Oh what a tangled web we weave. On healthcare and insurance and the 'Affordable Care Act' and the GATS agreement.

Ten years ago, the Obama Administration's "Affordable Care Act" as proposed and enacted likely breached the US's own Understanding on Commitments in Financial Services which required a "standstill" of financial services regulation, freezing new regulation as of its signing date, February 26, 1998.

This means that under binding WTO rules, it now likely has reached the end of its time limit, if that limit is ten years, as I suspect.

Bluntly, I don't know exactly how the US managed the Affordable Care Act as far as WTO financial services regulation,

Watch this Democracy Now segment with Lori Wallach, a trade expert and head of Public Citizen's Global Trade Watch about standstill in TISA, to see the problem.

This standstill also applies to health insurance, freezing our regulation at the level in february 1998. Nick Skala's 2009 paper explains the issue well.

The US position is very rigid and it involves an add on to the GATS which few countries (just 30, including us) signed up for, the Understanding on Commitments in Financial Services.

But the important thing to know is that the Affordable Care Act violated our own rigid ideology so much that it seems to me that could not possibly have been permanent under our own "top down" or "negative list" addition to the GATS (Generally GATS -and other WTO agreements use a positive list or opt-in in Internet lingo, while the US's "next generation" trade agreements use negative list which has the effect of a rigid freeze on all service sectors unless they opt out in advance.  uses "positive listing" or bottom-up In other words countries opt in the service sectors.  The Obama-Biden's administration's own trade agreements all used negative listing.


It can be seen especially that Biden's plan to "expand Medicare" will lead straight Medicare losing its exception from GATS. 

This can actually be seen directly from the Annex on Financial Services first paragraph, although it requires a good understanding of the meaning of its terms - such as the difference between being considered "services" under the definition of scope of the GATS, or not- to understand.

Being 'services' means not being 'services supplied in the exercise of governmental authority. In other words subject to GATS rules which tear a service up bit by bit.

If a service is a service as defined by the GATS it cant be sustained by subsidies long term,

This is a huge subject that requires a much more complete description.

What is a Service Supplied in the.pngreferendum

it must be minimally trade restrictive and limited to only the most limited government measures possible.  It means means tested and likely subjected to being treated like a welfare benefit for the poor only. Eventually.

Although this point may take a few years to arrive it. In short if Medicare is no longer a service provided in the exercise of governmental authority, and is just "services" as defined in the GATS, meaning included in its scope, , we lose it's sustainability,  irreversibly, and this comes at a time when massive numbers of jobs are likely to be lost, soon, both from outsourcing/offshoring and automation..

Not being "services" in this context means exempt. See our pages

This is a very sticky issue because Americans have been convinced quite effectively that GATS does not exist, and that its simply up to us and our votes.

This is completely untrue as we gave the WTO authority over a long list of services, including financial services including health insurance, in the mid 1990s.

So the entire country has been lied to really shamelessly about something that's very important to all of us.

We need to call foul, somehow, but how to do that without encouraging Trump. Obviously they are working in cahoots to steal the country's future.

WTO Annex on Financial Services, first paragraph shows a huge trap for the unwary

At around the same time as the last provisions of the "Affordable Care Act" were being implemented, the GFIA issued their position paper on TISA.

their paper shows what the position of global insurance industry lobby is, probably the most influential lobby on this issue. The insurance industry's positions.  Bluntly, they hate covering people who in their eyes are not risks, they are knowns. As in already sick.

And the US promised to lock in the insurance status quo as it existed in 1998.

lets return to the explanation of how TISA's standstill dates refer back to GATS in the 1990s, from Lori Wallach,  And the fact that Biden is likely to revive TISA.

Both the paper and Wallach's explanation show graphically the problem people with health conditions will still face from "standstill" clauses under the for profit health insurance systems around the world, systems which the US is pressuring other countries to permanently lock in via trade and investment agreements that become nearly impossibly costly to reverse. Especially in the US and countries that trade with us and under pressure, adopt this really regressive system that should have been dumped many decades ago. Politicians are lying, they obviously have no intention of fixing this. None of them can, individually, unless our country leaves or modifies our GATS commitments FIRST.

People should remember that in 1998 Rescission of non group insurance plans was still a huge problem. Retroactive cancellations of policies. ("Post claim underwriting" is another term for it. Search on YouTube on that term for videos of Congressional hearings. Also see the series of articles by Lisa Girion in the LA Times on the issue.))

A great many Americans (At least 1 million) have died in the US before their time under the 26 years of for profit insurance system since the signing of GATS in 1994) which most Americans still believe has been gridlocked in place simply by two inept parties inability to agree. But there is a dark side to this story, the dysfunctional healthcare system has actually been locked in place by trade agreements, especially the GATS, the WTO agreement that TISA is supposed to extend.

Will Biden revive TISA? The answer to that question is obvious looking at the coercive way he's been nominated, its almost certainly yes. Trump is likely to too. That is unless there can be some binding legal way to let the people decide on these deals. A national referendum.

 The US Democratic Party would like Americans to see them as responsible for bringing an end to the brutal pre ACA status quo but the evidence actually shows that for the last approximately 26-30 years the US, during both Democratic and Republican Administrations trade negotiators have been working behind the scenes to push to permanently lock in by trickery,  the for profit model, despite a wealth of evidence that it fails to adequately address the health needs of any of the targeted populations adequately.

Nobody, least of all any of the politicians are telling the truth, and lots of people are dying because of this.

There need to be major prosecutions because of this. Like the ones at Nuremberg.

GFIA Position paper on TISA.

We need out of this trap, but how? We need a moratorium on all legislation until the country has a referendum on these trade deals.

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