William S. and Christine S. Hall Center for Law and Health at Indiana University School of Law - Indianapolis, Indianapolis, IN, USA.
J Law Med Ethics. 2009 Winter;37(4):807-18. doi: 10.1111/j.1748-720X.2009.00452.x.
With the North American Free Trade Agreement (NAFTA), the health care sectors of the United States, Canada, and Mexico are becoming more economically integrated. NAFTA poses major challenges to the realization of the international human right. These include: (1) Cross Border Trade in Medical Products, (2) Cross Border Trade in Medical Services, and the attendant investment protections, (3) Portability and Comparability of Health Insurance Coverage, and (4) Protection of Public Health Insurance Programs. The United States, Mexico, and Canada all provide public health insurance programs either to the entire population as in Canada or to vulnerable groups as in the United States. In none of these countries have private, for-profit providers and insurers been able to provide universal and affordable health coverage and care in a truly free market. Private insurers and for-profit providers should not profit from the care of the healthy and wealthy in ways that compromise the public programs that serve the poor and seriously ill. Nor should they be allowed to use NAFTA processes to compromise public programs. Policy makers must consider implications of NAFTA and move toward assuring access to affordable health care for all people on the North American continent.
随着《北美自由贸易协定》(NAFTA)的实施,美国、加拿大和墨西哥的医疗保健行业正变得更加紧密地结合在一起。NAFTA 对实现国际人权提出了重大挑战。这些挑战包括:(1)医疗产品的跨境贸易;(2)医疗服务的跨境贸易以及相关的投资保护;(3)医疗保险覆盖范围的可携带性和可比性;(4)保护公共健康保险计划。美国、墨西哥和加拿大均提供公共健康保险计划,加拿大覆盖全体人口,美国则针对弱势群体。在这些国家中,没有任何一个国家的私营营利性供应商和保险公司能够在真正自由的市场中提供普及且负担得起的健康保险和医疗服务。私营保险公司和营利性供应商不应通过为健康和富裕人群提供服务而获取利润,从而损害为穷人和重病患者服务的公共计划。也不应允许他们利用 NAFTA 进程来损害公共计划。政策制定者必须考虑 NAFTA 的影响,并努力确保北美大陆所有人都能获得负担得起的医疗保健。