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GST ON HEALTH CARE – NOT TRULY EXEMPT

Dr. Sanjiv Agarwal
Debate on GST Impact: Health Care Services Exempt, but Essential Medical Devices Taxed at 5% Under Notification No. 9/2017. Health care services are exempt from GST under Notification No. 9/2017, covering services by clinical establishments and medical practitioners. However, medicines and medical devices like stents and implants are taxed at varying rates. Implants, crucial for health care, are taxed at 5%, equating them with aids like wheelchairs. Critics argue these essential items should be exempt, as they aren't luxury goods. Some believe taxing these items at 5% allows suppliers to claim input tax credits, preventing increased costs and supporting domestic manufacturing. The debate highlights differing views on how GST impacts health care and disability aids. (AI Summary)

Health care services have been specifically kept out ride the scope of GST net. This  is a fact and a perception too. These include services provided by medical establishments, clinics, medical practitioners, diagnostic centers etc.

The exemption has been provided vide the following entry No. 77 in Notification No. 9/2017-intergrated tax (Rate) dated 28.06.2017 .

'77 Services by way of health care services by a clinical establishment, an authorised medical practitioner or para-medics.'

However, medicines sold by pharmacy are subject to GST at varied rates and so are items like stents, implants etc taxed.

The general rate of medicines etc, inter alia is covered under the following classification:

Chapter No.

Items

Rate

30

Drugs or medicines including their salts and esters and diagnostic test kits, specified in List 3 or List 4 appended to the Notification No.12/2012- Customs, dated the 17th March, 2012

5%

98

9804 Specified drugs and medicines [i.e. List, 1 of Notification No. 12 / 2012-Central Excise, dated 17.03.2012 and List 3, 4 of notification No.12/2012- Customs, dated 17.03.2012] intended for personal use.

5%

98

9804 Other drugs and medicines intended for personal use.

12%

The Government has however, also taxed implants such as artificial limbs which is a necessary and integral part of health care services in relation to loss of limbs. Such artificial limb is recommended as a post health care to restore life  or to at least provide a workable living means so that one is not left to miseries. The GST shall be levied @ 5 percent (2.5% CGST + 2.5% SGST) or 5 percent IGST alongwith other items such as tricycle, wheel chair, walking aid etc. It is an irony that artificial limb has been equated to such equipments, though others are just aids. On the contrary, artificial limb is fitted to a body part.

The rates of GST on implants is @ 5% as per following classification:

  1. Coronary stents and coronary stent systems for use with cardiac catheters.
  2. Artificial kidney
  3. Disposable sterilized dialyzer or micro-barrier of artificial kidney
  4. Parts of the following goods, namely:-
  1. Crutches;
  2. Wheel chairs;
  3. Walking frames;
  4. Tricycles;
  5. Braillers; and
  6. Artificial limbs

Shockingly, all there items have been taxed but deserve to have been exempt fully. These are not luxury or cosmetic items meant for human consumption. Moreover, a large number of non-profit organizations are engaged in free or concessional supply of such goods.

There could be an argument that many big or corporate hospitals are also engaged in such supplies and charge a huge amount for this. But then, if we can tax hotels and restaurants at different tax rates based on categories on the basis of 'ability to pay', who stops the Government from adopting the same formula here. Tax big hospitals but spare such supplies generally. Tax officers, also human beings, must understand this and act upon. They are too answerable, atleast to God.  

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