Presidential Proclamation -- World Trade Week, 2013

The White House

Office of the Press Secretary

WORLD TRADE WEEK, 2013

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BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

As a Nation, we need to do everything we can to create good, middle-class jobs right here in America. And one of the best ways we can do that is by boosting manufacturing and expanding trade that allows us to sell more of our goods and services all around the world. We have made important progress toward meeting that goal under our National Export Initiative, and we are taking historic steps to help our businesses access new markets abroad. But we cannot stop there. We need to keep making the investments in commerce and infrastructure that drive our economic growth and bring more Americans into a thriving middle class.

We can start by modernizing our roads, bridges, and ports. These upgrades would allow American companies to ship their goods faster and cheaper, and they would encourage businesses worldwide to set up shop here and bring more jobs to our shores. So earlier this year, I proposed the Partnership to Rebuild America -- a collaboration between the private and public sectors to break ground on our most pressing infrastructure projects.

In the past 4 years, we have focused on opening up growing markets for our businesses through historic trade agreements and enforcing trade rights so American workers can compete on a level playing field. To build on that progress, we are joining nations in Asia and the Americas to negotiate a new, high-standard trade agreement: the Trans-Pacific Partnership. Once realized, the deal would boost our exports, support American jobs, and help our companies succeed in the global marketplace. And to ramp up trade with Europe, we also plan to launch talks for a Transatlantic Trade and Investment Partnership with the European Union.

My Administration is committed to expanding international commerce that creates jobs and grows our economy. During World Trade Week, we recognize workers, growers, and entrepreneurs nationwide who share that ambition, and we rededicate ourselves to advancing it in the year ahead.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 19 through May 25, 2013, as World Trade Week. I encourage all Americans to observe this week with events, trade shows, and educational programs that celebrate and inform Americans about the benefits of trade to our Nation and the global economy.

IN WITNESS WHEREOF, I have hereunto set my hand this seventeenth day of May, in the year of our Lord two thousand thirteen, and of the Independence of the United States of America the two hundred and thirty-seventh.

BARACK OBAMA

Here’s a quick glimpse at what happened this week on WhiteHouse.gov.

The President and the Department of Defense are taking unprecedented steps to protect our environment, achieve significant cost savings, and give our military better energy options.

Today at the White House, we convened the 10th annual meeting of the President’s Interagency Task Force to Monitor and Combat Trafficking in Persons.

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United Nations Approves Arms Trade Treaty

The United Nations General Assembly voted on Tuesday morning to approve the final text of the world’s first treaty regulating the trade of arms between countries, despite pressure from the National Rifle Association to have the United States kill the measure.

In passing the Arms Trade Treaty (ATT) — with a vote of 154 in favor to 3 with 23 abstentions — the General Assembly has finally completed work that has gone on for years, including two rounds of strenuous negotiations, and two incomplete conferences. The latest attempt to pass the document via consensus was blocked at the last minute through the combined efforts of Iran, North Korea, and Syria. Following that setback, more than one hundred countries — including the United States — co-sponsored the ATT to move forward in the General Assembly, which is made up of all 193 members of the U.N., resulting in today’s vote.

The legal arms trade, comprised of both the import and export weapons, constitutes around $70 billion annually. Attack helicopters, tanks, and other larger arms are covered under the treaty, as well as small arms and ammunition for these weapons. Under the terms of the treaty, states are required to determine whether the shipment of arms to a second country would be used to commit atrocities or violate human rights or if they could diverted for such a purpose, and report back to the U.N. Secretariat on their efforts. Counter to the right-wing fear-mongering in the United States, primacy of national legislation is recognized in the treaty, forgoing any possibility of a government “gun grab.”

It’s not clear, however, that President Obama would sign the newly passed treaty right away or even in the next few months. In a conference call with reporters on Thursday, the principal U.S. negotiator of the ATT Thomas Countryman demurred:

COUNTRYMAN: For any treaty the United States carefully studies it. It’s looked at from all angles by many different agencies, and any statements of clarification about how we interpret the treaty or how we will implement it are prepared before the President is asked to give his signature. That takes, even for a treaty simpler than this one, usually a few months. I’m reluctant to give any specific timeframe. I can only say that as with any other treaty, it will get a careful review by every relevant agency of the U.S. Government before it goes to the President for signature.

That pledge of careful consideration hasn’t done anything to lessen NRA opposition. On Friday the NRA’s action wing referred to the ATT as an “undead” treaty and denigrated the American Bar Association’s conclusion that the ATT will not adversely affect gun-ownership in the United States.

The ATT is already facing heavy opposition in the U.S. Congress, including the efforts of Sen. Jerry Moran (R-KS) to pass a concurrent resolution to keep President Obama from signing the text. But given that Democrats hold the majority in Senate Foreign Relations Committee, however, it is unlikely Moran’s resolution will pass. Unfortunately, Sen. Jim Inhofe (R-OK) did manage toslip an item into the FY 2014 Budget that would create a fund to block implementation of the ATT.

Secretary of State John Kerry has released a statement praising the U.N.’s adoption of the ATT, preemptively countering arguments about its possible infringement on the Second Amendment:

By its own terms, this treaty applies only to international trade, and reaffirms the sovereign right of any State to regulate arms within its territory. As the United States has required from the outset of these negotiations, nothing in this treaty could ever infringe on the rights of American citizens under our domestic law or the Constitution, including the Second Amendment.

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U.S. struggles with pharmaceutical goals in Asia trade talks

* Drug companies, advocates at odds over goals for pact

* White House undecided on protection for biologic medicines

* U.S. won't make new proposal at next TPP round in May

WASHINGTON, March 28 (Reuters) - The United States is striving to find an appropriate balance in Asia-Pacific free trade talks between providing strong patent and data protections for U.S. drug manufacturers and ensuring poor people have access to medicine, a U.S. trade negotiator said on Thursday.

"We're looking to promote innovation and R&D (research and development) that results in the development of new medicines. But we are also - and this is just as important - we are trying to promote access to medicines for all," Deputy Assistant U.S. Trade Representative Probir Mehta said.

The remarks at a discussion organized by the Washington International Trade Association show the conflicting pressure on President Barack Obama's administration in talks on the Trans-Pacific Partnership (TPP), a proposed free trade agreement between the United States and ten countries in the Asia-Pacific region that negotiators hope to conclude this year.

Mehta said the United States would not make a new proposal on pharmaceuticals when TPP negotiators meet in Peru in mid-May for their 17th round of talks but would continue to exchange information on each country's policies "with a view to finding possible common ground."

U.S. drug manufacturers want the strongest possible intellectual property rights (IPR) protections in the pact, but advocacy groups such as Oxfam and Doctors Without Borders are warning TPP countries such as Vietnam and Malaysia that such terms threaten to raise the price of medicines in the region by restricting production of generic drugs.

Former U.S. Trade Representative Ron Kirk summarized the situation at a meeting of the President's Export Council shortly before he left office this month.

"It is very difficult to convince (other TPP countries) of the need to embrace, accept, and implement robust IPR chapters when, many times, we haves NGOs (non-governmental organizations) from here in the United States that are sitting there and giving them contrary information," Kirk said.

The tension is illustrated in the area of "biologic medicines," where U.S. drug companies such as Pfizer and Eli Lilly and many members of Congress want test data for new drugs protected for 12 years in the TPP pact to delay the development of generic versions.

Congress provided 12 years of data protection for biologics in Obama's healthcare reform legislation, the Affordable Care Act, in line with what many experts say is needed to recoup the average $1.2 billion cost of developing the drugs.

But in annual budgets, the White House has proposed lowering the period of data exclusivity to seven years to encourage faster development of generic versions of the drugs and to save billions in Medicare and Medicaid costs.

So far, U.S. negotiators have not asked for 12 years of data exclusivity for biologics in the TPP, prompting Senator Orrin Hatch, the top Republican on the Senate Finance Committee, to recently ask whether the Obama administration was trying to change U.S. law to the lower standard through the TPP talks.

On Thursday, Mehta said "biologic medicines are clearly the future of the biopharmaceutical industry and certainly a very important area of innovation in the United States. But at this point, we are still reflecting on input and discussing this issue with our trading partners."

Although that stance might seem encouraging for groups that favor early availability of generic medicines, Stephanie Burgos, a senior policy adviser at Oxfam America, said she fears the Obama administration is simply waiting until the end of the negotiation to press its demands, forcing poorer TPP countries such as Vietnam and Malaysia to decide whether to accept tough intellectual property provisions or walk away.

"Instead of a compromise, it's like 'let's put this on hold until everything else is agreed' in the hope that countries that are objecting to the provisions won't have the wherewithal to continue objecting," Burgos said.

Jay Taylor, vice president for international affairs at Pharmaceutical Research and Manufacturers of Americas, said generic versions of most drugs are already available in TPP countries and shouldn't be affected by the pact.

"The TPP, if done correctly, should reduce tariffs and extra additive costs to medicines that ultimately hurt patients," Taylor said.

By lifting incomes in the region, it also should make medicines relatively more affordable, he said.

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Doctors, Insurers Trade Blame on Out-of-Network Fees

Just over a year ago, Angel Gonzalez, 36, awoke with searing chest pain at 2 a.m. A friend drove him to the closest emergency room.

Though he was living on $18,000 a year as a graduate student, Mr. Gonzalez had good insurance and the hospital, St. Charles in Port Jefferson, N.Y., was in his network. But the surgeon who came in to remove Mr. Gonzalez's gallbladder that Sunday night was not.

He billed Mr. Gonzalez $30,000, and an assistant billed an additional $30,000. Mr. Gonzalez's policy covered out-of-network providers, but at a rate it considered appropriate: $2,000. "I was on the hook for more than I made in a year," Mr. Gonzalez said.

A health-insurance industry report to be released on Friday highlights the exorbitant fees charged by some doctors to out-of-network patients like Mr. Gonzalez. The report, by America's Health Insurance Plans, or AHIP, contrasts some of the highest bills charged by non-network providers in 30 states with Medicare rates for the same services. Some of the charges, the insurers assert, are 30, 40 or nearly 100 times greater than Medicare rates.

Insurers hope to spotlight a vexing problem that they say the Affordable Care Act does little to address. "When you're out of network, it's a blank check," said Karen Ignagni, president and chief executive of AHIP. "The consumer is vulnerable to 'anything goes.' "

"Unless we deal with cost, we won't have affordability," she added. "And unless we have affordability, we won't have people participating" under the Affordable Care Act.

Among the fees on the report's list are a $6,205 outpatient office visit to a doctor in Massachusetts for which Medicare would have paid $152; a $12,000 bill for examining a tissue specimen in New York for which Medicare would have paid $128; and a $48,983 surgeon's fee for a total hip replacement in New Jersey that Medicare would have reimbursed at $1,543. Many of the highest billers were in New York, Texas, Florida and New Jersey.

Elisabeth R. Benjamin, co-founder of the Health Care for All New York coalition, who is often at odds with the insurance industry, said that "is one area we totally agree on." She continued, "Out-of-network billing is just out of control."

Even when out-of-network fees are compared with average commercial insurance reimbursements, which are usually greater than Medicare, she said, "It's pretty outrageous."

Doctors say the report is skewed because it focuses on a few dozen cases of overcharging that are not representative of their billing. In response to the insurers' report, the American Medical Association noted on Thursday that a recent analysis found that doctors' services account for just 16 percent of health care costs.

"There are outliers in every profession, in every business," said Dr. Andrew Y. Kleinman, a plastic surgeon who is vice president of the Medical Society of the State of New York.

Dr. Kleinman also noted that insurers had effectively shifted the costs of out-of-network care onto patients by changing reimbursement formulas. Instead of the rates commercial insurers usually pay doctors, insurers increasingly are basing their out-of-network payments on Medicare rates, usually far lower.

A growing number of high-end, flexible health plans offer policies that cover outside providers at, for example, 140 percent of Medicare. "They're selling you an insurance product you can't use," Dr. Kleinman said. "You're buying an insurance policy where the out-of-network benefit is worthless."

The industry's own report suggests that using Medicare rates as a benchmark will lead to patients' picking up much more of the cost for out-of-network care, whether they carefully select a specialist or, as in the case of Mr. Gonzalez and many others, have no choice in the matter.

Had Mr. Gonzalez been 65 or older, Medicare would have paid only $958 for the surgery. The average commercial price is $12,292, according to FAIR Health, an independent nonprofit group that tracks information on health care costs.

But Mr. Gonzalez's health plan, United Healthcare, determined the fee should be $1,273, of which the company paid $838. Mr. Gonzalez filed appeals, which were rejected. He then contacted Community Health Advocates at the Community Service Society of New York for help, and the group's caseworkers negotiated with the surgeon on his behalf.

After months of wrangling, the surgeon agreed to accept a significantly reduced payment: $340.

Consumer advocates and health insurance executives are calling for greater transparency in health care pricing, including upfront disclosure of prices of medical procedures and services.

"The health care industry can give you an estimate, just like any other industry," said Carrie H. Colla, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice, noting that the Dartmouth-Hitchcock Medical Center has a patient price estimator online.

"It's just not current practice right now," Dr. Colla said. "Sometimes a doctor won't even know. The patient really has to push for it."

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U.S.-Colombia Trade Promotion Agreement Now in Force

Ed note: This was originally published on tradeology, the official blog of the International Trade Administration

Today more than 80 percent of U.S. exports of consumer and industrial products to Colombia become duty-free as part of the U.S. – Colombia Trade Promotion Agreement. This includes agricultural and construction equipment, building products, aircraft and parts, fertilizers, information technology equipment, medical scientific equipment, and wood. Also, more than half of U.S. exports of agricultural commodities to Colombia become duty-free, including wheat, barley, soybeans, high-quality beef, bacon, and almost all fruit and vegetable products.

The agreement also provides significant new access to Colombia’s $180 billion services market, supporting increased opportunities for U.S. service providers. For example, Colombia agreed to eliminate measures that prevented firms from hiring U.S. professionals, and to phase-out market restrictions in cable television.

Prior to the enactment of this agreement, the average tariff that U.S. manufactured goods faced entering Colombia was 10.8 percent. With entry into force today, Colombia’s average tariff rate for manufactured goods from the United States has been reduced to 4 percent.

The impact of the tariff reductions of U.S. exports to Colombia will be immediate for many products; including recreational vehicles, like motorcycles and pleasure boats (Colombia’s average tariff on U.S. exports will be reduced from 13.7 percent to 5.4 percent today) and agricultural equipment, like tractors and harvesters (Colombia’s average tariff will be reduced from 10.8 percent to 3.1 percent today). This will make U.S. manufactured products much more competitive and could also potentially boost sales.

The economies of the United States and Colombia are largely complementary in terms of the goods each exports to the other. For example, Colombia is a large importer of grains from the United States while it exports a number of tropical fruits to our country. In addition, U.S. cotton, yarn and fabric exports to Colombia are used in many apparel items that Colombia exports to the United States.

The provisions of the agreement and the resulting tariff cuts present new opportunities for U.S. companies and give U.S. exporters an advantage over exporters from Colombia’s non-FTA partners. The International Trade Administration maintains a database that helps exporters monitor when tariffs on specific products go to zero. The FTA Tariff Tool currently has information relating to manufactured products.

Christopher Blaha is a Senior International within the Office of Trade and Policy Analysis and Julie Anglin is the Colombia Desk Officer within the International Trade Administration.

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