ASEAN Economic Community (AEC)

and Healthcare Services

Tan Tai Hiong ASEAN Secretariat

PIT VIII & MUKERNAS PDUI

Sheraton Gandaria City Hotel
Jakarta, 7 April 2017
 About ASEAN

Lao PDR ASEAN Collectively as a Group:

Total Land Area = 4.49m km2
(7th largest in the world)

Viet Nam
Myanmar Total Population = 629m (2015)
Philippines
(3rd most populous in the world)

Cambodia Total GDP = US$ 2.43t (2015)

Thailand
(6th biggest economy in the world)
Brunei Darussalam
Malaysia
Source: ASEANStats

Singapore Indonesia

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Historical Milestones of ASEAN Economic Community (AEC)
2003:
1967: Bali Concord II: 2008: 2016-2025:
Birth of ASEAN ASEAN AEC Blueprint
ASEAN Community Charter 2025

1997: 2007: 2015:

ASEAN Vision AEC Blueprint Formal Establishment
2020 & Acceleration of ASEAN Community
of AEC 2015 incl. the AEC

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 Key Achievements of AEC 2015 (1 of 2)

1. More Liberalised Market and Reduced Trade Costs

Most tariff lines at zero duty (99.2% for ASEAN-6 and 90.9% for CLMV) and trade facilitation
measures (Customs Procedures, Rules of Origin, Non-Tariff Measures, Standards, SPS)
Significant liberalisation of most services sectors through 9 packages of commitments

2. Enhanced Mobility of Skilled People

Eight MRAs have been concluded: engineering, nursing, architectural services, surveying,
medical practitioners, dental practitioners, accountancy, and tourism professionals.

3. Improved Investment Regimes and Business-enabling Environment

ASEAN Comprehensive Investment Agreement (ACIA) provides for liberalisation, facilitation,
promotion, and protection of cross-border investment.
Legal frameworks, standards and cooperation initiatives in various areas such as
agriculture, finance, competition policy, consumer protection, and intellectual property.

4. Improvements in Infrastructures and Connectivity

Establishment of ASEAN Open Skies, ASEAN Highway & Railway Network links
Transport facilitation initiatives: goods in transit, inter-state transport, multimodal transport

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 Key Achievements of AEC 2015 (2 of 2)

5. More Equitable Economic Development

Projects under the Initiative for ASEAN Integration (IAI) Work Plan to assist CLMV countries
Initiatives for development of Small and Medium Enterprises (SMEs)

6. Better integration into the global economy

Free trade and comprehensive economic partnership agreements with 6 partners: China,
Japan, Korea, Australia-New Zealand, and India
Regular dialogues and on-going cooperation initiatives with EU, US, Canada, Russia.
On-going RCEP negotiation and ASEAN-Hong Kong FTA in 2016
Reviews/upgrades to the existing FTAs

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AEC Blueprint 2025
Provides for objectives and strategic measures
of each element of AEC 2025

Adopted by ASEAN Leaders at the 27th ASEAN

Summit (22 Nov 2015, Kuala Lumpur)
Part of ASEAN 2025: Forging Ahead
Together which provides for ASEAN
Community Vision 2025 and the Blueprints
towards ASEAN 2025 across 3 pillars of
ASEAN Political-Security Community
(APSC), ASEAN Economic Community
(AEC), and ASEAN Socio-Cultural
Community (ASCC).

Builds upon AEC Blueprint 2015

With immediate priority to complete the
unfinished implementation measures
New emphasis on MSMEs, evolving digital
technology, good governance, and green
technology

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 Characteristics of AEC 2015 and AEC 2025

AEC 2025
AEC 2015 (2016-2025)
(2008-2015)
Highly Integrated and
Single Market and Cohesive Economy
Production Base Competitive, Innovative
Competitive Economic and Dynamic
Region Enhanced Connectivity
Equitable Economic and Sectoral Cooperation
Development Resilient, Inclusive and
Integration into the Global People-Oriented, People-
Economy Centred ASEAN
Global ASEAN

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 Elements of AEC Blueprint 2025
Resilient, Inclusive,
Competitive, Enhanced
Highly Integrated & People-Oriented & Global ASEAN
Innovative & Dynamic Connectivity &
Cohesive Economy People-Centered
ASEAN Sectoral Cooperation
ASEAN
Trade in Goods Effective Competition Transport Strengthening the Strategic approach
Trade in Services Policy ICT Role of MSMEs towards external
Investment Consumer Protection E-commerce Strengthening the economic relations
Environment Strengthening IPR Energy Role of the Private Review and improve
Financial Integration, Cooperation Sector existing ASEAN
Food, Agriculture,
Financial Inclusion, Productivity-Driven Public-Private FTAs and CEPs
and Forestry
and Financial Growth, Innovation, Partnership Enhance economic
Tourism
Stability R&D, Technology Narrowing the partnerships with
Healthcare non-FTA DPs
Facilitating Commercialisation Development Gap
Minerals Engage with regional
Movement of Skilled Taxation Cooperation Contribution of
Labour & Business Science Stakeholders on and global partners
Good Governance
Visitors &Technology Regional Integration Support to the
Effective, Efficient,
Enhancing Coherent and multilateral trading
Participation in Responsive system
GVCs Regulations, and Engagements with
Good Regulatory regional and global
Practice institutions
Sustainable
Economic
Development
Global Megatrends
and Emerging Trade-
related Issues

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 Healthcare in AEC 2015

AEC 2015 deals with healthcare as part of:

Liberalisation of trade in services through the ASEAN Framework Agreement on Services
(AFAS);
Mutual recognition of qualifications of healthcare professionals through the Mutual
Recognition Arrangement (MRA)
Other areas of regional initiatives in healthcare are undertaken under the ASEAN Socio-
Cultural Community (ASCC) Pillar
Liberalisation of trade in services seeks to reduce or eliminate restrictions in Market Access
(MA) and National Treatment (NT) in the services sectors:
MA deals with restrictions to provide service in a foreign market
NT deals with discriminatory treatment to foreign service suppliers vs. local service suppliers
Mutual Recognition Arrangement (MRA) deals with mutual recognition of the qualifications of
the professionals between countries according to the rules set in the MRA.
MRA is not about market access: it is not for unrestricted flow of foreign professionals.
MRA addresses unnecessary repeat of procedures for assessment of qualifications for
qualified professionals. Relevant domestic regulations still applies
MRA is also part of initiatives under a services agreement such as the AFAS

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 AFAS Liberalisation of Healthcare Services

Under the ASEAN Framework Agreement on Services (AFAS), all ASEAN Member States (AMS)
are required to liberalise services across all sectors and modes of supply
All AMS have made commitments in healthcare services in the latest 9th AFAS Package and
will need to continue improving it for the 10th AFAS Package (ultimate target of AEC 2015)
5 subsectors of healthcare services out of 155 subsectors of the universe of services sectors
Hospital Services (CPC 9311), Medical & Dental Services (CPC 9312), Other Human Health
Services (CPC 9319), Services provided by midwives, nurses, physiotherapists and para-
medical personnel (CPC 93191), and Veterinary Services (CPC 932)
The 4 modes of supply in international trade in services are as follows:
Mode 1 (Cross-border Supply): supply of service from the territory of one country into another
country (e.g. tele-diagnosis of a patient in Bangkok by a doctor in the US)
Mode 2 (Consumption Abroad): supply of service in the territory of a country to a consumer of
another country (e.g. A Malaysian patient gets treatment at Mt.Elizabeth hospital in Singapore)
Mode 3 (Commercial Presence): supply of a services through commercial presence of a
service supplier in the territory of another country (e.g. a Korean clinic opens in Manila)
Mode 4 (Presence of Natural Persons): supply of service through the presence of natural
persons from one country in the territory of another country (e.g. and Indonesian medical
doctor provides surgery practice in Brunei)

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 Mutual Recognition Arrangement (MRA)

3 MRAs related to healthcare have been signed in ASEAN: Nursing (Dec 2006), Medical
Practitioner (Feb 2009) and Dental Practitioner (Feb 2009)
Foreign practitioner may apply for registration in host country subject to these conditions:
Possess professional qualification recognised by authorities of country of origin
Valid professional registration and current practicing certificate/license in country of origin
Has been in active practice for at least 3 years (Nursing) or 5 years (Medical and Dental)
In compliance with CPD at satisfactory level
Certified of not having violated any professional or ethical standards
Has declared that there is no pending investigation or legal proceeding
In compliance with other requirements as may be imposed by host country
3 ASEAN Joint Coordinating Committees (AJCCs) for the 3 MRAs have been established
since 2007 (AJCCN) and 2009 (AJCCM and AJCCD) to implement the MRAs:
Exchange and publish info on domestic regulations, esp. on procedures for practice
Identify core competencies and common curriculum
Identify and undertake exchange programs
Explore mechanisms to facilitate greater mobility of ASEAN health professionals
Currently in process for setting up secretariat and a comprehensive website (Indonesia)

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 AEC 2025:
ASEAN Trade in Services Agreement (ATISA) and Healthcare

Trade in Services
The next agenda of the AEC 2025 is to facilitate the negotiations and implementation of the
ASEAN Trade in Services Agreement (ATISA) for further integration of services in ASEAN.
Builds-upon and enhances existing ASEAN services agreements incl. AFAS & ASEANs FTAs
Forward looking and considers best practices as well as new trade in services topics
ASEAN Economic Ministers (AEM) had agreed to prioritise completion of negotiations for
ATISA and the transition to negative list approach within 2017

Healthcare
Unlike AEC 2015, Healthcare is included as a section of the AEC 2025 Blueprint
ASEAN will continue to promote the development of a strong healthcare industry that will
contribute to better healthcare facilities, products and services to meet the growing demand for
affordable and quality healthcare in the region:
Continue opening up of private healthcare market and Public-Private Partnership (PPP)
investments in provision of universal healthcare in the region
Further harmonisation of standards and conformance in healthcare products and services
Promote sectors with high-growth potential such as health tourism and e-healthcare services
Further facilitate the mobility of healthcare professionals in the region

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 Thank you

services@asean.org

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