Ostry A S
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada.
Int J Health Serv. 2001;31(3):475-80. doi: 10.2190/MT8D-H4EC-JKME-3KD3.
The World Trade Organization (WTO) creates new challenges for the Canadian health care system, arguably one of the most "socialized" systems in the world today. In particular, the WTO's enhanced trade dispute resolution powers, enforceable with sanctions, may make Canadian health care vulnerable to corporate penetration, particularly in the pharmaceutical and private health services delivery sectors. The Free Trade Agreement and its extension, the North American Free Trade Agreement, gave multinational pharmaceutical companies greater freedom in Canada at the expense of the Canadian generic drug industry. Recent challenges by the WTO have continued this process, which will limit the health care system's ability to control drug costs. And pressure is growing, through WTO's General Agreement on Trade in Services and moves by the Alberta provincial government to privatize health care delivery, to open up the Canadian system to corporate penetration. New WTO agreements will bring increasing pressure to privatize Canada's public health care system and limit government's ability to control pharmaceutical costs.
世界贸易组织(WTO)给加拿大医疗保健系统带来了新挑战,加拿大医疗保健系统可以说是当今世界最“社会化”的系统之一。特别是,WTO增强的贸易争端解决权力(可通过制裁来执行)可能使加拿大医疗保健系统容易受到企业渗透,尤其是在制药和私人医疗服务提供领域。自由贸易协定及其扩展协议《北美自由贸易协定》,以牺牲加拿大非专利药品行业为代价,给予了跨国制药公司在加拿大更大的自由度。WTO最近提出的挑战延续了这一进程,这将限制医疗保健系统控制药品成本的能力。而且,通过WTO的《服务贸易总协定》以及艾伯塔省政府推动医疗服务提供私有化的举措,企业渗透加拿大医疗保健系统的压力正在增大。新的WTO协定将给加拿大公共医疗保健系统的私有化带来越来越大的压力,并限制政府控制药品成本的能力。