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Secret proposal for trade in health services in direct conflict with global agenda for health

3 February, 2015
A recently leaked proposal tabled by Turkey in the TISA negotiations argues for a system that promotes insurance reimbursement (for those who have health insurance) for treatment at lower cost in another country.

“The proposal would raise health care costs in developing countries and lower quality in developed countries in Europe, North America, Australia and elsewhere,” explains Dr Odile Frank, who has analysed the document for Public Services International (PSI).

Frank argues that under such a proposal, costs to government would rise, as would premiums for health insurance.

The unauthored document appears to have been inspired by a paper in “Health Affairs” by Aaditya Mattoo and Randeep Rathindran that appeared in 2006. In that paper, the authors advance the case that insurance companies in the United States should reimburse patients to travel abroad for a range of low-risk surgical treatments in order to take advantage of lower costs and to realize gains from this trade, representing savings to the insurance industry. The incentive for patients would be less co-payment outlays, whether or not the travel costs are covered, selectively lower co-payment rates or selectively lower premiums for patients who travel abroad for treatment. 

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