The real cause of Bernie Sanders' problems with the DNC (and America's healthcare mess!)

Basically, 2/3 of Bernie's much-needed platform, as well as the self-stated agendas of (all?) other politicians, to a large extent are potentially blocked by trade agreements that (the leaderships of both) US parties have been cooperating in hiding! They represent a huge betrayal of the American people by both parties. And the reasons for this are complicated and urgently need the nation's attention, or else the policy trap could become so costly to reverse it could become permanent, at a cost of as much as 41% or more of the nations jobs according to a Harvard study. (the agreements also potentially trade away service jobs, basically the 80% of the economy that isn't manufacturing.)

The biggest problem? Trade agreements block most of the individual pieces that would go into Medicare For All, unless the entire service sector becomes noncommercial. So really, only full single payer has a chance of surviving the WTO rules which otherwise have been shown to tear mixed systems apart. In the US the risk will be aggravated by selling policies across state lines.

Then international companies will become involved and then it will immediately become so expensive to change it will become impossibly costly. And job losses expected in the coming years will aggravate the affordability problem, already by far the worst in the world. The only healthcare solutions affordable to millions of Americans may soon be offshore. And indeed, it seems as if that is where this artificially created and unnecessary 'crisis' may be intended to lead us, as we allegedly seem to have already promised to globalize our healthcare in the GATS trade agreement, 20 years ago. A pending agreement, TISA seems to make the situation far worse.

(Update: See this 2014 KMOV story which likely has GATS implications)

Unless Americans act soon to withdraw the impacted service sectors from that coverage in trade agreements, they potentially block almost all of the progressive agenda especially many Democratic candidates "mixed system" healthcare proposals which will run into inherent limitations of the GATS agreement which must be fixed.

And this blockage seems intended to lock in, to become permanent. By ignoring the need for carve outs, we're stumbling blindly into a trap.

FTAs like GATS and the pending TISA, its progeny, TTIP, GPA, etc, also could endanger existing benefit programs. Or eventually require that poorer patients (because of the principle of proportionality) be offshored for some procedures. (medical tourism) Or long term care. 

In short we may be walking into a trap - the system is likely rigged by both parties who are likely colluding to hide it. Nothing else, I have concluded, explains this.

This capture is occurring all around the world, not just in the US. For example, similar issues are occurring in the UK.

The policy clashes that endanger progressive agenda caused by GATS have been written about enough in other contexts (academic literature about trade, healthcare, higher education and financial services, but very little about insurance, unfortunately) outside of the US-that the inherent conflicts are quite easy to show.

Around a decde ago, a bunch of papers were published in the UK, followed by actions consistent with their agenda and requirements. Here is a good example, a paper by Allyson Pollock and several others in the Lancet. It explains that under current WTO rules, it public services exemption is so narrow it would not include the UK's NHS.

That would expose the NHS to a huge number of problems quite similar to the ones that all attempts at subsidized measures to help the destitute or otherwise unable to purchse health care, we are similarly afflicted by.. Measures by governments (whenever tax money is involved) unless a sector is exempted by being toptally free from the beginning, must be intentionally limited to the absolute minimum possible.

Also the privatization means the cost of funding increases tremendously because of "highly mobile global capitals" demands for huge profits - or they take their money elsewhere. That demand destroys public health care. 

The same is of course, clearly happening in the US. the poster child of medical injustice.

However, only a very few papers have been published in the US, . One paper's (In Health Affairs) authors seemed particularly well connected, and has the smell of a 'cover your ass' kind of document - but it did explain the problems-


Another's, Nicholas Skala, who was a single payer activist and 3rd year law student- suddenly died. The chart above-from his paper, ("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")

gives an idea of just some of the potential gotchas.:

A little bit over a month before his death, he told the US House the following: The only healthcare proposal that has a chance to be sustainable is a full single payer system.

He was right.
And we must carve out policy space first to get it. That may cause a real commotion in the WTO, because of the issues' history.

--------------The following is cited from the essay-------
--------------"GATS and Public Service Systems"-----

GATS coverage is very broad The scope of the GATS is very broad. In principle, it covers any measure, taken by any government, at any level, which affects the supply of a service (1).

"The GATS contains no broad exclusion for public services, for public service systems or their regulation, or for non-profit service providers or delivery. Except for Article I:3, the agreement contains no exclusion for public services, for public service delivery, or to protect governmental regulatory authority associated with public service systems (2). It also treats public and private service providers and delivery as "like" (3). Similarly, the GATS treats private non-profit and private for-profit service providers and delivery identically (4)"

"The GATS preamble provides little substantive protection The preamble provides little substantial protection for governments' regulatory authority. In the preamble, Members have noted their recognition of "the right of Members to regulate, and to introduce new regulations, on the supply of services within their territories in order to meet national policy objectives..." However, this general, preambular language is non-binding and subordinate to the more specific, binding obligations that are contained in the text of the
agreement itself."

GATS general exclusions are few and, except in one instance, limited There are few general exceptions or exclusions to the agreement's broad coverage. Among these are:

an exemption to protect "essential security interests" (Article XIVbis), which, uniquely, is self-defining and very broad,

other exceptions, each of which are subject to strict limitations. These include, for example, exemptions to "maintain public order"

and to "protect human, animal or plant life or health" (Article XIV),


an exclusion for services that are supplied "in the exercise of governmental authority" (Article I:3).

The last of these -- the critical "governmental authority" exclusion -- is the subject of this

The GATS "governmental authority" exclusion

Article I:3 of the agreement states:

"For the purposes of this Agreement...

(b) 'services' includes any service in any sector except services supplied in the exercise of governmental authority;

(c) 'a service supplied in the exercise of governmental authority' means any service which is supplied neither on a commercial basis, nor in competition with one or more service suppliers." 

The "governmental authority" exclusion is very narrow

This exclusion is far narrower than it may at first appear.

Firstly, in order for a service to be excluded, both criteria must apply.

That is, in order for the exclusion to apply, a service must be supplied on a non-commercial basis and its delivery must not be in competition with another service supplier.

Thus, the exclusion does not apply to services that are supplied on a non-commercial basis but which are supplied in competition with another service provider. Similarly, the exclusion does not apply to services that are supplied on a commercial basis even where these services are supplied in the absence of competition with any other service supplier.

Hence, only a small sub-set of services -- those that are provided by completely non-commercial, absolute monopolies -- appear to be protected by this exclusion. Secondly, the exclusion is narrow by virtue of the ordinary definition of its terms.

The agreement does not define the phrases "on a commercial basis" and "in competition with one or more service suppliers". However, the ordinary definitions of these terms are broad, making the set of services that they describe very large, and the set of services that falls outside them -- and hence outside the scope of the agreement -- quite small.

-----------------------------end quote------------------

A win by Bernie Sanders, if he actually implements proposed single payer ( Otherwise - as soon as we allow tiers, meaning, if we allow commercial health insurance to continue, then we must make the public offering deliberately bad, because of the principles of proportionality, and minimal trade restrictiveness whenever subsidies are involved. )

To avoid what is called "crowd out" a new term which emerged after GATS. Basically it means that the public measure must be tailored to only be purchaseable as a last resort.

What is a "measure"? - Every law, basically. (source UNCTAD) see below.


That means that most everything people want - and politicians promise, is forbidden.

Except possibly a single unitary healthcare system for everybody with no other healthcare available. No fees, and no tiers. for everybody. No concierge medicine for the rich. That way the rich will keep it good. They will need it to be good as much as everybody else does. That is the only way.

(Assuming we could successfully complete the potentially quite expensive GATS Article XXI procedure)

Otherwise, everything will break right away. That is what it is designed, almost sadistically, to do. Tiers are the trap that kills it.

GATS would have us offshore some patients and import doctors ) would likely result in challenges in the existing or pending/proposed trade bodies, and losses in those forums could expose the US to sanctions.

GATS and the new revised GPA also attempt to privatize and trade away public jobs, if foreign firms bid for  them successfully.

It seems they really want to take advantage of a huge pool of desperate highly skilled young people with degrees in some countries with authoritarian regimes where people cannot advance unless they are BOTH rich AND have connections.

We should not prop up other countries patronage systems with our peoples jobs.

At the expense of our own families futures.

Numerous trade deal plans being advanced by what has occasionally been called the "Washington Consensus" would also be particularly hard on women and minorities, traditional Democratic strongholds, because they offshore or outsource a great many jobs and subsume all domestic regulation, in the interests of a discredited neoliberal global public services-destroying, wage lowering trade in services agenda.

Similarly, the neoliberal privatizations being advanced as sort of Trojan Horses by both parties in the guise of reforms, seem certain to lead to privatization of Social Security and Medicare because of the Annex on Financial Services.

While being unable to actually improve the lot of Americans growing poor because all their halfway measures - ones that compete with corporations, must be minimally trade restrictive. That requirement also applies to many other services too, higher education, banking, environmental services. So, its likely a number of current proposals are actually blocked by trade deals. Do those advancing them as their platforms know this? They may not. 

(The US dominated OECD has even set up a Services Trade Restrictiveness Index to guide countries in what is permitted to them.)

Additionally, the US also agreed to in essence freeze all nonconforming measures in 1998, and also to eliminate the existing ones or reduce them in scope.

Unless they qualified for the very narrow exemption by being totally noncommercial, lacking any competition, and free. Some other exemptions exist but even if they apply, some other qualifications mean they are unlikely to be as helpful as people might hope. They would be unlikely to apply. As you can read in my links.

Here is one "standstill" as it is called (image below). Link to document at WTO.

Discussion of standstill on Democracy Now.
Note there is also a new trade agreement in the works, TISA intended to dovetail with the GATS

Subsequent changes, like Obamacare, and Dodd-Frank, because of this clause, were likely doomed from the start. And may be rolled back.

That would be the rational assumption. No matter what is promised. Thats likely just for the TV cameras. 

This is a serious problem. 

Proceeding as we are in ignorance of the main problems, presented by legally binding trade agreements provisions seems almost guaranteed to lead to disaster. 

(See this document from the state of Maine, this paper in the International Journal of Health Services, and  this article from Health Affairs. And many other explorations of the issues that we are trying to introduce you to.

But, the media refuses to discuss it. And so do politicians.

And social media, they seem to be censoring this issue too. Even though understanding it is important to solving our world's biggest problems honestly. 

It seems legislators all around the world want to preserve plausible deniability.

That's a very bad sign. They need to be informed, whether they want to be or not.

They should be served legally with these facts.

Ignorance causes big problems.

Which is shown by this document: Link to original PDF.

Showing thats its quite possible GATS was responsible for the financial crash in 2008

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