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Ontario Liberals fail to protect health care in trade deal with Europe

Ontario Liberals fail to protect public health in CETA trade deal

While the Harper Conservative government has pushed ahead with its Comprehensive Economic Trade Agreement (CETA) with the European Union, the Ontario Liberal government has failed to protect public health care.

Under the North American Free Trade Agreement (NAFTA) protection for public health care was initially supposed to be provided through the Annex II Social Services Reservations.  Annex II protects social services “maintained for a public purpose”.

Unfortunately, the meaning of “public purpose” is disputed and the provision may not provide protection where there is private sector involvement in health care. 

To clarify that health services delivered as public services are excluded from NAFTA, the parties negotiated a general reservation in 1996.  This addition to NAFTA's Annex I meant that services provided by provinces since 1994 would be excluded from NAFTA liberalization.

With CETA, however, general reservations like those seen in Annex I under NAFTA
for public services are not included.  Instead, the provinces must name the specific services that they want excluded from the liberalization ratchet that locks-in privatization.

This means that we will be left only with the weaker protection of public health care provided by Annex II, including its lack of clarity over the meaning of “public purpose”. 

Worse, the Ontario government is moving more public health care services to private, for-profit delivery through public private partnerships, private surgical and diagnostic clinics, and by underfunding public health care services and leaving more care to private purchase (for those who can afford it).  As a result the separation of public and private care has become much less clear, making the protection provided by Annex II more uncertain.

Impact on drug costs

The trade deal will increase the cost of pharmaceutical drugs by delaying the release
of generic drugs.  Current estimates place this extra cost to the public at $2.8 billion per year.  Notably, while drug costs have sky-rocketed since the 1990s, significant relief has been provided in the last several years by new generic drugs becoming available.    

Expansion of Medicare threatened 

CETA allows private corporations to bring charges against the public through international commercial tribunals if public health care is expanded in some way, e.g.
if government establishes a universal and comprehensive public drug plan, or even
just brings a privatized health service back into the public sector.  This will stymie, or,
at best, add extra costs to efforts to effectively reform our health care system. 

What needs to be done

Trade agreements negotiated by Conservative governments have strengthened corporate power at the expense of the democratic control of working people.  Since such deals began in the 1980s, the bargaining power of working people has diminished and inequality has increased, here and in the United States.

As a very basic minimum, the Ontario Liberal government should at least be willing
to specifically and explicitly ensure that nothing in CETA shall be construed to apply to measures adopted or maintained by a party with respect to health care or public health insurance. 


  1. Hey,I highly appreciate your writing.I'd like to share little point with you.My thought is this: healthcare really ins't a traditional market commodity in the sense that I Phones or cars or massage services are it doesn't correspond to supply and demand in the same way, this is corroborated by the fact that although Private Healthcare advocates always tell us competition will lower prices and improve quality, private healthcare coasts have only risen in the last decades. not only this but people having healthcare is of such national importance that treating it as another marketable good seems like a inadequate and frankly wrongheaded approach.Thank you so much!!!
    medical device consultant 


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