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Friday, December 27, 2013

Will GST prick our health?

| December 27, 2013

Dr S Subramaniam must make clear what comes under the ambit of the health sector since it is GST-exempted. He seem clueless on the issue but is there a bigger hidden agenda?

Controversial issues surrounding the Goods and Services Tax (GST) is becoming the highlight of the media in and around the country. Now, that comes as no surprise since we got cartoons from the government trying their very best in explaining in simple terms what this ‘alien GST’ is all about.

The entire fiasco started when Najib Tun Razak unveiled the confirmed date for the implementation of GST during the tabling of the 2014 Budget.

In a quickie, he rattled the various GST-exempted goods and services. As usual, Najib loves to play games in the dark and that is exactly what he did in announcing the GST.

He instantaneously left many baffled from the industry in what to expect with the GST in place. He did his waltz in parliament and left the audience gazing in stars for more in-depth explanations; which was definitely not forthcoming from him.

It was just disgusting and appalling to witness the country’s premier more engrossed in justifying the GST-free ‘cencaluk’, ‘budu’ and ‘belacan’ while conveniently ignoring the intricacies and complexities engulfing the entire GST proposal.

Let us just magnify the idiosyncrasy exhibited in announcing that the health industry will be exempted from GST. Does he even have the inkling of what encompasses under the word “health”?

Was he not briefed by the Health Minister on the definition of the word and the repercussion when with a single slash Najib exempted the health industry from GST?

And now you have Health Minister Dr S Subramaniam scrambling and fumbling with the correct words to justify as to how the exemption will be affected on the health sector.

There is no shadow of doubt that the entire Barisan Nasional cabinet has doctorates in “flipology” looking at how the health minister in a turnaround manner changed his statement from “no impact” to “minimizing” the consequences of GST towards healthcare in Malaysia.

For Najib, by removing the sugar subsidy, he has solved the problem of the 2.8 million diabetics in the nation. Now all co-morbidities and mortality rates associated with diabetes will save him more money to channel to his cronies. How simplistic!

Subra being a medical doctor himself has shown signs of rust on his degree. Why cannot he be clear and precise as to what and which category constitutes as being GST-free under the ‘health sector’?

He is obliged to define the sector in the Malaysian context as we are fond to associate almost any activity as health related.

Is this list complete?

Though accepted that it is not a piece of cake to maneuver the health sector in any community worldwide, don’t we have very highly paid unproductive consultants sitting on the various government formed agencies who should easily list out the exempted items.

As a consequence of the ambiguity that has surfaced, ordinary citizens now wonder if the following are GST exempted in the health sector (goods and services):
  • Essential drugs and medications and will there be any annual capping on the value consumed
  • Medical equipment for rehabilitation or treatments like wheelchairs, nebulizers, orthopedic related supports like knee-guards, neck support ext., dental and optical accessories and necessities
  • Doctors and other health providers’ fees/charges
  • Nursing services, in-house or outdoor
  • Counseling fees for psychologists/psychiatrists
  • Message and reflexology centers
  • Medical/pathology laboratories’ services and products
  • Over the counter products like baby milk, teats, bottles, sterilizing tablets, pampers, toothpaste, toothbrush, non-poison cough and cold remedies, balms, local anti-inflammatory rubs/gels/ointments, medicated shampoos, herbal shampoos
  • The various supplements, be it artificially produced or natural based like vitamins and minerals, fish oil, evening primrose oil ext.
  • Organic fish, chicken, eggs, vegetables, cholesterol-free dairy products
  • Centers providing Ayurvedic, Chinese, Indian and Malay traditional medicines/services like acupuncture, meditation, ‘bomoh’ services; since they are now considered as complementary medicine and accredited even in government hospitals
  • Specialized foot wear, eye wear for medical reasons
  • Sun tan lotions, insect repellents, anti-wrinkle creams, anti-aging products and alike
  • Disposables like gloves, insulin syringes, finger cots, tongue depressors, wound dressings, antiseptic creams/ointments
  • Tinted windscreens on private vehicles for dermatological or optical reasons
  • All supplies made to health related institutions like private clinics, medical centers, private hospitals, pharmacies, Chinese medicine shops
The list above is definitely not exhaustive but there are legal consequences in defining them to clear any dispute when business transactions are done within a facility which can legally be classified under the “health sector”.

The minister must get down to work immediately and not wrestle with the media on how the GST will impact the health industry.

The health industry is very complex and can often fail to demarcate articles and services from being classified as completely health related, partially or remotely. There is just no room for errors here because there are legal repercussions in the event disputes are brought to court to challenge a particular charge.

Cunning plot

It may not be much of an issue with government-run health institutions as Najib has declared all government services are exempted from GST; but then will it be fair to impose (if any) GST on the same or similar product or services acquired from the private sector?

If this is done, the government better be ready to see bigger crowds in their hospitals and clinics and further burden the genuine tax payers.

Or does the government intend to further privatize most of its health services to its cronies in time to come? There is strong inclination indicating such indeed.

Najib and Subra may well be cunningly plotting to push healthcare burden to the public in the silent.

Their non-committal stances will only rife speculations that they are in cahoots with some rich crony conglomerates in formulating a punishing National Healthcare System Blueprint in Malaysia.

Again, the rich will get richer and the wage earners will be suppressed.

Narinder Singh is a FMT team member.

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