I don't understand what the problem is. Is the suggestion that the WTO
will force the Candian health care system to partially privatize? Maybe
foreign-owned companies could then enter the market and compete for
part of it. Why would this threaten Canada and not Europe? I thought
they both had government-run health systems.
Thanks,
Andrew Hagen
[EMAIL PROTECTED]
On Wed, 28 Mar 2001 09:18:15 -0800, Ian Murray wrote:
>
>Published on Wednesday, March 28, 2001 in the Toronto Star
>World Trade Organization Targets Canadian Health Care System
>by Stuart Laidlaw
>
>Despite its failure to get a mandate in Seattle, the World Trade
>Organization has been progressing with free trade talks in Geneva for more
>than a year.
>
>The talks, required to start by 2000 under past trade deals, have been held
>with very little fanfare, behind closed doors and with little input from
>those affected.
>
>This week, three more days of talks will take place - again in Geneva, again
>behind closed doors and again without input from those affected.
>
>And make no mistake about it: health care will be on the table.
>
>Ottawa, of course, has vigorously claimed otherwise. It has, after all,
>invoked a feature of existing world trade deals allowing countries to
>specifically exempt parts of their economies from international free trade
>rules. On the face of it, this would seem to protect our cherished health
>care services from foreign and private incursion.
>
>A closer look, however, reveals several concerns.
>
>First off, both the U.S. and Europe have said they will be demanding an end
>to such exemptions. If they are successful - and these two working together
>make a powerful team - Canada's protection will be gone. Canada's own
>bargaining position at these talks - demanding the right to export health
>care while not allowing any imports - dangerously undermines our credibility
>in arguing to keep health care off the table.
>
>But even if the U.S. and Europe are not successful, and even if we can
>successfully negotiate our import-banning, export-pushing trade position,
>there is still plenty of reason to worry. That's because, while health care
>itself is exempted, much of what makes it up is not.
>
>Take public health insurance. Canada has registered health insurance at the
>World Trade Organization as a financial service, leaving the very heart of
>medicare vulnerable to trade deals requiring Canada to open the field to
>foreign and private investors.
>
>You would hope that this classification applies only to the private health
>insurance plans many of us enjoy at work to cover dental care or medication,
>but there's nothing in Canada's WTO commitments to spell that out. It just
>says "health insurance," leaving it up to the WTO to define for us.
>
>There's more. The Canadian Centre for Policy Alternatives - echoing
>sentiments by more conservative trade experts such as John Kirton of the
>University of Toronto - argues that Canada could see much of its medicare
>system whittled away under the WTO's General Agreement on Trade in Services.
>
>Services such as labs, food services, janitorial services, accounting, data
>processing, telecommunications (such as Ontario's new phone-a-nurse service)
>and even hospital administration in the form of management consulting are
>already under the purview of the WTO's agreement on trade in services.
>
>A foreign company could argue that it is not trying to tell Canada how to
>run its health-care system, but just wants a shot at managing parts of it.
>If the WTO agrees - and it tends to favour free market arguments - we would
>be forced to allow private companies into our health-care system.
>
>Not that private companies aren't already in the health business in Canada -
>which further weakens the government's assertion that medicare is safe from
>the WTO.
>
>Here's how: The WTO allows governments to exempt any service provided "in
>the exercise of government authority," as long as such services are not also
>available commercially.
>
>In other words, if a service is exclusively provided by the government, it
>is exempt. But if that service is provided through a mix of both government
>and private interests, it is open to the full force of the WTO.
>
>Health care is such a service. The government, through medicare, obviously
>plays a huge role. But much of the health-care system is, in fact, privately
>run. Doctors' offices operate as private businesses. So do the labs in many
>hospitals, after-hours clinics, dental offices, homecare providers and
>nursing homes. Even the hospitals themselves are often private, non-profit
>corporations. This makes our health-care system a mixed private-public
>system, and therefore subject to WTO rules.
>
>Ottawa's trade negotiators have characterized such concerns as
>"hypothetical," and doubt any such challenges would ever materialize.
>
>That is folly, and we need only look as far as the recent death of the Auto
>Pact to see the threat to health care.
>
>The 35-year-old pact regulating the manufacturing of cars in North America
>was struck down by the WTO last year under its General Agreement on Trade in
>Services, the deal being refined and expanded this week in Geneva.
>
>The Auto Pact required that the Big Three automakers make as many cars in
>Canada as they sold. Japan and Europe successfully argued before the WTO
>that the deal actually regulated the marketing of cars, not the manufacture.
>
>And because marketing is a service, the Auto Pact fell under the General
>Agreement on Trade in Services, which requires that countries treat foreign
>companies the same way they treat domestic companies. That forced Canada to
>lift the tariff on Japanese and European imports.
>
>If the World Trade Organization is willing to stretch the coverage of its
>service deal to include auto manufacturing, you can bet it will be willing
>to bring Canada's health-care system under its umbrella, too.
>
>Brave words by our negotiators and doubts that it will ever happen are
>simply not enough.
>
>Four weeks ago in this space, John Core, former head of the milk marketing
>board, urged farmers to keep a close eye on the agricultural talks in Geneva
>to ensure that Ottawa's negotiators stick to their commitments to protect
>Canadian farmers.
>
>"It will not be acceptable at the end of the talks for our negotiators to
>say, `We tried,'" he wrote.
>
>It's a warning we all should heed.
>
>Stuart Laidlaw is a member of The Star's editorial board.
>
>
