dumping

The WTO defines "dumping" as "exporting a product at a price lower than the price it normally charges on its home market", and outlines "anti-dumping" agreements, where governments are constrained on how they "can or cannot react to dumping" - note that the nation upon which the products are dumped are the ones constrained, not the home country of the dumping company.

On a purely economic basis, this dumping (also described in the node of that name) seems quite beneficial to the target country, as they're getting goods at a cheaper price than in the company's home market. And we all want cheaper stuff, right? So why are anti-globalization protesters pushing for tougher anti-dumping laws?

There's a popular tactic called predatory pricing, where a company will dump huge stocks of cheap products on a particular country at prices below the cost of production (often at a loss), driving local competitors out of business. Once the company gains a monopoly (or at least major market share), it's free to jack up prices again, secure in a captive market. Ever wonder how Coca-cola and Pepsi manage to take over local beverage industries all over the world?

This is especially damaging in the case of Third World agricultural operations driven out of business by large grain deliveries (ironic, since many of these enter the country as food aid). Good governments will make sure local food suppliers are not destroyed, and will keep their countries from growing wholly dependent on food imports.

Another, more insidious form of dumping is the shipping of banned chemicals over the border in order to dispose of huge stocks of unsellable merchandise. When DDT was banned in the US in the 60's and 70's, Third World countries suddenly received a lot of cheap pesticide, courtesy of Bayer. DDT is still in use in some parts of India and the Philippines, despite its harmful effects on both humans and the environment. These days, Chlordane and Malathion are still widely available.

Every time the FDA issues warnings or bans another drug, you can bet we'll get several "new and improved!" formulations over here. Phenylpropanolamine-based cough medicine is still being sold over the counter, but some large multinationals have quietly taken it out of their in-house pharmacies (for their employees' protection, of course).

The recent furor over genetically-modified food merely meant that Monsanto's test farms moved out to relatively media-shielded sites, such as the Southern Philippines. Of course, this is also a prime test market, especially with all these people unable to afford GMO test kits (and generally, too poor to care).

Isoprophyl alcohol, despite having been banned for antiseptic use in 2000 by the local Bureau of Food and Drugs, is still being heavily marketed by Johnson & Johnson, as "Band-Aid" brand rubbing alcohol. Since it is an industrial cleaning agent, FDA safety standards call for keeping it away from eyes, skin and clothing, but in the Philippines, you see TV ads where this product is being used on babies. A rival local alcohol manufacturer (who sells the safer ethyl alcohol), backed by the local medical associations, has run several ads calling for enforcement of the ban, but as usual, superior amounts of money and lawyers can defeat any cause.

In health care, dumping is the practice of taking a very ill uninsured patient out of a private hospital on some pretense and moving that patient to a public hospital in order to avoid paying for the cost of said patient's treatment.

When a person suffers a serious injury or illness and an ambulance is summoned, the paramedics will treat and transport to the nearest hospital capable fo dealing with the condition. Under American law, no hospital may refuse to treat a patient simply because they are uninsured. As of this writing, we don't just let people die. If a patient shows up at an emergency room suffering from a heart attack, they'll be treated. Naturally, such care is very expensive and as American hospitals are expected to turn a profit, treating such cases interferes with the profit motive. During the 1980s it became common for a private hospital to take such a patient, treat them to the least extent possible, put them in another ambulance and then dump them outside a public hospital, which would then be forced to bear the entirety of the patient's treatment, including any surgery, cardiac catheterization, and other expensive procedures. In the late 1980s after a report on 60 Minutes the law was changed so that no hospital could engage in such flagrant dumping. As emergencies are dispersed geographically, so to the cost of emergency care would also be dispersed between facilities.

Nevertheless dumping continues. Patients can be transferred to another hospital if said patient requires specific care available only at the larger hospital. Say in-house dialysis (very common among drug users) or neurological care. If a patient needs dialysis regularly then the transfer can be sent, even though the receiving hospital will have to bear the lion's share of the costs. The general standard is that the patient needs to be stable before transfer- temperature and blood pressure under control, bleeding controlled and pain and other initial medications provided. There also has to be a real medical need for the move, and clear communication with the admitting physician. This reduces the amount of dumping, but it still occurs.

Who pays for these people

Hospitals anticipate that they will receive a certain number of uninsured patients, and try to recover these costs by boosting their overall cost structure. They compete for profitable work to offset these losses, one reason why maternity rooms that were shared in the 1990s are now almost all private suites with HDTVs. The result tends to be higher overall healthy care costs. Private hospitals have it somewhat easier. They tend to be located in more prosperous parts of town, where insurance coverage is higher. Remember that ambulance deliveries are geographic in nature, so uninsured patients tend to go to hospitals located in the less prosperous parts of town, meaning public hospitals. The additional cost burden that comes with serving poor and indigent populations tends to fall predominantly on public hospitals, and hospitals located in poorer areas have been known to close for economic reasons, even though there is a clear need for health care in the community. Where I live in Columbus, Ohio, South Hospital closed for that very reason. Hospitals operating in poorer parts of town tend to be smaller, and are branches of larger facilities located in more prosperous (and profitable) areas.