Truth or consequences? The law and politics of the gats health care debate

Abstract

The debate between critics and defenders of the General Agreement on Trade in Services (GATS) has drawn attention to the GATS, prompted greater government efforts at consultation, challenged the democratic legitimacy of the WTO, and led to an exploration of possible interpretations of the GATS clauses that could impact on health and social policy. This article argues that defenders of the GATS are probably correct in their legal interpretations of the key protections of policy autonomy contained in the Agreement, most notably the Article 1:3 “governmental authority” clause. That is not the whole story, however: maintaining the conditions of policy autonomy in the health care sector will prove increasingly difficult in a liberalized trading environment.

Le débat entre les critiques et les défenseurs de l'Accord général sur le commerce des services (GATS) a attiré l'attention sur ce dernier, poussé les gouvernements à améliorer les consultations, contesté la légitimité démocratique de l'OMC et mené à explorer certaines interprétations possibles d'articles du GATS qui pourraient avoir une incidence sur les politiques sociale et de santé. D'après cet article, les défenseurs du GATS ont probablement une interprétation juridique exacte des principales protections de l'autonomie des politiques qu'offre l'Accord, notamment l'article 1:3 “autorité gouvernementale”. Cela, toutefois, ne suffit pas: maintenir les conditions de l'autonomie des politiques dans le secteur de la santé sera de plus en plus difficile dans le contexte de la libéralisation des échanges.

Notes

Mark Crawford is a Lecturer in the Department of Political Science at the University of Northern British Columbia. His published commentaries on constitutional law and politics and electoral reform have appeared in the University of Toronto Faculty Law Review and in several newspapers. Currently, his research focuses on the interface between domestic policy and international trade, and related questions of public philosophy. Earlier drafts of this paper were presented at the Canadian Foreign Policy conference at Carleton University, 6–7 November 2003, and the conference, “WTO and Beyond”, hosted by Simon Fraser University 15–16 July 2004. The author is grateful to participants at both conferences, especially William Dymond and Christopher Kukucha, as well as the Editor of this Journal and three anonymous reviewers, for their very helpful comments.