What TTIP means for the Health Sector: Unchecked Costs and Greater Pressure to Privatise
In their position paper on TTIP the presidents and chairs of the German Medical Association (Bundesärztekammer (BÄK)), the German National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung (KBV)), the German Dentists Association (Bundeszahnärztekammer (BZÄK)), the Federal Union of German Associations of Pharmacists (Bundesvereinigung Deutscher Apothekerverbände (ABDA)) and the German National Association of Statutory Health Insurance Dentists (Kassenzahnärztliche Bundesvereinigung (KZBV)) made the following joint declaration: “We demand a positive list which clearly states that TTIP shall not apply to the health service and the healing professions.” The statement demonstrates that Germany’s main health professionals are clearly opposed to TTIP being applied to the health sector.
Background: The German health service is not a free market. In a European context we understand this to mean that every patient has the right to a treatment that is best for him/her and that meets his/her medical needs. This basic principle of solidarity is fundable because refundable services are regulated by Germany’s self-governance principle (according to which all stakeholders – including patients – are called on jointly to play their part in ensuring the effective functioning of the public health insurance system.) But within the framework of these regulations, commercial competition is both provided for and considered desirable.
By contrast the US health system is highly market-orientated and has considerably fewer solidarity elements.
Given that the health system is part of the public services provision, there is a plan to exempt health services from TTIP altogether – by way of an exemption clause. This clause states that TTIP shall not impinge on the freedom of the parties to the TTIP Agreement to set their own health policies; to structure their health services; and to provide medical care. The problem however is that the public and private sectors are both closely intertwined with the health service – and it is not always possible clearly to separate these sectors, even from a legal point of view. As such this may seriously limit the effect of the proposed exemption clause.