insurers should be required to offer the same plans on the exchange that they offer to large corporations.

I really don't see why they should be allowed to offer different plans to different groups of people.

Then patients can be shipped overseas for low cost care.

Once that occurs then the WTO gains jurisdiction over US health care so the parts of the ACA that make ACA plans unprofitable (the inability to reject sicker patients) can be jettisoned as violative of the standstill clause in the 1998 Understanding on Commitments in Financial Services. (Health insurance is explicitly included as a financial service.)

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Here is the text.: https://www.wto.org/english/docs_e/legal_e/54-ufins_e.htm

Participants in the Uruguay Round have been enabled to take on specific commitments with respect to financial services under the General Agreement on Trade in Services (hereinafter referred to as the “Agreement”) on the basis of an alternative approach to that covered by the provisions of Part III of the Agreement. It was agreed that this approach could be applied subject to the following understanding:

(i) it does not conflict with the provisions of the Agreement;


(ii) it does not prejudice the right of any Member to schedule its specific commitments in accordance with the approach under Part III of the Agreement;


(iii) resulting specific commitments shall apply on a most-favoured-nation basis;


(iv) no presumption has been created as to the degree of liberalization to which a Member is committing itself under the Agreement.

Interested Members, on the basis of negotiations, and subject to conditions and qualifications where specified, have inscribed in their schedule specific commitments conforming to the approach set out below.

A. Standstill

Any conditions, limitations and qualifications to the commitments noted below shall be limited to existing non-conforming measures.

B. Market Access

Monopoly Rights

1. In addition to Article VIII of the Agreement, the following shall apply:

Each Member shall list in its schedule pertaining to financial services existing monopoly rights and shall endeavour to eliminate them or reduce their scope. Notwithstanding subparagraph 1(b) of the Annex on Financial Services, this paragraph applies to the activities referred to in subparagraph 1(b)(iii) of the Annex.

Financial Services purchased by Public Entities

2. Notwithstanding Article XIII of the Agreement, each Member shall ensure that financial service suppliers of any other Member established in its territory are accorded most-favoured-nation treatment and national treatment as regards the purchase or acquisition of financial services by public entities of the Member in its territory.

Cross-border Trade

3. Each Member shall permit non-resident suppliers of financial services to supply, as a principal, through an intermediary or as an intermediary, and under terms and conditions that accord national treatment, the following services:

(a) insurance of risks relating to:


(i) maritime shipping and commercial aviation and space launching and freight (including satellites), with such insurance to cover any or all of the following: the goods being transported, the vehicle transporting the goods and any liability arising therefrom; and


(ii) goods in international transit;


(b) reinsurance and retrocession and the services auxiliary to insurance as referred to in subparagraph 5(a)(iv) of the Annex;


(c) provision and transfer of financial information and financial data processing as referred to in subparagraph 5(a)(xv) of the Annex and advisory and other auxiliary services, excluding intermediation, relating to banking and other financial services as referred to in subparagraph 5(a)(xvi) of the Annex.

4. Each Member shall permit its residents to purchase in the territory of any other Member the financial services indicated in:

(a) subparagraph 3(a);


(b) subparagraph 3(b); and


(c) subparagraphs 5(a)(v) to (xvi) of the Annex.


Commercial Presence

5. Each Member shall grant financial service suppliers of any other Member the right to establish or expand within its territory, including through the acquisition of existing enterprises, a commercial presence.

6. A Member may impose terms, conditions and procedures for authorization of the establishment and expansion of a commercial presence in so far as they do not circumvent the Member’s obligation under paragraph 5 and they are consistent with the other obligations of the Agreement.

New Financial Services

7. A Member shall permit financial service suppliers of any other Member established in its territory to offer in its territory any new financial service.

Transfers of Information and Processing of Information

8. No Member shall take measures that prevent transfers of information or the processing of financial information, including transfers of data by electronic means, or that, subject to importation rules consistent with international agreements, prevent transfers of equipment, where such transfers of information, processing of financial information or transfers of equipment are necessary for the conduct of the ordinary business of a financial service supplier. Nothing in this paragraph restricts the right of a Member to protect personal data, personal privacy and the confidentiality of individual records and accounts so long as such right is not used to circumvent the provisions of the Agreement.

Temporary Entry of Personnel

9. (a) Each Member shall permit temporary entry into its territory of the following personnel of a financial service supplier of any other Member that is establishing or has established a commercial presence in the territory of the Member:

(i) senior managerial personnel possessing proprietary information essential to the establishment, control and operation of the services of the financial service supplier; and


(ii) specialists in the operation of the financial service supplier.


(b) Each Member shall permit, subject to the availability of qualified personnel in its territory, temporary entry into its territory of the following personnel associated with a commercial presence of a financial service supplier of any other Member:


(i) specialists in computer services, telecommunication services and accounts of the financial service supplier; and


(ii) actuarial and legal specialists.


Non-discriminatory Measures

10. Each Member shall endeavour to remove or to limit any significant adverse effects on financial service suppliers of any other Member of:

(a) non-discriminatory measures that prevent financial service suppliers from offering in the Member’s territory, in the form determined by the Member, all the financial services permitted by the Member;


(b) non-discriminatory measures that limit the expansion of the activities of financial service suppliers into the entire territory of the Member;


(c) measures of a Member, when such a Member applies the same measures to the supply of both banking and securities services, and a financial service supplier of any other Member concentrates its activities in the provision of securities services; and


(d) other measures that, although respecting the provisions of the Agreement, affect adversely the ability of financial service suppliers of any other Member to operate, compete or enter the Member’s market;

provided that any action taken under this paragraph would not unfairly discriminate against financial service suppliers of the Member taking such action.

11. With respect to the non-discriminatory measures referred to in subparagraphs 10(a) and (b), a Member shall endeavour not to limit or restrict the present degree of market opportunities nor the benefits already enjoyed by financial service suppliers of all other Members as a class in the territory of the Member, provided that this commitment does not result in unfair discrimination against financial service suppliers of the Member applying such measures.

C. National Treatment

1. Under terms and conditions that accord national treatment, each Member shall grant to financial service suppliers of any other Member established in its territory access to payment and clearing systems operated by public entities, and to official funding and refinancing facilities available in the normal course of ordinary business. This paragraph is not intended to confer access to the Member’s lender of last resort facilities.

2. When membership or participation in, or access to, any self-regulatory body, securities or futures exchange or market, clearing agency, or any other organization or association, is required by a Member in order for financial service suppliers of any other Member to supply financial services on an equal basis with financial service suppliers of the Member, or when the Member provides directly or indirectly such entities, privileges or advantages in supplying financial services, the Member shall ensure that such entities accord national treatment to financial service suppliers of any other Member resident in the territory of the Member.

D. Definitions

For the purposes of this approach:

1. A non-resident supplier of financial services is a financial service supplier of a Member which supplies a financial service into the territory of another Member from an establishment located in the territory of another Member, regardless of whether such a financial service supplier has or has not a commercial presence in the territory of the Member in which the financial service is supplied.

2. “Commercial presence” means an enterprise within a Member’s territory for the supply of financial services and includes wholly- or partly-owned subsidiaries, joint ventures, partnerships, sole proprietorships, franchising operations, branches, agencies, representative offices or other organizations.

3. A new financial service is a service of a financial nature, including services related to existing and new products or the manner in which a product is delivered, that is not supplied by any financial service supplier in the territory of a particular Member but which is supplied in the territory of another Member.


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only administer the plan the corporation decided to offer.

...and wipe these parasitic bastards out of business.

They want NO part of working with government oversight; and they are leacherous thieves if not watched over.

Ax them out of business. If the wealthy want to have privatized medicine up on a hill somewhere, let them buy a speedy policy from these assholes. As for the rest of us 99% - who needs them!

Many of the nation's health problems could be fixed with a Marshall type plan for preventing issues before they start with diet, exercise, etc. Tbe public school meals are a joke in many places. A piece of week old iceberg lettuce counts as a serving of fresh veggies.

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....there are still others in the exchanges. Check out your state's exchange website or the national site, you'll see at least several in most states.

And of course no viable, passable alternative is presented by critics of the ACA.

What planet do you live on?

Single payer NOW! Vote: BERNIE SANDERS! He is the ONLY candidate who will kick these parasites out of our health care system!

A House aide confirmed to TPM that Republican staffers requested the change to the so-called risk corridor program, which is designed to keep premiums stable by making payments to insurers if they lose more money than expected in the law's first few years.


http://talkingpointsmemo.com/dc/obamacare-cromnibus-risk-corridors

Getting rid of them may cause short term pain, but they don't influence long-term decisions. The real problem seems to be sicker enrollees and not enough healthy enrollees.

The next stage will be globalizing health care and shipping patients overseas or having foreign doctors and nurses care for them here using L-1 visas.

That will keep health insurance profitable by eliminating US working people from the equation.

The insurance companies will just "retire."

It's a billion dollar industry.

Also, dozens of countries have been negotiating for market access by their firms into all of the areas where we have labor shortages like healthcare, education, IT, etc. the developing world - after decades of back and forth now anticipate these negotiations will be resolved soon (because of fast track) and it seems, now there is a rising level of anticipation and preparation. At lower costs.

(Otherwise we would have to train our own. maybe even pay for their education)


Hillary Clinton has given speeches elsewhere about the labor shortage in the US.

Indian firms known for treating their IT employees quite badly have been big donors to her past campaigns.

ever they have negotiated with their foreign employers. It may not even be US minimum wage. I am not sure if it needs to be. there is a long history of Less Developed Countries (LDCs) opposing so called wage parity, necessity tests, etc, as being market access barriers.

Some countries may claim - if we raise our minimum wages now while trade negotiations are going on- its possible that they may claim that our "minimum" wages are intentionally set high to keep their corporations out. They might be able to get WTO to rule on them. WTO might do something like abolish them. Since we're a developed country we are supposed to no longer need subsidies - some subsidies are supposed to be reserved for LDCs. I dont know, that stuff is very very complicated. I am just guessing.

If you are interested in reading this debate its under the general heading of Disciplines on Domestic Regulation, and its on the WTO web site. the bulk of the stuff that i remember was in 2006. A lot of South American countries weighed in on this.

Definitely use "Disciplines on Domestic Regulation"

Hmm.. one paper I just found implies that minimum wages and prevailing wages would apply on some level..

Here: https://www.citizen.org/documents/Mode_4_3.06.pdf

Lots of countries thugh have weighed in on this and their proposals differ. All of them are anxious for the 20 year long GATS development branch negotiations to be completed so they can take advantage of this more.

Trade is fine, but no trade agreements unless they are bilateral and include guarantees that protect ordinary people, ordinary workers.

we would win them.

perhaps we could do it using lots of automation. its possible an unanticipated effect of these deals will be dramatically increasing automation because otherwise many firms may not be able to get work even here in the US (if it involves government procurement)

Countries with more favorable regulatory structures may get them. After all, that is one of the benefits of the agreements, increased competition for jobs which lowers wages. isnt that great!

This is what we've been pushing to the world. And we've been successful. All the leaderships of all the countries want to dismantle their safety nets too with automation looming on the horizon.

Also, shipping off their workers overseas is attractive too, rather than having them at home calling for an end to corruption.

that Hell.

What would be the pointof negotiating and signing these huge deals if the next President and Congress could just back out of them?

No, thats why Bill Clinton signed GAT5, to give corporations stability.

And its one of the main reasons health insurance is so screwed up now.

...without proper planning.

We pay a fortune for a good plan, only to find that there are no "in network" doctors within 50 miles.

The ACA leaves insurers too many ways to screw the poor.

then we really have no escape. Even if the ACA is dumped we will never get out of for profit health care,

You can read a little bit about the "lock in" and the consequences of it in this paper from the state of Maine. note that when they talk about "Friends of Services" talks beginning that is actually the plurilateral services deal which is almost completed in Geneva, now ten years later.

Basically we would have to compensate any foreign entrants to the market for their expected lost profits for an undeterminate period based on the potential profits and the size of the market- it could be a lot of money basically just for our freedom from health insurance.

...medical providers and people seeking medical care? Every other first world country has solved this problem. Why can't we?

We need single payer, Medicare for all.

Last edited Tue Apr 19, 2016, 04:41 PM - Edit history (1)

So now everything has to be privatized.

Public health care (education, etc) are basically being framed as stealing customers from globalized services, for example, foreign insurance firms, and other low cost/low actuarial value financial services which could make a profit off of them. vendors that are already well established in Third World countries.

ridiculously priced hea!th care and drugs. Like my iv drip aka conventional chemo priced at $40k per round. I needed 12 rounds, so $1/2 million for that. It is insane.

Losses on this scale are not easily redressed.

From something that was causing a loss. I don't think we'll ever see single-payer in the United States -- I get the sense that only a small minority of Dems support single-payer and Republicans are rabidly opposed.

Your information is wrong. People really want the country to free us from the insurance companies and don't understand that bad trade policy prevents it.

Can you point me to polling that indicates support for single-payer is huge?

do you consider that Unitedhealth profits were up and stock prices were up and they beat expectations a loss ????? Profits were just not as sickeningly obscene.

As insurance giants pull out of "unprofitable markets," the states will have to take up the slack somehow.

gradually opening Medicare to younger people would be the way to go, since it is an existing system and would not require the creation of a whole new bureaucracy.

that anything short of single-payer, is just rearranging deck chairs on the Titanic.

The President shows no spine on a public option, thinking it's impossible, yet somehow he thinks it's possible for insurance companies to, essentially, newly insure burning homes.

Apparently Harvard doesn't teach basic math.

What do Insurance Companies provide? Profit to their shareholders and their CEO. Hemsley is the highest paid COE in the country. Over 100 Million a year.