It appears that WTO rules directly conflict with expansion of any public services not carved out from their rules in writing, especially single payer healthcare, raising questions as to whether there is a cover up going on by politicians and the insurance and drug industries, creating a false impression that the changes taking place are reversible by voting. Soon they wont be.

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It appears that WTO rules directly conflict with expansion of any public services not carved out from their rules inwriting, especially state and national political campaigns for single payer healthcare, raising questions as to whether there is a cover up going on of the ability of WTO rules to block policy by politicians and the insurance and drug industries, creating a false impression that the changes taking place are reversible in normal manner, through elections, they are not. Trade deals go to great lengths to make changes, such as opening a service sector to international trade, irreversible. Which would effectively block single payer. the danger of this happening soon is substantial. In fact it really should be stated that officially, our entry into NAFTA and especially the WTO, was a committment to never create new public services again. The country was never told this. The WTO rule most important to understand and easiest to overlook in its importance is WTO GATS Article I:3(b) and(c), which explains what constitutes a "service supplied in the exercise of governmental authority", which represents one of the only exclusions available from GATS liberalisation rules.

The WTO General Agreement on Trade in Services "GATS" is a trade agreement on services, which became effective on January 1, 1995, and its coverage is extremely broad. Few people realize this but on the advice of a great many experts, it would seem to bar most of what appears to be needed in order to make healthcare insurance (and other services such as higher education, water and many others) affordable in the current and coming years. Additionally, there is a strong likelihood that the gridlock on healthcare over the last 20 years was caused by GATS and that its hiding is intentional.

If so this would have caused the death of around a million poorer Americans to date, (killed by inability to access any affordable healthcare and therefore deterred from seeking needed care by cost until it was too late) This crime of exclusion would repesent a crime against humanity with no statute of limitations.

Additionally, the nation's lack of awareness, perpetuated by an increasingly "captured" media. (see defs of "captured state", "state capture", and "control fraud") may be leading us into a lock in- a trap- an essentially unfixable situation.

The goal would be preventing the creation of any workable fix for healthcare, prolonging a murderous, but extremely profitable situation until world trade constraints, part of an increasingly recognized to be illegitimate trading system, were silently triggered.

The effect of this system could lead to the options available for the majority of Americans outside of employer provided healthcare to gravitate towards "solutions" that either were delivered offshore or which involved the large scale replacement of much of the US workforce with foreign firms who would also gain a right to use their employees, bypassing the better known pathways for work permissions, by means of "movement of natural persons" provisions in trade deals such as the "Fourth Mode of Supply" in GATS (GATS Mode Four) and similar provisions in pending deals such as the one now pending in Geneva on services (parts are available to read via leaks)

Its possible that organized efforts to force poorer Americans who had a family member with a chronic illness to leave the country to get medical care could be illegal under some international treaties. The choices between allowing a huge change that undermined wages and working conditions for skilled professions and either leaving or giving up needed healthcare has the smell of an organized campaign which is particularly troublesome.

Forcing Americans to go overseas for care or accept seriously attenuated healthcare comparable with that in much poorer nations here, (after all, its an emergency) is an example of the problems posed by endorsing systems which have been shown repeatedly to be failures. (Such as the hideously broken US model for almost totally unregulated for-profit insurance system and the market spiral drug pricing system.)

The planning of a system to open up trade in services, pushing wages in the US and other developed countries down to world average levels has been a core "feature" of the GATS since its inception. This fact is important and its been totally kept out of the media (as has anything about GATS really)

Some countries - India is notable in this respect, claim that their #1 goal in participating in the WTO is increasing their service exports. Not just as parts of standalone companies but also in a pure staffing capacity which is repugnant to many Americans because its goal is simply to replace US workers with much cheaper foreign replacements without any rationale other than avoiding prevailing wages in what are clearly professions which require substantial skill and cost to enter. (A good example is nursing and medicine)

There is no denying that the US has a healthcare affordability problem but that is caused mostly by the huge waste caused by the health insurance layer which adds so much complexity, and extra accunting costs, as well as increases the eventual cost of health care by preventing people from accessing doctors until they are literally forced to.)

It also possible that the desire on the part of the US pharma industry to lower the availability of inexpensive generic drugs intenationally has led to some kind of deal having been struck recently with India to trade jobs for market access as a domestic provider (National Treatment) a shift that would allow US pharma companies to buy out their competitors, a change that would likely lead to big increases in the prices of generic drugs a change the poor people of the world cannot afford.

GATS also seems to frame subsidies, such as Obamacare subsidies as a market failure and limit their use. It may even bar the long-term provision of subsidies as we know them today, instead forcing shifts to globalization of services. (It's quite likely that international trade will be leveraged in some manner to bring this about, a change which would not necessarily bring anything like decent quality services at low cost for the poor, because making such services attractive would likely be barred, if they caused crowd out of commercial offerings. Its likely that if they did continue, they would have to be greatly limited in scope, perhaps only available to people after they had been destituted and could no longer pay even a tiny amount.

Were the situation more like that in countries where public healthcare pre-existing to GATS (most developed nations) or delivered for free, there would be no such cripling of the public system. However, here, because of the particularly twisted way these rules work, the government entity, for example, a US state, might be subjected to successful suits in a WTO dispute resolution tribunal by foreign firms to stop it! (This bears mulling around in your mind for a moment, please think about that a foreign, non-accountable panel could determine our policy in a vital area like health care, and that the decision would be final and would be enforceable by huge fines if it was not obeyed. )

It should be noted that GATS specifically endorses the concept of selling highly tiered services such as healthcare and education without government interference as corporate rights, rights that totally exclude any much needed right to health care. And also that it operates at a supranational level, totally unaccountable to democratic rule of law. So, no US Presidential candidate or state or other candidate for office could realistically hope to fix this once it fully locks in, a danger that is imminent by the proposal by the GOP and Trump to sell one policy across state lines.

Changes, once allowed, cannot be reversed except by buying a nation's freedom at what would be in healthcare, a tremendous cost, via the so-called Article XXI procedure.

For how this could work, the example of the US-Gambling WTO case between Antigua and the US is instructive; however, health insurance is such a large potential export industry for the US that the likelihood of the US insurance industry allowing any deviation from GATS orthodoxy is virtually nil. In effect the poor captive people in the US market's lives are in danger of being sacrificed on the altar of corporatism in perpetuity.)

The scope of GATS is very wide and offers little refuge for exceptions under the conditions that exist today, which are quietly being made irreversible.

GATS applies to measures (meaning virtually any law or action, or failure to take action, of any kind at any level of government or quasi-governmental authority). GATS applies to "measures of general application affecting trade in services" of all signatory World Trade Organization (WTO) Members. "[A]ffecting trade in any service" is the broadest imaginable scope, and it has few exceptions, one of the only ones being those services "supplied in the exercise of governmental authority", denoting that area of governmental activity that does not effectively relate to trade and commerce and should therefore remain the prerogative of governments (free of trade-liberalization constraints). Defining the phrase "service supplied in the exercise of governmental authority" in Article I of the GATS as only "a service which is supplied neither on a commercial basis, nor in competition with one or more service suppliers".

(That also means that no "public option" could ever have existed. that the whole construct of "public option" appears to have been a lie. Made up by who? And who repeated it knowingly?)

So, if a service is completely noncommercial- it passes this test, basically the question is if the service is completely noncommercial - rendered free of charge or at least in a manner that does not suggest commerce and competition - it is allowed to continue providing the service with governmental support. What this means is that single payer has to be just that, single payer, meaning there cannot be any competition, or private providers of services, in an entire country, (This is the real reason why the NHS in the US is being torn apart by the GATS rules as we speak) and by extension it means it must be free because otherwise what would you do when people could not pay. Logic dictates that if there is only a single payer it has to be free because there has to be only one tier in a noncommercial venture.

If this test was passed, when negotiations were ongoing in 1994 then a country's entire service sector, in this case, healthcare payment, would have been excluded from the scope of the GATS. (That appears to be how Canada escaped having their health care privatized.)

When the GATS was still new, there was much discussion about if concepts such as "on a commercial basis" and "in competition with" still left much room for interpretation. However, in recent years, a number of scholarly works by members of the WTO staff have clarified much of this ambiguity putting the situation in the US under a bright light that it is unaccustomed to. Now the definition of "service supplied in the exercise of governmental authority" is no longer ambiguous; also the efforts of a great many American politicians can be seen to be messaging so as to make it clear to future WTO tribunals that US healthcare is to be seen as the most commercial in the world, and the one least likely to ever be framed as a "service supplied in the exercise of governmental authority" - if the rules are to mean anything. (A similar dynamic also would apply to other government services such as higher education, statutory systems of Social Security, and so on, if similar bright lines are crossed. It seems an effort is being made on one hand to clearly cross them, while on the other hand to hide the meanings of such behavior. If so, the American public needs to know these rules and the costly implications of them better.

This is a UNCTAD course on WTO dispute resolution, which right at the beginning spells out these rules and gives health care as an example (http://unctad.org/en/docs/edmmisc232add31_en.pdf).

Essay on Public Services and the GATS, also on the UNCTAD web site (http://www.ictsd.org/downloads/2008/06/cassim_steuart_part3.pdf).

Interpretation of Article I, Section 3 (b) and (c) of the General Agreement on Trade in Services by Markus Krajewski, published by Center for International Environmental Law (CIEL).

Video by Ellen Gould of the Council of Canadians describing GATS to a Seattle audience - this is the best video on GATS that I know of, it described these aspects of it in detail (https://www.youtube.com/watch?v=LHIfSfb-RvM).

Health-Care Memo by Public Citizen's Global Trade Watch (https://www.citizen.org/documents/Health%20Care%20Memo.pdf).

GATS- What is it? (testimony to California Legislature on GATS).

Note how its clear that public services must be delivered on a noncommercial basis to be GATS legal. Otherwise they must be non-discriminatory and "not more burdensome than necessary to ensure the quality of the service".

Additionally, GATS rules elevate international trade in importance. This could lead to a modern-day equivalent of exile for people with illnesses or intolerable variations in medical care, without any accountability for service providers.

Despite the obvious red flags, the GATS puts all choices through a test of trade restrictiveness, claiming this is deregulation. However, the effect is to create a huge new system of particularly onerous and pseudo-legalistic regulations. Therefore I personally suspect new initiatives to globalize service professions will take on a life of their own, which could spin totally out of control, driven by the desire to increase profits, in a rapidly imploding economy.

What we will see is a chain of new, dishonestly framed initiatives (don't expect the US media to tell us about the WTO drivers of these changes) that could result in new "emergency" tiers in our US healthcare system (which would then become permanent additions to the health-care landscape due to the "ratchet" clauses in GATS and its progeny - more recent "negative list" deals that are even more potentially wide in scope, as they include service sectors unless explicitly excluded (i.e., carved out). Additionally, arrangements to send patients overseas to developing countries to save money on poorer patients' care increasingly are being framed and sometimes naively viewed as a form of "New Deal" for developing nations, and therefore could rapidly gain political importance and be very hard to reverse. (The idea of using world-services trade to reduce wages in developed countries is not new; however, the idea of using economic development of the poorer countries to justify it has become particularly popular recently due to work by Christoph Lakner and Branko Milanovic - specifically the work and one graphic, and the conceptual life taken on by the so called elephant chart, and the arguments for economic integration of the developing world without it needing to actually develop (an unwise and unsupported expectation, if it depends on the developed countries sacrificing the livelihoods of their allegedly "overpaid" workers to fulfill it) within the context of a "Global New Deal", which have been advanced by many.

However, rationalization of greed is very powerful and there is little reason to believe that such efforts (which represent more of an effort to preserve extreme levels of inequality and injustice than reduce them) would change anything.

Restrictions on regulation of financial services embedded within the 1997-1998 additions to the GATS would, by themselves, prohibit the channeling of increased profits to any specific use, as that is clearly a new regulatory action, as opposed to liberalisation, and so is arguably blocked by a freeze in new financial regulation, which could be challenged by an effected party, and rolled back by a WTO tribunal, if seen to adversely effect profits. This danger has been hanging over the ACA since its beginning, and is likely to be triggered by selling one policy over state lines because this is the principal request of foreign nations to the WTO and United States, as a precondition to entering our market to sell insurance. (See http://www.citizen.org/documents/PresidentialWTOreport.pdfand citizen.org/documents/usa.pdf.)

The addition of this "Global New Deal" therefore must be seen in its true context, a response to rising calls to carve out public services of general application broadly - effectively ending what amounts to a backlash against the rising standards of living and the emergence of a large middle class, which really came into its own in both developed and developing countries in the 20th century.

The push therefore is more of an effort to make an illegitimate system seem legitimate, really a global coup as a response to improvements in global communication and a widespread loss of faith in what is becoming a culture of governmental impunity, than anything else. It won't help anything and instead will feed into a set of unrealistic expectations held by a great many groups that problems that are not being solved will be solved, a bad thing that creates a dangerous situation when the promised goals fail to materialize, leaving everybody with their hands tied by byzantine international laws that create a dysfunctional state of lock-in into irreversible deals that are not working. Additionally, these deals seem likely to hijack an urgent need to maintain flexibility in the face of global climate change, instead hijacking immigration reform into a corporate agenda, which could result to a backlash against "immigrants" (despite the Mode Four programs, as they are called specifically being labeled as "non-immigration" - more of a loophole around limits on work visas than an actual fact. For more on this "movement of natural persons" agenda, which could end up representing a huge step backwards for labor rights, see "Legalizing Human Trafficking" CorpWatch).

So, as we see, there are two sides to the GATS healthcare agenda to make healthcare more profitable again, replacing workers here with a new kind of powerless guest worker who could not question insurer decisions, in a lower tier of healthcare where accountability chains stretched overseas (GATS also requires cross licensing of foreign professionals) or shipping patients elsewhere "Patient Mobility".

However, we could not expect lowering costs on the supply end to solve the systemic structural problems, as it's explicitly forbidden to force corporations to apply increased profits to reduce medical-loss ratios, etc., by WTO law, which the US was the chief advocate for in the 1990s (this is because health insurance is explicitly denoted by the US as a financial service, and explicitly included as a covered service under the GATS, a standstill therefore applies to it - as well as to other financial services like banking! - a little-known gotcha that could bite us quite severely, and also which it can be seen both parties are eager to cover up).

This dishonesty clearly illustrates what I think needs to be recognized as the inherently "criminogenic" aspects of trade deals generally, especially trade deals involving what Americans and Europeans see as public services (even if the WTO and increasingly corrupt US government does not see them that way; that's a framing that the public has been deceived on).

Any back-room agreement that creates "lock-ins" on what a government can do is "criminogenic" (in GATS case it requires that they continually eliminate regulations on international trade or that could make their domestic markets less profitable for foreign investment, and, NO MATTER WHAT THE COSTS TO THEIR PEOPLE OF THESE CHANGES, they must be always in the deregulatory direction!).

So, what we see is lying on a massive scale by both parties.

GATS - driving a tendency to make promises they know they cannot keep by politicians hoping to get elected - is poison for good government because its HIDING requires governments perform a sort of skit, a state of dysfunction that must be simulated to explain their failure to ever do anything.

It's clear that the world would be far better served by an end to the portions of the GATS and similar more-recent agreements that overlap with "services", which clearly need a non-commercial emphasis to avoid becoming unavailable to the vast majority of humanity as automation replaces much human labor, resulting in extreme levels of unemployment globally unless education can be made public so that people without large savings can afford to educate their children to the increasingly advanced level - for example, in the pure sciences, even postdocs have difficulties gaining permanent positions without having published significant papers in their fields.

Rather than push a great many people into employment where its likely they will fail, we should attempt to make it easier to live decently on very small amounts of money, by making certain services, such as healthcare, universal, of high quality, and completely free. This would allow the preservation, otherwise, of the multilateral trading system.

Healthcare, water, and education are particularly important. It's already impossible for many parents to find ways to fund an adequate education for a child, which may soon involve eight or more years of college, plus several years of unpaid internships or postgraduate study, until they can gain employment. Funding this will become a more and more difficult without large amounts of money. What will happen if only the wealthy can pursue college is the process of granting degrees will become fraudulent and subject to high levels of corruption. This is already a serious problem in a number of countries.

Looking ahead, it is impossible to see any system of illogic that could justify this system we are forcing nations (especially our own) into. This path we see is an example of why (amoral) corporations should never be allowed to take over the world as they are doing, especially not under the aegis of the United States, a country with a stated goal of advancing democracy is instead advancing a system dedicated to its undoing.

This is the global value-chains approach advocated by the multilateral-trading system, which justifies everything in terms of profit and losses to the Gross National Product.

This is incredibly inefficient and results in a system that its own people largely cannot win. Healthcare is a prime example of this.

Instead we should consider a system based on Gross National Happiness. (GNH).

It does not end with GATS. Even the GATS seems to have been seen as too moderate by radical trade negotiators.

Now the US is advocating for several newer agreements that seem to be even stricter in this respect (according to documents leaked from the negotiations that are ongoing in Geneva). Corporations, like addicts, once they gain the upper hand, as they have, are unable to say no or seek moderation. The GATS and especially the newer agreements being negotiated contain a principle, originally called "progressive liberalisation", and the related concepts "ratchet" "standstill" "negative list" "capture of autonomous levels of liberalisation", which refuse to ever allow the privatization or scope of global takeover by the commercial to be limited until it has privatized all service sectors and modes of supply, even those that have not been invented yet.

Once this happens, unless the sector has been explicitly carved out, it appears to me to become functionally a crime for a government to attempt to assist its people in managing the trade in it. This makes the need for carve outs that explicitly remove these service sectors from coverage by any and all such agreements to be incorporated in laws - including international laws - at every level and widely published. (To avoid what is happening now, which is similar to "adverse possession" or theft by notorious forcible occupation of the commons, a sort of second global enclosure, of everything of economic value by corporations, who hope to then sell it back to the increasingly impoverished people of the planet. This is being done behind our backs as people merely live their lives, by corporate entities as a front for the already extremely wealthy. Such activities should be seen as a form of antisocial activity because it is so destructive to the future wellbeing of the planet, and humanity. Concentration of wealth should be seen as an evil because it actually strongly diminishes global prosperity.)

Therefore an essential element for this situation's legality, probability of a set of conditions solving a problem - is absent.

Nowhere is this more obvious than in US health care. The current situation - when one faces the facts, appears to be one of an artificially created limbo in the United States while GATS went through repeated sets of negotiations over 20 years. The failure to fix the problem - a problem prolonged for the worst of reasons - has been characterized by large numbers of deaths to poorer Americans (>50,000 annually x 20 years = over 1 million excess deaths amenable to improved healthcare.) in what amounts to a huge, criminal medical economics experiment.

Medical experimentation on human beings without informed consent is illegal under international law.

Will it ever end? Only if we expose it to the light of day.

Hiding it is arguably a crime.

(Article changed on January 18, 2017 at 01:52)

(Article changed on January 18, 2017 at 18:11)

Authors Bio:
Chris is a person with a questioning and inquisitive mind living in the United States, who believes another world is possible.