HEALTH SERVICES AS SERVICES SUPPLIED IN THE EXERCISE OF GOVERNMENTAL AUTHORITY UNDER GATS ARTICLE I:3(C): LEGAL DESIGN CHOICES FOR UZBEKISTAN BASED ON COMPARATIVE LEGISLATIVE EXPERIENCE

Abstract

This article analyses how Uzbekistan can structure its health system so that a clearly defined core package of health services qualifies as “services supplied in the exercise of governmental authority” under GATS Article I:3(c). Since this provision applies only to services supplied neither on a commercial basis nor in competition, the legal status of health services depends primarily on domestic legislative and institutional design rather than on ownership alone. Focusing on Uzbekistan’s ongoing health reforms and WTO accession ambitions, the article proposes concrete statutory design choices, including the establishment of a State-Guaranteed Health Services regime, a strict free-entitlement rule, public-mandate contracting with regulated tariffs, and legally enforceable separation between guaranteed and paid services. Drawing on comparative experience from the United Kingdom, the European Union, Thailand, and Estonia, it argues that embedding these techniques in national law can preserve policy space for core public health services while ensuring their defensibility under GATS Article I:3(c).