title: 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.
abstract: The collapse of the World Trade Organization's (WTO) Doha Round of talks without achieving new health services liberalization presents an important opportunity to evaluate the wisdom of granting further concessions to international investors in the health sector. The continuing deterioration of the U.S. health system and the primacy of reform as an issue in the 2008 presidential campaign make clear the need for a full range of policy options for addressing the national health crisis. Yet few commentators or policymakers realize that existing WTO health care commitments may already significantly constrain domestic policy options. This article illustrates these constraints through an evaluation of the potential effects of current WTO law and jurisprudence on the implementation of a single-payer national health insurance system in the United States, proposed incremental national and state health system reforms, the privatization of Medicare, and other prominent health system issues. The author concludes with some recommendations to the U.S. Trade Representative to suspend existing liberalization commitments in the health sector and to interpret current and future international trade treaties in a manner consistent with civilized notions of health care as a universal human right.
authors.affiliation: Northwestern University School of Law, Chicago, IL 60611, USA. n-skala@law.northwestern.edu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Skala
mesh_terms: D003132:Commerce; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration / Q000592:standards; D018166:Health Care Reform / Q000191:economics* / Q000458:organization & administration / Q000592:standards; D006291:Health Policy; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D007390:International Agencies; D007391:International Cooperation; D020398:Medicare Part C / Q000191:economics; D009310:National Health Insurance, United States / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards; D011057:Politics; D014481:United States; D019472:Universal Health Insurance / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards; D014944:World Health Organization