Single Payer Health Systems
In reply to the discussion: Just checked my new ACA rates [View all]Baobab
(4,667 posts)(Note there are elements of satirical/sardonic thinking in my rant here, please understand I am very very very tired of telling people all this, it takes a toll on somebody, so please understand - the core is factual and please i beg you verify it and learn more about it, by googling phrases i use. We have been victimized by a huge scheme, we of planet Earth. )
In 1998 the US signed a document - part of the WTO GATS understanding on financial services which contains something called a standstill clause that freezes all regulations and creates what is in essence a one way street So called "progressive liberalisation" - You should Google that term. Basically, as Lori Wallach discussed in a Democracy Now episode around two years ago about TiSA, in a show entitled "a plan that only banksters could love" the WTO General Agreement on Trade in Services agreement which will be merged with TiSA has special dates that will apply to set a ceiling for any public "state owned enterprise" "non conforming monopoly" etc, Rollback means that regulations literally have to be - will likely have to be "rolled back" to their state when the financial part of the GATS was signed (1998) if challenged (and its guaranteed that insurance firms will challenge it because its seen as a trade barrier, preventing international firms that want to enter the market - also open hospitals or set up arrangements to treat sick Americans overseas, for example in india. this maintains a healthy profit margin and is compatible with the free trade ideology of both US political parties, generally the trade deals and the secrecy has been a model of cooperation and consensus between the two US parties. (See "Washington Consensus" )
In exchange for opening "essentially all service sectors and modes of supply" services and their labour become tradeable commodities on the international market - with contracts to perform work, such as run schools, prisons, and perhaps even legislatures - except for the politicians (privatizations scope would be determined by the two part test found at GATS Article I:3 (b) and (c) - Those services that fail the test because they are not completely free and services provided as an exercise in governmental authority to low bidding firms, (which is called Mode Four) countries corporate leaders get concessions like National Treatment and Most Favored Nation (abbreviated MFN) in the foreign lands. Also, "the rise in monthly premiums may be reduced by 2.7% over ten years" (sound familiar) . Low cost providers with offices of convenience in countries with favorable regulatory structures and low wages may even operate hospitals. International services firms already have a presence in prisons, refugee detention and health care plan management, may be able to open new facilities outside of the US to care for the indigent sick. The demand for 'cafeteria style' plans that target specific diseases for extra coverage may be popular. For example, people could pick from a list of diseases to cover, excluding ones they felt were unlikely. Also firms can offer discounts to people who are willing to agree to be put into suspended animation if they become sick, allowing them to be shipped to the other side of the world for lower cost treatment, assuming their credit card is not declined.in short I can see a huge expansion in selling of "consumer driven" health care plans in the US that offer high deductible catastrophic coverage, and US firms will get the right to sell insurance and open factories in other countries and be treated exactly as if they are a domestic firm there. Plus profitability will be maintained. Former employees, such as doctors nurses, teachers, programmers, etc who clearly have lost their jobs as a result of treaties may receive retraining benefits.
The additional regulations - enacted after the signing of the GATS likely violate its standstill which reads as follows. " Standstill Any conditions, limitations and qualifications to the commitments noted below shall be limited to existing non-conforming measures." TiSAs standstill clause is essentially the line at the very beginning of the so called "mandate" which reads as follows" In detail, the agreement should seek to bind, in general, the autonomous level of liberalisation of the
parties " Those words will be seen as basically blocking any New Deal like programs in order to ensure that corporations have a level playing field. Also, dozens of other provisions act to systematically make cost reduction impossible without maintaining the rigid ideology of good better best being bought only by money-
Limits in medical underwriting are likely to be dumped too as violative of both standstill and the "fair and equitable Treatment" (FET for short) legal standard- as violative of the rights of investors to regulatory constancy- The other poster who said that our system really doesn't have any way to ask a company to not make its accustomed profit on something, was right, the lack of cost controls is a regrettable part of our private for profit only system, a uniquely American aspect that we are now successfully exporting by means of trade deals, resistance is futile, as shown by the failure of proposals such as the one linked here to gain buy in from the stakeholders, these deals are procedurally superior to national laws so they take precedence, as shown by the tone of this UNlinked document- ht tp://ww w.euro parl.eur opa.eu/sides/getDoc.do?pubRef=-//EP//NONSGML+AMD+A8-2016-0009+002-008+DOC+PDF+V0//EN (may need to remove the spaces then plug it into browser and then when it starts arriving, right click, save it as filenameyouchoose.pdf and then open- if the mime types are wrong and it doesnt open a PDF viewer as it should-)
that violates the Constitution, also we cannot switch to single payer because that would violate around a dozen provisions in the GATS ( see "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" by the late Nicholas Skala, RIP )
and also TiSA which is almost completed Also TPP and TTIP its likely. (see https://www.policyalternatives.ca/sites/default/files/uploads/publications/National%20Office/2016/02/Major_Complications.pdf especially the discussion of Achmea/Eureko v. Slovak Republic which you can find a factual summary of in the document here ) An long planned "solution" to the crisis created by rigid mercantile ideology is of course, more of the same- TiSA likely will push wages down by globalizing healthcare and education, maintaining profitability by opening services - "everything you cannot drop on your foot" to competition. Global subcontracting with no wage parity requirement, with disciplines on domestic regulation" to insure that no regulation is "more burdensome than necessary to ensure the quality of the service" Its likely that the convenient emergency would help with the sensitive nature of the transition, that, especially if they get the timing just right so it all falls apart creating a health care emergency just as the TiSA is signed. TiSA is almost completed in Geneva. So that is all basically in the pipeline -
May the Good Lord have mercy on our souls.
Too much </sarcasm>