There is a lot of speculation about what Trump will do in health care, but his path is already fairly clear if one looks at the US's long stated policies on trade in health care services. It will be called deregulation, but it actually will involve the most Byzantine and non-intuitive new regulations imaginable, which will be totally out of our hands! Changing so much so fast will mean disaster for most Americans finances.
What will be the coming administration's healthcare policy- We already know!
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It's already clear. Whatever they come up with it will have
to lead to - "progressive liberalization" which means ever increasing
privatization - and then globalization. It must involve more liberalization,
never less (liberalization means global privatization) It will be called
deregulation, but it actually will involve the most Byzantine and non-intuitive
regulations imaginable, which will be totally out of our hands to change! (Even
though it's likely to be a disaster for most Americans finances, it will be
great for the biggest corporations.)
This was signaled clearly to an international audience by Donald Trump when he said that his plan would be "selling across state lines" that is a code word because it means foreign health insurers will come in as quickly as possible rapidly killing any chance of single payer forever, (policy is taken out of the realm of the changeable) as foreign corporations gain a perpetual entitlement to market access.
There is a good description of this case in this paper by Nicholas Skala .:
Health insurance is a covered service under GATS, and explicitly included, however up until now no foreign insurers have entered our market because of the complexities of selling 50 policies in 50 states, with different legal standards of care.
Once "one policy is sold across state lines" foreign trade begins and is locked in, killing single payer forever.
Another discussion of these triggers from the State of
The main goals of the (WTO) "GATS" are making
business more profitable by lowering costs, such as wages, and encouraging
international trade, especially when it acts as a sort of New Deal to
assist the economic development of the developing world.
Therefore, state owned monopolies in developed countries - as well as developing ones, have to be broken up and rendered profitable so they make attractive prospects for privatization and globalization. Irreversibly. This is the United States' goal, especially. Everybody knows this, except for us Americans. And it's very controversial, because other countries cannot afford to give up their public services, especially if they get nothing in return. So, there is an implicit promise of market access. (If they can be the low bidders.)
It's a huge shift of power away from democratic institutions that becomes irreversible, because of its international trade aspect, shifting wealth away from the workforce, especially the public sector, to global services firms, overwhelmingly large multinational corporations, it's a change that strongly favors large multinational corporations. Some of that wealth will also go to large staffing firms based in developing countries. The losses of the allegedly overpaid workers in the developing world will be divided between the owners of the multinational corporations and their employees who are expected to be largely from low wage developing countries. Since the changes will increase profitability in areas like health care they will be framed as gains. They won't lower costs, they will increase profits. That's the goal.