This applies to both health care and education and has since 1995. Carve outs are explicit reservations that need to go right into the FTA text before its finished (in the case of GATS they would need to be agreed upon by any other country that had been involved in the health insurance market in the US, which may still be zero because of the 50 states but not for long- It has to be explicit so that foreign corporations don't get an entitlement to market access "forever" which trumps any national interest.
Basically its a guarantee that their firms would always be able to sell their wares (such as cheap insurance for people with pre-existing conditions - or poor people- (because of a standstill clause enacted in the 90s we likely will lose any changes subsequent to those dates, such as February 26, 1998 ) its likely that that will be how poor people are covered- they likely would agree to travel for hospitalization- better than no care at all-
Its a right to permanent market access without government interference that they get by entering the market.
Carve outs are urgently needed soon! Without a carve out no state single payer can work, because they wont be able to be single payer, they will be stuck as a sort of expensive insurance of last resort for the poor or sick, a high risk pool that is bound to become extremely expensive or low quality high cost, and then collapse in three or four years from the adverse selection death spiral, like all the others have.
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