“While GST has simplified India’s indirect tax system, critically assess how effectively it balances the economic objectives of revenue generation with public health goals in India.”
According to a report by the WHO and UNICEF, nearly 60% of India’s population still lacks access to basic healthcare services, partly due to high out-of-pocket expenses, which are compounded by the indirect tax burden. Thus, the task remains to balance economic objectives with the nation’s public health priorities to ensure that GST serves both economic growth and the health of its citizens.
Role of GST in balancing public health goals:
POSITIVE ROLE:
- Revenue Generation for Public Health Programs:
GST has significantly increased tax revenue, which can be allocated to public health initiatives and welfare programs.Example: Increased tax revenue allows for potential funding of national health schemes like Ayushman Bharat. - Simplification of Tax Structure:
GST eliminates cascading taxes, making the economy more efficient, which can indirectly boost health-related sectors by improving economic stability. Example: Healthcare sectors may benefit from a more predictable tax regime that encourages investment and growth. - Encouragement of Formal Economy Participation:
GST promotes formalization of sectors, leading to better compliance and greater transparency in industries related to health, such as pharmaceuticals and healthcare services. Example: More businesses in the healthcare supply chain are now tax-compliant, improving access to certified products. - Increased Focus on Essential Goods:
The lower GST rate on essential goods (5% on medicines, for instance) helps improve access to healthcare products, especially for low-income households.
Example: Generic medicines are taxed at a lower rate, making them more affordable for the masses.
NEGATIVE ROLE:
- Higher Tax Rates on Health-Related Goods:
Despite the focus on essentials, certain health-related products, such as diagnostic equipment, prosthetics, and health insurance premiums, continue to face high GST rates. Example: Health insurance premiums are taxed at 18%, making it less affordable for the general population, particularly for the economically vulnerable. - Potential Burden on Low-Income Groups:
GST is a regressive tax, impacting low-income and vulnerable populations more heavily, as they spend a higher proportion of their income on taxed goods like medicines and basic food items. Example: Non-luxury food items and nutritional supplements face GST, raising costs for poorer families who depend on them for basic nutrition. - Increased Costs for Healthcare Services:
GST on healthcare services may increase the overall cost of treatment, making healthcare less accessible for low-income groups. Example: Some outpatient and diagnostic services now carry GST, which adds to the financial burden on the patient. - Limited Health-Specific Tax Relief:
While certain healthcare goods and services are taxed at lower rates, there is limited scope for broader tax relief or exemptions for health-promoting products.
Example: Products like smoking cessation aids, which are essential for public health, are taxed, thus discouraging their use and hindering public health campaigns. - Disproportionate Focus on Economic Growth:
GST’s primary focus is economic efficiency and growth, and there is little emphasis on health-centric reforms that could directly address health disparities.
Example: While GST revenue has been directed towards infrastructure, health priorities such as disease prevention and education receive minimal funding from this source.
While GST has contributed to economic efficiency and revenue generation, its negative impact on public health goals—such as affordability, access to healthcare, and targeting health disparities—highlights the need for a more balanced approach, integrating health-focused exemptions and targeted policy interventions.