can do. In particular it is thought to freeze new financial services regulations after its signing date, unless they were enumerated then. In the case of the US that date is February 26, 1998. If challenged in a WTO dispute proceeding a country that has violated a "standstill" may have to roll back its regulatory state to the level of regulation in effect on that date. A related concept, "ratchet" is also said to apply in WTO law - it denotes a one way capture of all deregulation in a committed sector making it a violation to re-regulate. See the definitions of "standstill", "rollback" and "ratchet" in trade parlance.

Interpretation of Article I, Section 3 (b) and (c) of GATS - PublicServicesScope

This article by Markus Krajewski discusses GATS' important "governmental authority exception" which defines the scope of GATS jurisdiction. (and what can be seen as a "public service" under GATS, the definition is very narrow- everything else is subject to all sorts of rules which privatize them and bar government subsidization except if its 'minimally trade restrictive') - by Markus Krajewski

State Health Reform Flatlines

US states and the Federal government have tried the same things over and over again, and have repeatedly failed to make for-profit health insurance - especially nongroup insurance, affordable as more and more Americans fell theough the cracks. This paper details the history up to the mid 2000s. It shows how despite knowledge in high places that the strategies being used don't work, they continue to be recycled. (This is because the GATS and recent, even more ideologically extreme rules give them no choices that would work, and the ideology is a higher priority than people's lives.) Meanwhile 50-120 Americans die each day due to preventable factors amenable to improved healthcare or improved access to healthcare.

GATS and Women

"GATS is likely to have a disproportionately negative impact on women"

Model clauses for the exclusion of public services from trade and investment agreements ( EPSU & Markus Krajewski)

This paper discusses how trade agreements could be modified in the EU to protect their existing public services from trade and investment agreements which are designed to tear them apart and privatize public services against the people's will, behind their backs. _______ Unfortunately the EU examples given are much less applicable to the US because we are trying to do something which we ourselves devoted a great deal of energy into preventing by creating the WTO, other economic governance organizations and making all these conditions binding on ourselves especially, which seem generally to only allow the poorest (LDC) countries to set up new public services and monopolies. Also look up "LDC Services Waiver" for a related issue involving the jobs.

Ellen Gould discusses GATS on Talking Stick TV.

Video - Ellen Gould is a trade expert whose insight here is quite accurate. See what she tells us here about domestic regulations, technical standrds, licensing, medical standards, everything. Lots of info on what they want to do with healthcare. The WTO could sanction us if we wanted our doctors to meet higher standards than those in the developing countries. (around 25:00) The WTO also wants us to allow for profit offshoring of poor patients. Which would be subject to the same problems as the for profit system does now, except likely worse, with less accountability.

GATS and Financial Services Deregulation by Patricia Arnold

Medicare, Social Security and other governmentally subsidized financial services are put in grave danger by the GATS - This paper by a noted professor in accounting who has written a great deal of highly readable material on the WTO and its interaction with financial regulation is a short and concise intro to many of the major issues, particularly the threats GATS poses to Social Security and Medicare if those areas are allowed to compete with commercial banks or insurers. Caution is needed because millions could see huge changes in their only retirement benefits just as they were needed the most if Social Security and/or Medicare lose their protection from GATS rules, which is likely if current proposals are implemented,- see the Annex on Financial Services.

GATS and Public Service Systems

This is a must-read article as its by far the most concise and understandable explanation of the "governmental authority exception" an all important "two-pronged test" or definition, that defines the scope of what is allowed to be a public service and what is not, in the GATS agreement. In other words, what is subject to privatization rules, and what isn't. This definition is also borrowed or imported, in the computer programming sense, "as is" into hundreds of other trade agreements all around the globe. So this essay is extremely useful in understanding which healthcare or higher education proposals could work (and which ones would be subjected to a death of a thousand cuts, and couldn't) for example. The essay was originally written and published by the government of British Columbia province in Canada.

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"

Trading Health Care Away? GATS, Public Services and Privatisation

"But talks have since begun to change one of the 28 agreements overseen by the WTO -- the General Agreement on Trade in Services or GATS. The US, EU, Japan and Canada are trying to revise GATS so that it could be used to overturn almost any legislation governing services from national to local level. And non-government organisations (NGOs) and trade unions are demanding that services in the public interest be clearly exempt from GATS. It details how public services may not in fact be excluded from GATS and explores the implications for public health care."

Patient Mobility Beyond Calais: Health Services Under WTO Law by Markus Krajewski

"The paper analyses the impact of WTO law on transnational patient mobility by transplanting the Watts case of the European Court of Justice into WTO law. The first part of the paper concerns the question whether medical or hospital treatment abroad concerns “trade in (health) services” in the meaning of the GATS. This part identifies the legal construction of this notion through the four modes of supply and also gives a short factual account of the scope and structure of trade in health services on a global level. The next part will ask more directly which measures fall into the scope of the GATS. In particular, it has to be determined whether the exclusion of services supplied in the exercise of governmental authority from the GATS influences the application of the agreement to health and medical services. Having determined under which circumstances the GATS applies to measures affecting the cross-border supply of health services, the subsequent part of the chapter discusses the substantive obligations of the GATS. After a short overview of the main principles of the GATS, the chapter will provide an in depth inquiry into the specific commitments in health services of the EU and other WTO Members, because only the exact analysis of the limitations and qualifications of these schedules allows us to clearly determine the impact of the GATS on the cross-border to provision of health services. In addition, the potential of the general exception clause of the GATS to justify regulations of health systems which violate GATS obligations needs to be ascertained. Lastly, the legal status of GATS in the EU legal order, in particular the contentious issue of direct effect, needs to be assessed, because only if the GATS is directly applicable would a patient who received medical treatment abroad be able to rely on the agreement to claim reimbursement of the costs of said treatment."

Putting Health First - Canadian Centre for Policy Alternatives

Canadian Health Care Reform, Trade Treaties and Foreign Policy - this essay describes the traps in the GATS agreement for Canadian health care, and it also would totally apply to a hypothetical US healthcare plan if it had prexisted the creation of the WTO. it also discusses 'carve outs' and why they are needed by Canada to protect their Medicare (public health care) from Trade Agreements put forward by countries like the US that try to destroy, and privatize them. Note: the situation of the Canadian system is different than the UK's as Canadian Healthcare is exempt from GATS, and the UK's public option the NHS like US's optional short term public experiments like the ACA are subject to the GATS privatization agreements progressive liberalization ratchet, etc. requirements. Unfortunately.

Public Citizen: Medicare and Social Security - SOS: Save our Services from the WTO

Bottom Line: If the Bush administration succeeds in even partially privatizing Social Security, under the WTO GATS agreement foreign corporations could end up with treaty rights to raid our tax dollars for profit and Americans could face shredded retirement and Medicare safety nets. For now, Social Security is probably safe from the GATS because the agreement exempts services that are exclusively a government monopoly and are not also offered on a commercial basis. But if Social Security is even partially privatized — as the Bush administration is advocating — and folks begin to invest some of their federal retirement funds in the stock market, then GATS would require some things that the privatizers don’t want to talk about. The agreements would: * permit foreign and offshore firms to compete for private Social Security accounts, thus preventing the most stringent regulation of these accounts and increasing the risks to retirees; * make it harder to fix Social Security after the privatization experiment predictably fails, because GATS requires that nations first compensate all of their trading partners for lost future economic opportunity if they “take back” the service from the private sector and make it public again. * Failure to compensate would result in punitive trade sanctions, which is why some say GATS makes privatization a one-way street.

Public Citizen: Comments on International Services Agreement ("TISA")

TISA is the US and Australia's proposed "mext generation" trade agreement to promote global outsourcing and offshoring of services. Its "everything in by default" approach makes it much more likely to be dangerous and its effects unpredictable. It would block Medicare for All and limit public services to only those which met very narrow exceptions or were essential to national security. It would create a lot of dishonesty in government because what politician would honestly say that a trade agreement tied their hands from delivering positive change, only allowing corporations to take more and more?

Public Citizen: Health Care Memo

"...However, many of today’s international trade agreements establish binding obligations constraining federal, state and local government policy and actions in numerous service sectors, including health services. These rules are not limited to trade in services across borders, but also constrain government regulation of foreign service sector firms operating within the United States. As a result, today’s “trade” pacts are delving deeply into domestic regulatory issues that have little or nothing to do with the traditional concept of trade between nations".

Public Citizen: "Presidential Candidates' Key Proposals on Healthcare and Climate Will Require WTO Modifications"(2008)

This essay's by Public citizen explains how the 2008 Presidential candidates proposals (just as today) all violated provisions of the GATS agreement and US 'commitments' and other trade rules and how those commitments were likely to conflict with the promises, making them impossible or very difficult to implement the longer we waited. The references are extremely useful. Highly recommended you read this if you are interested in healthcare in the US.

Public Citizen: Threats to Health Care Policy

"The WTO’s GATS delves into “areas never before recognized as trade policy"... "The GATS represents a 180-degree turn from the U.S. approach to health care policy − away from regulating industries for the benefit of the consumer, and towards regulating governments for the benefit of multinational firms and industries".

The recent Achmea case has received a lot of news coverage in Europe but almost none of it actually explains what the case was about. This PDF..

contains a factual summary (on page 13) which explains that the case was about the electoral victory in Slovakia of a candidate who ran on a platform of restoring single payer health care in the country, as well as limiting the profits of any health insurer, in the intirim period to 20% changes which which were immediately attacked in the first of two Investor vs. State arbitral lawsuits. Slovakia lost the first round. This case is also a good introduction to the sordid history of the IntraEUBITS.

Joint Declaration on the GATS agreement and Higher Education

Public higher education is under attack, globally. This attack begun in an WTO agreement called the General Agreement on Trade in Services, or 'GATS'. This is a statement on the GATS by the organizations that accredit literally thousands of universities in the US, Canada, and the EU, including the European University Association on whose web site it is hosted.

Services Trade and the Uruguay Round: An Issue Overview (December 5, 1995 CRS 95-1169)

"The General Agreement on Trade in Services (GATS), which went into effect on January 1, 1995, is a significant achievement, but only a first step on the road to liberalization of services barriers. For the first time, legally enforceable multilateral rules and principles for services trade are part of the international trading system. At the same time, the immediate elimination or reduction of barriers to services transactions was much less than desired by many. The GATS, however, includes provisions for future negotiations to liberalize trade. The Congress will have an important consultation role in these negotiations. If agreements are achieved, legislation may be necessary to implement them."

The Potential Impact of the World Trade Organization's General Agreement on Trade in Services on Health System Reform and Regulation in the United States. (2009)

This paper is perhaps one of the best introductions to the GATS and healthcare issue for Americans on this site. In this 2009 paper, the late Nicholas Skala, explains the "GATS" agreement, and its implications for US healthcare reform and why we urgently need to apply for and pursue a specific procedure (Article XXI) to withdraw from the GATS in order to avoid built in traps for the unwary, for example, to get sustainable public health care. If you only read a few papers on GATS on this site, make sure this is one and also read the materials on GATS Article I:3 and 'governmental authority exclusion" keyword. Also see "explainer" tagged items.

Lori Wallach discusses 'standstill' in this short video on Democracy Now

Note: THIS ALSO APPLIES TO TODAY'S US HEALTH INSURANCE, because it is a financial service, and Please also read the glossary entry for "negative list" because the two are functionallly the same, a freeze on any new regulation. So blocking any new public services and locking in any and all privatization, etc, of existing ones. TISA will do that and its standstill dates will go back to tthe 1990s, so its ceiling will likely leave new regulations like the ACA, out. The status quo for health insurance in 1998 was very bad.