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HOW TRADE RULES THREATEN HEALTH CARE WORKERS & CONSUMERS

SAME AGENDA; NEW PLAYING FIELD: Corporations have been working for the last several decades to transform health care into a corporatized, profit-driven industry. For workers, their efforts have meant increasing job pressures without commensurate increases in pay. Now health care corporations are trying to tighten the screws even more by pushing their anti-worker agenda in the international trade arena.

Today’s trade rules create rights for multinational service corporations when they operate in the U.S. and other countries. These rights may enable health care corporations to lock in privatization and challenge important health care regulations in the United States.

Health care is one of the services covered by the GATS (the WTO General Agreement on Trade in Services) and the draft FTAA (the Free Trade Area of the Americas) rules on services. These rules threaten health care workers in negative and far reaching ways.

WHAT DO THESE RULES MEAN FOR HEALTH CARE WORKERS? 

Currently proposed services rules will place regulations on staffing, worker health and safety, and licensure and certification at risk.

The proposed rules on "domestic regulation" could allow foreign corporations and governments to challenge a wide range of U.S. health care regulations as "more burdensome than necessary." For example, laws requiring reasonable staffing ratios, use of safe needles, and professional licensing could be challenged using this rule. The likelihood of such a challenge is high given that employers already argue that many health care regulations, including staffing ratio laws and occupational health and safety laws, are unnecessary. Currently, we can often persuade the Congress, the state legislatures, and the courts that employers are wrong about this. But under the proposed services rules, decisions about challenged laws would be made by a three-person tribunal of corporate trade experts operating outside the public view. Workers and consumers would have no right to observe the proceedings or present their perspective. In almost every case decided under the WTO and NAFTA trade tribunal system to date, corporate interests have won and the public interest has lost. These rulings are backed up with a powerful enforcement system.

Services rules may promote worker exploitation:

Services rules on the temporary entry of workers could relax limitations on the temporary entry of workers under conditions that are unfair to all workers. These rules are likely to require participating countries to allow transanationals to bring immigrant workers into a country solely for the purpose of working for a particular employer. Workers would have to leave the country if they were fired, so they would have no bargaining power to insist on decent treatment and fair wages. These rules would make organizing more difficult and lower wages in the industry. WTO staff have stated that one of the aims of these rules is to lower labor costs.

Services rules may promote the further privatization of health care:

The "national treatment" rule included in the proposed agreements could prohibit governments from treating private health care corporations from abroad any less favorably than public service providers based in the U.S. Down the road, this could entitle foreign corporations to an "equal right" to access public money currently used to fund public services in the U.S. By giving corporations these rights, services rules could make it harder to keep remaining public health care delivery systems intact or to reverse the privatization of the U.S. health care sector. Services rules, for example, could make the higher reimbursement of public providers in the federal Medicaid "DSH" program illegal. The Medicaid DSH, or disproportionate share hospital, program is our nation’s primary source of support for safety net hospitals that serve the uninsured and underinsured. Services rules could also threaten laws requiring pharmaceutical companies to provide lower cost drugs to the VA, the medicaid program, and federally qualified safety net clinics.

Rules on procurement of services also endanger living wage laws and laws requiring companies that receive public money to respect the right to organize:

Rules on government procurement, if written the way negotiators would like to write them, will almost certainly make it illegal for governments to set requirements regarding working conditions when they spend public money to purchase services. If language like this is negotiated, corporations and governments may be able challenge living wage ordinances and other critical labor laws as violations of trade agreements.

TAKE ACTION: Let your elected representatives know that the services rules now being written into the GATS and the FTAA are a big problem for health care workers and health care consumers. It’s especially critical to urge your elected representative to oppose fast track (you can reach the Congressional switchboard by calling 202-224-3121). Fast track would hand George Bush broad discretion to negotiate anti-worker provisions into trade agreements and then ram those agreements through Congress with little oversight. It’s also critical to reach out and form alliances with health care consumers and with groups involved in providing services to low-income communities. For more information on trade in services, read the report, "Trade and Investment in Services: The Stakes for Workers and the Environment," which can be obtained from ASJE at 503-736-9777 or contact Lynn-Marie Crider, Research Director of the Oregon AFL-CIO and Labor Co-Chair of the ASJE Global Trade Working Group (503-585-6320 ext. 18).

THE ALLIANCE FOR SUSTAINABLE JOBS AND THE ENVIRONMENT

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503-736-9777