The Obama administration has been negotiating an agreement called the Trans-Pacific Partnership (TPP) for the past three years that is now heading into the final stages and could be signed into law as early as October. If it is not stopped, this new agreement has the potential to prohibit single payer health insurance, even at the state level, or any new public insurance, could cement the privatization of Medicare, could prevent many of the mechanisms that are commonly used to control health care costs and would raise the prices of medications and pharmaceutical devices.
The TPP is being negotiated as a trade agreement, but in fact, it is much more than that. Of the 29 chapters, only five are traditional trade chapters. The others contain many policies that corporations have tried to advance through Congress and through World Trade Organization (WTO) talks without success. These include patent and property protections, financial deregulation, greater legal standing for investors and corporations, the end of ’Buy America’ and weakening of what are called state-owned enterprises (SOEs). This is why the TPP is being called “NAFTA on steroids.”
The bottom line for the TPP is to advance the neoliberal economic agenda with which we are becoming more familiar; this means de-funding public programs, privatizing public resources by making them available to corporations and treating every entity, be it education or health care, as a commercial enterprise. For those of us who advocate for universal health care systems and public health programs, the TPP would be a disaster.
What we know about the specific provisions in the TPP come from chapters that have been leaked and from industry reports. There has been a virtual media blackout on the TPP. Unlike past trade agreements which were available for public viewing on the US Trade Representative (USTR) website, the text of the TPP is classified. Members of Congress are only allowed to see portions of the text upon request, and then must do so on a ‘read and retain’ basis without aids of any sort for note-taking. They are not allowed to speak publicly about what they have read. However, the more than 600 corporate advisors who are working with the Office of the USTR have access to the text on their computers in live time as it is negotiated.
The reason for the secrecy was revealed after the former USTR, Ron Kirk, left his position to work for a Washington lobbying firm. In essence Kirk said that if the people knew what was in the TPP, they wouldn’t be able to get it signed. This is due in large part to the public opposition to the WTO and free trade agreements.
The TPP, and its sister the Trans-Atlantic Trade and Investment Partnership (aka TAFTA), are backdoors to advance the WTO agenda. Since the Doha Round of WTO talks which began after the ‘Battle of Seattle,’ the WTO has essentially stalled. And since the passage of NAFTA, 14 free trade agreements have been stopped by public protest. The new approach being used for the TPP is to gather a group of small nations including Vietnam, Brunei, Malaysia, Singapore, Chile and Peru and, with the assistance of allied nations including Australia and New Zealand, bully them into accepting harmful provisions. A unique feature of the TPP is that it contains a ‘docking provision’ which allows other nations to join the TPP after it has been negotiated as long as they agree to its terms.
Together, the TPP and TAFTA will redefine the terms of the global economy in ways that give corporations greater power than sovereign nations. Corporations will be able to sue nations in a trade tribunal that operates outside of national judicial systems if environmental, labor and consumer protection laws interfere with expected profits. The trade tribunal will be staffed by corporate lawyers on leave from their jobs to serve as judges. For many poorer nations, this will lead to weakening of these laws rather than paying tens of millions of dollars in compensation to transnational corporations.
The effect of the TPP on health care in the US and around the world could potentially undermine decades of work by single payer and public health advocates. We know from text leaked in June, 2011 that the TPP will grant twenty year patents for pharmaceuticals and medical devices that can be renewed if a new indication is found or the mechanism of delivery is altered. This is a process called ‘Evergreening’ and it is designed to prevent generics and protect profits. The TPP will also give greater legal standing to health corporations to challenge reimbursements from health systems and to include the cost of marketing into what is considered a ‘fair market value.’
The TPP will undermine public health efforts by raising health care costs for public health systems and also by preventing public health education efforts, such as ant-tobacco campaigns, if they are viewed as conflicting with corporate profits. This aspect of the TPP even has Mayor Bloomberg concerned.
It is also possible that the TPP could prevent the establishment or expansion of public insurances. On one hand, public insurances could be viewed as state-owned enterprises and could be prohibited from having any market advantages that are not also offered to private insurances such as subsidies, access to capital or tax preferences. On the other hand, a single payer health insurance in particular could be prohibited altogether because it would create a monopoly that would exclude private insurances. This is explained in detail in an article published by Nick Skala in 2009.
And finally, the TPP, if it is similar to the WTO provisions, could prevent Medicare from returning to a fully public system, regulation of specialty hospitals, limitations on for-profit disease management products and requirements that health insurers spend a particular amount of premiums on health services (regulation of the medical loss ratio). It would open the door to greater privatization of health care which is already resulting in great inequalities in access to health care services and health outcomes.
The time to stop the TPP is now. President Obama recently made a formal request to Congress to grant him Fast Track, also called Trade Promotion Authority, and a vote is expected in late September or early October in both the House and Senate. Fast Track, which was previously used by President Clinton to pass the WTO and NAFTA, gives the President the authority to negotiate and sign trade agreements before the agreement goes to Congress who would then only have the ability to vote yes or no on it. It would prevent hearings in Congress on the text of the agreement and amendments. Under the Commerce Clause of the U.S. Constitution, it is Congress that has the responsibility to oversee commerce and trade, not the president.
The first step to stop the Trans-Pacific Partnership and to achieve transparency and a democratic process in Congress is to stop Fast Track. Constituents are meeting with their members of Congress now while they are on break in their home districts to ask for a commitment to vote “no” on Fast Track. Some are planning events for September 17, Constitution Day, to thank members who commit to a no vote or to ‘spank’ members who won’t commit by exposing their corporate connections. On September 21 and 22, there will be a “Stop the TPP Action Camp” in Washington, DC with ongoing actions starting September 23 and continuing through the vote. Volunteers are needed to participate in visibility actions on September 23 and 24 and then to join the “Fair Trade Brigade” daily in Congress to remind members that trade should put people and the planet before profits.
Personally, as an activist for single payer health insurance, I feel that I must devote my time and attention to stopping the TPP. It is something that can be stopped, as the past 14 trade agreements have been. It is a cause that unites all of us who advocate for economic and social justice. And, when we work together and win, it will be a blow against the further consolidation of global corporate power. Stopping the TPP is essential to our ultimate goal of a universal health care system based on single payer health insurance.