Does health insurance impede trade inhealth care services?

There is limited trade in health services despite big differences in the price of health care across countries. Whether patients travel abroad for health care depends on the coverage of treatments by their health insurance plan. Under existing health insurance contracts, the gains from trade are not fully internalized by the consumer. The result is a strong"local-market bias"in the consumption of health care. A simple modification of existing insurance products can create sufficient incentives for consumers to travel. For just 15 highly tradable, low-risk treatments, the annual savings to the United States would be $1.4 billion even if only one in 10 patients who need these treatments went abroad. Half of these annual savings would accrue to the Medicare program alone. The authors examine how measures by destination countries to improve and credibly signal the quality of health care can enhance the scope for trade.

An assessment of telecommunications reform in developing countries

The authors analyze the effect of policy reform in basic telecommunications on sectoral performance using a new panel data set for 86 developing countries across Africa, Asia, the Middle East, and Latin America and the Caribbean over the period 1985 to 1999. The authors address three questions: 1) What impact do specific policy changes-relating to ownership and competition-have on sectoral performance? 2) How is the impact of change in any one policy affected by the implementation of the other, and by the overall regulatory framework? 3) Does the sequence in which reforms are implemented affect performance? The authors find that both privatization and competition lead to significant improvements in performance. But a comprehensive reform program, involving both policies and the support of an independent regulator, produced the largest gains-an 8 percent higher level of mainlines and a 21 percent higher level of productivity compared to years of partial and no reform. Interestingly, the sequence of reform matters: mainline penetration is lower if competition is introduced after privatization, rather than at the same time. The authors also find that autonomous factors, such as technological progress, have a strong influence on telecommunications performance, accounting for an increase of 5 percent a year in teledensity and 9 percent in productivity over the period 1985 to 1999.Trade Finance and Investment,Environmental Economics&Policies,ICT Policy and Strategies,Economic Theory&Research,Labor Policies,Environmental Economics&Policies,Economic Theory&Research,ICT Policy and Strategies,Health Economics&Finance,Education for the Knowledge Economy

Liberalizing basic telecommunications : the Asian experience

The authors examine the liberalization of the basic telecommunications sector in Asian countries with a view to identifying good policy and determining how multilateral negotiations can promote it. They find that most Asian governments, despite the move away from traditional public monopolies, are still unwilling to allow unrestricted entry, eliminate limits on private and foreign ownership, and establish strong, independent regulators. But where comprehensive reform has been undertaken-including privatization, competition, and regulation-the availability of main lines, the quality of service, and the productivity of labor are significantly higher. Somewhat surprisingly, little unilateral liberalization has occurred since the last round of telecommunications negotiations under the General Agreement on Trade in Services (GATS). The new round therefore faces the challenge of not merely harvesting unilateral liberalization, as in the past, but of negotiating away existing restrictions. Since quantitative restrictions on the number of telecommunications service suppliers are pervasive, deepened GATS rules could help ensure transparent and nondiscriminatory allocation of licenses. There may also be a need to sharpen the regulatory principles established in the last round and to create rules that safeguard not only the rights of foreign suppliers but also those of consumers.Decentralization,ICT Policy and Strategies,Environmental Economics&Policies,Economic Theory&Research,International Terrorism&Counterterrorism,ICT Policy and Strategies,Economic Theory&Research,Environmental Economics&Policies,Knowledge Economy,Education for the Knowledge Economy

Measuring services trade liberalization and its impact on economic growth : an illustration

The authors explain how the output growth effect from liberalizing the service sectors differs from the effect from liberalizing trade in goods. They also suggest using a policy-based rather than outcome-based measure of the openness of a country's service regime. They construct such openness measures for two key service sectors'basic telecommunications and financial services. Finally, the authors provide some econometric evidence--relatively strong for the financial sector and less strong, but nevertheless statistically significant, for the telecommunications sector--that openness in services influences long-run growth performance. Their estimates suggest that growth rates in countries with fully open telecommunications and financial services sectors are up to 1.5 percentage points higher than those in other countries.Environmental Economics&Policies,Payment Systems&Infrastructure,Trade Finance and Investment,Economic Theory&Research,ICT Policy and Strategies,Banks&Banking Reform,Economic Theory&Research,Environmental Economics&Policies,Governance Indicators,ICT Policy and Strategies

Liberalizing Basic Telecommunications: The Asian Experience

The liberalization of the basic telecommunications sector in Asian countries is examined in this paper with a view to identify the elements of good policy and examine how it can be promoted through multilateral negotiations. We find that despite the move away from traditional public monopolies, most Asian governments are still unwilling to allow unrestricted entry, eliminate limits on private and foreign ownership, and establish strong independent regulators. Where comprehensive reform including privatization, competition and regulation has been implemented, there are significantly higher levels of main line availability, service quality and labor productivity. Somewhat surprisingly, there has not been much unilateral liberalization since the last round of GATS telecommunications negotiations. The new round therefore faces the challenge of not merely harvesting unilateral liberalization as in the past, but of negotiating away existing restrictions. Furthermore, since quantitative restrictions on the number of suppliers are pervasive, deepened GATS rules could help ensure the transparent and non-discriminatory allocation of licenses. There may also be a need to sharpen the regulatory principles established in the last round, and to create rules that safeguard not only the rights of foreign suppliers but also those of consumers. In diesem Papier wird die Liberalisierung des Telekommunikationssektors in asiatischen Ländern mit dem Ziel untersucht, die Elemente guter Politik zu identifizieren und zu prüfen, wie diese Politik durch multilaterale Verhandlungen unterstützt werden kann. Trotz ihrer Abkehr von traditionellen staatlichen Monopolen sind die meisten asiatischen Regierungen weiterhin nicht geneigt, uneingeschränkten Marktzugang zu gewähren, Beschränkungen privaten und ausländischen Eigentums an Telekommunikationsunternehmen aufzuheben und starke unabhängige Regulierungsbehörden zu schaffen. Wir zeigen, dass dort, wo umfassende Reformen - Privatisierung, Wettbewerb und Regulierung - durchgeführt wurden, die Zahl der Anschlüsse, die Servicequalität und die Arbeitsproduktivität deutlich gestiegen sind. Etwas überraschend ist, dass es seit der letzten Runde der Telekommunikationsverhandlungen unter dem GATS (General Agreement on Trade in Services) kaum einseitige Liberalisierungen gegeben hat. Die neue Runde steht deshalb vor der Aufgabe, nicht nur - wie in der Vergangenheit - einseitige Liberalisierungen zu "ernten", sondern existierende Beschränkungen in Verhandlungen zu beseitigen. Da die Zahl der Anbieter regelmäßig begrenzt ist, könnten vertiefte GATS-Regeln überdies dazu beitragen, die transparente und nicht-diskriminierende Zuteilung von Lizenzen zu gewährleisten. Außerdem könnte es notwendig sein, die in der letzten Runde beschlossenen Regulierungsgrundsätze zu schärfen und Regeln festzulegen, die nicht nur die Rechte ausländischer Anbieter sondern auch die der Verbraucher sichern

Liberalizing Basic Telecommunications: The Asian Experience

The liberalization of the basic telecommunications sector in Asian countries is examined in this paper with a view to identify the elements of good policy and examine how it can be promoted through multilateral negotiations. We find that despite the move away from traditional public monopolies, most Asian governments are still unwilling to allow unrestricted entry, eliminate limits on private and foreign ownership, and establish strong independent regulators. Where comprehensive reform including privatization, competition and regulation has been implemented, there are significantly higher levels of main line availability, service quality and labor productivity. Somewhat surprisingly, there has not been much unilateral liberalization since the last round of GATS telecommunications negotiations. The new round therefore faces the challenge of not merely harvesting unilateral liberalization as in the past, but of negotiating away existing restrictions. Furthermore, since quantitative restrictions on the number of suppliers are pervasive, deepened GATS rules could help ensure the transparent and non-discriminatory allocation of licenses. There may also be a need to sharpen the regulatory principles established in the last round, and to create rules that safeguard not only the rights of foreign suppliers but also those of consumers. In diesem Papier wird die Liberalisierung des Telekommunikationssektors in asiatischen Ländern mit dem Ziel untersucht, die Elemente guter Politik zu identifizieren und zu prüfen, wie diese Politik durch multilaterale Verhandlungen unterstützt werden kann. Trotz ihrer Abkehr von traditionellen staatlichen Monopolen sind die meisten asiatischen Regierungen weiterhin nicht geneigt, uneingeschränkten Marktzugang zu gewähren, Beschränkungen privaten und ausländischen Eigentums an Telekommunikationsunternehmen aufzuheben und starke unabhängige Regulierungsbehörden zu schaffen. Wir zeigen, dass dort, wo umfassende Reformen - Privatisierung, Wettbewerb und Regulierung - durchgeführt wurden, die Zahl der Anschlüsse, die Servicequalität und die Arbeitsproduktivität deutlich gestiegen sind. Etwas überraschend ist, dass es seit der letzten Runde der Telekommunikationsverhandlungen unter dem GATS (General Agreement on Trade in Services) kaum einseitige Liberalisierungen gegeben hat. Die neue Runde steht deshalb vor der Aufgabe, nicht nur - wie in der Vergangenheit - einseitige Liberalisierungen zu "ernten", sondern existierende Beschränkungen in Verhandlungen zu beseitigen. Da die Zahl der Anbieter regelmäßig begrenzt ist, könnten vertiefte GATS-Regeln überdies dazu beitragen, die transparente und nicht-diskriminierende Zuteilung von Lizenzen zu gewährleisten. Außerdem könnte es notwendig sein, die in der letzten Runde beschlossenen Regulierungsgrundsätze zu schärfen und Regeln festzulegen, die nicht nur die Rechte ausländischer Anbieter sondern auch die der Verbraucher sichern.International Economic Order, Trade Negotiations, Market Liberalization, Services Trade, Telecommunication Services, International Relations/Trade, F02, F13, L96,