International Trade in Health Services and the GATS

Chantal Blouin, Nick Drager And Richard Smith

Description

Health ministries around the world face a new challenge: to assess the risks and respond to the opportunities of the increasing openness in health services under the World Trade Organization's (WTO) General Agreement on Trade in Services (GATS). 'International Trade in Health Services and the GATS' addresses this challenge head-on by providing analytical tools to policymakers in health and trade ministries alike who are involved in the liberalization agenda and, specifically, in the GATS negotiations.
This book informs and assists policymakers in formulating trade policy and negotiating internationally. There is ongoing and animated international debate about the impact of GATS on public services in general and health in particular. In response, the book offers different perspectives from more than 15 leading experts. Some of the authors stress opportunities linked to trade in health services, others focus more on the risks.
The book offers:
▪ Detailed legal analysis of the impact of the agreement on health policy
▪ An overview of trade commitments in health-related services
▪ New empirical evidence from nine country studies
▪ A simple 10-step explanation on how to deal with GATS negotiations.
'International Trade in Health Services and the GATS' is a must-have resource for policymakers and other practitioners working in the trade and health sectors.

Sujets

• Globalization and Health
• Department of Health Services
• Public health
• Health

Informations

• Publié par: world-bank-publications
• Publié le: 15 septembre 2005
• Nombre de lectures: 25
• EAN13: 9780821362129
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

International
Trade in
Health services
and the GATS
current issues and debates
Editors
Chantal Blouin • Nick Drager • Richard SmithInternational
Trade in
Health Services
and the GATS
Current Issues and DebatesInternational
Trade in
Health Services
and the GATS
Current Issues and Debates
Edited by Chantal Blouin,
Nick Drager, and Richard Smith
THE WORLD BANK
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ISBN-10: 0-8213-6211-9 e-ISBN: 0 8213-6212-7
ISBN-13: 978-0-8213-6211-2 DOI: 10.1596/978-0-8213-6211-2
Library of Congress Catologing-in-Publication Data has been applied for.Contents
Preface and Acknowledgments vii
Contributors ix
Acronyms and Abbreviations xi
1 Trade in Health Services and the GATS: Introduction
and Summary 1
Richard Smith, Chantal Blouin, Nick Drager
2 Strategic Considerations for Developing Countries:
The Case of GATS and Health Services 17
Mina Mashayekhi, Martine Julsaint, Elisabeth Tuerk
3 Update on GATS Commitments and Negotiations 83
RudolfAdlung,Antonia Carzaniga
4 Ten Steps to Consider Before Making Commitments
in Health Services under the GATS 101
Julia Nielson
5 Making Commitments in Health Services under
the GATS: Legal Dimensions 141
David P. Fidler, Nick Drager, Carlos Correa, Obijiofor Aginam
6 Economic Dimensions and Impact Assessment
of GATS to Promote and Protect Health 169
Chantal Blouin
7 Trade in Health Services under the Four Modes
of Supply: Review of Current Trends and Policy Issues 203
Chantal Blouin, Jens Gobrecht, Jane Lethbridge, Didar Singh,
Richard Smith, David Warner
8 Trade in Health Services and the GATS: What Next? 235
Richard Smith, Chantal Blouin, Nick Drager
Appendix Tvices and GATS: A Framework
for Policymakers 245
Rupa Chanda, Richard D Smith
Index 305
vPREFACE and
acknowledgments
Trade liberalization can affect health in multiple ways. Sometimes the impact is
direct and the effect is obvious, as when a disease crosses a border together with a
traded good. Other times the effects of trade liberalization are more indirect. For
example, reducing trade tariffs may lead to lower prices for medical equipment
and health-related products; changing international rules concerning patent pro-
tection affects access to essential medicines and technology transfer; and liberal-
ization of trade in health services can alter national health systems. There is a link
between increased trade and economic growth, which itself can lead to reduced
poverty and higher standards of living, including better health. It is important to
link the trading system with sound social policies to move toward a more equi-
table distribution of the potential economic benefits of trade openness.
One of the key challenges faced by ministries of health arising from trade
rules is accurately assessing and responding to the risks and opportunities for
population health and human development of the increasing openness in health
services under GATS.
This book attempts to address this challenge head-on, providing analytical tools
to policymakers, in both the health and trade ministries, who are involved in the lib-
eralization agenda more widely, and the current GATS (General Agreement on
Trade in Services) negotiations more specifically. The book includes an overview of
current evidence on the health sector implications of the liberalization of health
services trade in selected countries; focusing especially on developing countries. We
hope that it will be a tool for trade capacity building and for facilitating national dia-
logues on what are the best policy options on health services and trade agreements.
The topic is a controversial one, so we ensured that the different chapters reflect a
range of views on the GATS and health services. The objective is to provide infor-
mation that will contribute positively to the debate on GATS. Moreover, although
viiviii International Trade in Health Services and the GATS
we focus largely on the GATS negotiations, the book should not be seen as limited to
the multilateral sphere. Regional and bilateral trade negotiations are omnipresent
now and the health issues raised here are relevant to these negotiations as well.
The book is, of course, the product of a collaborative effort by many organisa-
tions and individuals. Building on its recent work on globalization and health, the
WHO partnered with researchers and analysts in order to develop the materials
included. The first phase of this work led to the presentation and discussion of draft
chapters and case studies at a workshop in Ottawa, Canada, in July 9–11, 2003.
Bringing together more than 70 participants, this forum allowed for vigorous dis-
cussion among trade and health experts and representatives of government min-
istries and agencies, non-governmental organizations, professional associations, aid
agencies and academic institutions from more than 20 countries (The North-South
Institute provided technical support, while the Canadian Public Health Association
undertook logistical support for the workshop. The University of Ottawa’s Institute
for Population Health hosted the event.) The second phase of this work led to revi-
sions to the chapters; the results of which are presented here. A third phase will see
the methodologies suggested here being implemented in a variety of national con-
texts to begin the process of gathering together consistent evidence on the extent of,
and impact of, trade on health, which will then be reported at a later date.
In bringing this phase to fruition, we would like to thank all the collaborators.
First, the contribution of the authors of each chapter in the book, and also to the
authors of the various country case studies summarized herein: Susan Cleary,
Francisco León, Alfred Inis Ndiaye, Cha-aim Pachanee, Cintia Quiliconi, Soledad
Salvador, Guang Shi, Untung Suseno, Michael Thiede, Stephen Thomas, and Suwit
Wibulprasert. We also benefited from the participation and comments of Benedikte
Dal, Ross Duncan, John Foster, Jens Gobrecht, Ajay Gupta, Margaret Hilson, Laurie
Hunter, Ron Labonte, Susan Joekes, Paul Mably, Aaditya Mattoo, Blanka Pelz, Matthew
Sanger, Ted Schreker, Scott Simon, David Strawczynski, and David Warner. We are
also grateful to the remaining participants to the Ottawa workshop, who also con-
tributed greatly to the improvement of the quality of the chapters. Our thanks also go
to UNCTAD, OECD, WTO, and the South Centre for their contribution. For its sup-
port in the preparation of the final version of this book, we would like to thank
Stephen McGroarty of the World Bank’s Office of the Publisher as well as the review-
ers who contributed their time and energy to improve the quality of the manuscript.
Finally, we would like to thank the sponsoring agencies for this project: the Canadian
International Development Agency (CIDA), Health Canada, the International Devel-
opment Research Centre (IDRC), the World Bank (WB), and the World Health
Organisation (WHO). The views and positions expressed in the book are the views of
the authors, and should not be seen as representing official policy of the organiza-
tions or governments which supported its publication.