New York Times appears to be trying to cover up GATS' effect on healthcare
Despite a desperate need, the GATS forbids government subsidies, except the most minimal ones possible, in emergencies,, as far as I can tell. We've been lied to for decades about this. . The NYT should be more honest about GATS.
What is also particularly irksome is Congress constant attempts to look as if there was no GATS in the way.; Human experimentation is a crime, without informed consent.Maybe one million poor Americans have died during the 26 yrs US healthcare has been rigged.
In any case the situation is highly deceptive. This is typical of the US media and politics. Here is the article.
The insurance companies do this in order so people will pay for but never get to actually use the insurance they pay for, instead that money goes to subsidize the prices of rich customers.
This is a form of genocide of the poor. Hospitals are closing right and left in rural areas, as the nation dis-invests and discards large segments of society, so air ambulances are a necessary cost.
A $52,112 Air Ambulance Ride: Coronavirus Patients Battle Surprise Bills
Congress was close to a solution before getting hit with millions of dollars of ads from private-equity firms.
Then the pandemic struck.
They were hardly close to any solution. Its barred by a trade agreement.
(FYI: GATS struck on December 8, 1994 when President Bill Clinton signed the URAA. Like it or not, this is fact. And it severely limited what the US can do in healthcare. Instead the solution is supposed to be more globalization.)
- 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.
- 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
- 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.
- 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.
- 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.
- 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.
- 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."
- The Wrong Model: GATS, Trade Liberalisation and Children’s Right to Health (by John Hilary for Save the Children.org) This is very good.
- 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.
- 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 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.
- 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-
- 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".
- 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."
- 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
- 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".
- 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.
- 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.
- Health and Social Services: Background Note by the Secretariat, S/C/W/50, 18 September 1998 (WTO Council for Trade in Services) This is a very important MS Word document from the WTO Council on Trade in Services. Essential reading for anybody in the UK or US, because it explains very concisely the problems GATS causes for a UK style NHS - (NHS is a public option, not a single payer system) And its being privatized incrementally. This is a problem created by GATS - its based on the fact that the UK has a public health system, *but still sells health insurance*. Similarly, US cannot have a sustainable public program because it sells health insurance. See P11 in this file and our Glossary's entry on "governmental authority exclusion" - This is important to understand well.
- FEDERALISM_and_WTO_re_US-HEALTH_INSURANCE_AmericanBarAssn_lswc_Ethan_Marks This paper won an ABA award and it contains a large number of properly formatted legal citations which are useful for anybody who wants to prove to lawmakers or journalists that indeed, this issue is fact and the mainstream con-artists who claim it isn't are unfortunately, the disinformation.
- GATS Article XXI (21) Jurisprudence/notes from WTO
- edmmisc232add31_en.pdf