Rewriting the regulations: how the World Trade Organisation could accelerate privatisation in health-care systems

The World Trade Organisation (WTO) is drawing up regulatory proposals which could force governments to open up their public services to foreign invest ors and markets. As part of the General Agreement on Trade in Services (GAT S) negotiations, the WTO working party on reform of domestic regulation is developing a regulatory reform agenda which could mark a new era of compuls ion in international trade law. Article V1.4 of the GATS is being strengthe ned with the aim of requiring member states to show that they are employing least trade-restrictive policies. The legal tests under consideration woul d outlaw the use of non-market mechanisms such as cross-subsidisation, univ ersal risk pooling, solidarity, and public accountability in the design, fu nding, and delivery of public services as being anti-competitive and restri ctive to trade. The domestic policies of national governments will be subje ct to WTO rules, and if declared illegal, could lead to trade sanctions und er the WTO disputes panel process. The USA and European Union, with the bac king of their own multinational corporations, believe that these new powers will advantage their own economies. Health-care professionals and public-h ealth activists must ensure that this secretive regulatory reform process i s opened up for public debate.