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12 Health L. Rev. 3 (2003-2004)

handle is hein.journals/hthlr12 and id is 1 raw text is: My temple should be a house ofprayer, But you have made it a den of thieves. Get out! Get out! (Lyrics from Jesus Christ Superstar) Introduction Canada's publicly funded health care system, Medicare, is the country's most cherished social program. It is a near-sacred institution, comparable to the temple in the New Testament story from which Jesus drove the merchants who had set up shop. Many believe that international trade agree- ments threaten to flood Canada's sacred institution with unwanted merchants of its own in the form of foreign for-profit investors.' They fear that these agreements will force Canada to open its health care system to entry by for- eign service providers and insurers, causing a slide into a US-style system of health care driven by for-profit providers and insurers.2 A contrasting view has been presented by the federal government, which has assured the public that inter- national trade agreements pose no threat to the integrity and sustainability of Medicare.3 The two trade agreements that have received the most criti- cal attention are the North American Free Trade Agreement (NAFTA) and the General Agreement on Trade in Services (GATS). The NAFTA is an agreement implemented in 1994 between the federal governments of Canada, the US and Mexico that aims to create a free trade area between the ter- ritories of the three countries. The GATS is an agreement for liberalization of trade in services implemented in 1994 that imposes rules on all member countries of the World Trade Organization (WTO). Health Law Volume 12, Number 1 Institute In this article, I provide a brief overview of the implications of the NAFTA and GATS for Medicare with the objective of determining the reality behind the contrasting views dis- cussed above.4 I will do so by examining: The values underpinning international trade agreements; ' Key characteristics of Canada's health care system; and * The key provisions and potential implications of the NAFTA and GATS for Canada's health care system. International Trade Agreements and Health Care - Conflicting Values? The key objective of most international trade agreements, including the NAFTA and GATS, is trade liberalization through the reduction of barriers to trade. The rationale is that trade unhindered by government interference will result in the best allocation of scarce resources, and improved eco- nomic growth and welfare. The success of trade liberaliza- tion is largely dependent on the presence of an open market within each of the trading partners. In an open market, goods and services are allocated on the basis of purchasing power and there is no concern with equity of distribution. On its face therefore, trade liberalization is incompatible with the goals ofthe Canadian health care system where the free mar- ket gives way to high levels of government intervention in order to achieve goals of distributive justice. 3 Merchants in the Temple? The Implications of the NAFTA and GATS for Canada's Health Care System Tracey Epps

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