Single Payer and Health Implications of the TPP
by Chris Lowe
President Obama has notified Congress that he will send them the Trans-Pacific Partnership agreement (TPP) for ratification. The soonest he can do that is September 11, 2016, thirty days from when he made the notification. Some observers think he will wait until after the election on November 8.
Health Care for All-Oregon has taken a position opposing the TPP and joined other groups in Oregon, led by the HCAO member group, Oregon Fair Trade Campaign, in advocating against ratification.
HCAO’s position reflects harmful implications of the TPP for the effort to achieve single payer universal health care, as well as restrictions the TPP imposes on efforts to limit health care costs to patients, employers, and governments at present, as well as under future single payer systems. Overseas, the TPP has potentially horrific effects on health in poorer countries in the TPP region, for the sake of large pharmaceutical company profits. HCAO disagrees with the assumption that those profits represent the only national interest of the United States at stake in the treaty.
The potential of the TPP to interfere with the achievement of single payer health care in the U.S. comes through its provisions on trade in services, on state owned enterprises, and its dispute mechanisms. Under those provisions, a foreign company could seek financial compensation from the U.S. government for claims that the creation of a state-owned public insurance system deprived them of the opportunity to make profits. That potential might make it less likely for the federal government to grant states the necessary waivers under the ACA and other laws to create state-level single payer systems, and might add to the costs of creating universal national health insurance.
The TPP would also create financial penalties for measures to cut current costs to Medicare, Medicaid, and private insurers and their customers created by monopoly prices for pharmaceuticals and some medical devices. In effect it would lock into place current laws preventing drug price negotiations by Medicare and penalize future efforts by government agencies in that direction. It would also create extended monopoly powers for new patents in pharmaceuticals, new biologic medicines, and new medical devices. Government action to limit abuse of such monopoly powers could be met by claims for financial compensation from the federal government, strengthening the hand of anti-regulation lobbyists.
Those same provisions would have even worse effects on poor countries and poor people in all TPP countries, in effect banning laws that require or permit the production of generic counterparts to brand-name drugs. Life-saving drugs would become unavailable to tens of millions of people, or the burden of subsidizing them to pay for outrageous profits would drag down efforts at economic development by poorer nations.
Oregon Senator Jeff Merkley and Representative Peter DeFazio are committed to voting no on ratification. Representatives Earl Blumenauer and Suzanne Bonamici have not taken a final position, but both voted in favor of “fast track” authority requiring an immediate up or down vote, thereby voting away their potential power to have amended the TPP. Senator Ron Wyden and Representatives Kurt Schrader and Greg Walden are regarded as likely supporters at this point.
However, both Hillary Clinton and Donald Trump oppose the TPP as the presidential candidates of the Democratic and Republican parties. Those are the parties to which all of the Oregon members of Congress belong. Green Party presidential nominee Jill Stein opposes the TPP, while Libertarian nominee Gary Johnson supports it.