http://www.citizen.org/documents/Preside ntialWTOreport.pdf

"Many policymakers remain unaware of the WTO's expansive limits on domestic policy space and the
changes that must be made to existing WTO rules to implement their most prominent policy proposals.
Over the past dozen years, U.S. policymakers continue to express surprise when domestic non-trade
policies - including recently the U.S. ban on Internet gambling and in the past various environmental
policies - have been ruled to be WTO violations. In part, this lack of awareness stems from the way inwhich the WTO was initially approved. As newspaper reports indicated when a bipartisan coalition
approved U.S. membership in the WTO by wide margins in 1994 during a lame-duck session, hardly a
single member of Congress even read the 800-plus pages of WTO text.7
For this report, we reviewed the health care and climate change proposals of Sens. Hillary Clinton (DN.
Y.), John McCain (R-Ariz.), and Barack Obama (D-Ill.) - the three principal presidential candidates.
Our methodology was simple: we analyzed proposals outlined in documents on the candidates'
campaign websites, specifically in the issue-specific sections on health care and the environment. In
general, the two Democrats had very detailed proposals in both areas, while the Republican did not.
Our report thus unavoidably dedicates more page space to analysis of the Democratic plans. However,
we make no recommendations on what health care or climate proposals should be pursued by the
candidates, nor take any positions in support of or opposition to any candidate.
Candidates committed to ensuring their proposals become policy must address these WTO problems.
Among the needed changes is the withdrawal of certain key health- and environment-related sectors
from WTO coverage. Redressing WTO limits on U.S. health care policy space could not be more
urgent. Currently there are very few foreign insurance firms or health care providers in the U.S.
market, thus a withdrawal of existing U.S. GATS commitments in this area - which requires
compensation under WTO rules - will be less costly now than when there are more foreign firms
operating here in the future. Additionally, specific provisions of WTO agreements that limit domestic
policy space and flexibility regarding non-trade policies must be modified. And, elements of U.S.
offers to commit new policy space to WTO jurisdiction in the WTO Doha Round negotiations that
would impose new limits on non-trade policies must also be withdrawn. Finally, while not a central
focus of the report, we also identify as requiring renegotiation the North American Free Trade
Agreement (NAFTA) and other "Free Trade Agreement" (FTA) foreign investor rules that empower
companies to directly sue governments in foreign tribunals for taxpayer-funded compensation if health,
environmental or other domestic policies interfere with their future expected profits.
CHANGES TO EXISTING WTO RULES ARE NECESSARY TO IMPLEMENT
CANDIDATES' HEALTH CARE PROPOSALS
The WTO, which became operational in 1995, administers 17 different agreements, a minority of
which actually have to do with traditional trade issues like tariffs and quotas. For the purpose of
analyzing the candidates' health care proposals, the most important of the WTO agreements is the
General Agreement on Trade in Services (GATS).8 Because the demand in the late 1980s by U.S.
government and industry to include the service sector of the economy in a trade agreement was so
controversial around the globe,9 GATS is structured as a "bottom-up" agreement. This means that the
agreement applies only to the service sectors each nation volunteered to bind (or "commit" in WTO
parlance) to the obligations and constraints set forth in the GATS text.
In 1994, the United States committed almost 100 service sectors - such as banking, insurance,
telecommunications, construction and gambling - to GATS constraints with little public discussion,
congressional debate, or understanding.10 U.S. GATS commitments include (and thus constrain) many
health services, including: (see above URL)

and I am aghast that you might say something like that.

but if we do get it, it will be from congress.  Look for Kennedy and Clinton to take the lead.