Finance minister Pranab Mukherjee, in the latest budget, re-introduced the healthcare service tax, dubbed the sick tax, which was shelved last year after widespread protests.

In his 2011 budget, Mukherjee had made the first mention of a five percent service tax on diagnostic tests as well as on private clinics with more than 25 beds and central air conditioning. The move brushed the social media livewire and Mukherjee was roundly pilloried for proposing the tax. The finance minister hastily withdrew the tax after the medical community and the healthcare industry along with patients’’ representative groups and consumer forums mounted a campaign against the tax.

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However, the minister has brought it back this year again.

Dr Meera Shiva, a health expert, says, "Given the fact that out-of-pocket expenditure (oope) in healthcare sector in India is almost 80 percent, it is adding to the woes of the poor patients. It will increase the healthcare cost by a minimum of 10 to 15 percent. That will create troubles even for middle-income households."

The government doesn't give licenses to facilities which have less than 25 beds and which don't have air-conditioning. "Introduction of service tax with this clause becomes an ugly joke as most of the hospitals are air-conditioned due to the fear of inviting infections and diagnostic centres with all the sophisticated technologies do not work without air-conditioning these days," Shiva points out.

Dr Anupam Prakash from Max Hospital says that people face long queues and lack of facilities at government hospitals and turn to private hospitals out of need, and not by choice. "The fact that a patient has to seek treatment from a private hospital in itself is a government failure. It is like punishing people for their own failure," he says.

The new rule not only brings the hospitals under the tax ambit, it even ropes in small nursing homes and diagnostic centres. The patient will have to shell out more even for a simple medical procedure or diagnostic with the healthcare providers shifting the costs to the consumer.

Dr Sandip Singh from Primas Hospital says that government hospitals too sometimes ask the patients to get their tests done outside the hospital. "The finance minister should have rather focused on regulating corporate hospitals and private clinics. These kind of hospitals are generally in small towns or cities and the population availing facilities is generally the lower middle class. Expensive medical treatment is already not affordable and this will add to the misery of the patients," he says.

Dr Anup Saraya, leading dermatologist and a faculty in AIIMS says, 'Interestingly, the government has proposed to allow deduction up to Rs 5,000 for preventive health check up for health insurance holders, which is an increase from the last year's Rs 2,000. They are not only encouraging the private hospitals' tendency to overcharge insurance holders through unnecessary check-ups, they are also disillusioning people into buying health insurance. It is a system practiced in western world, particularly US."

The government has once again overlooked the concerns of the medical fraternity and the civil society members to decrease the cost of healthcare in India along with the noble suggestions from experts on regulation of the government hospitals, corporate hospitals and private clinics. It has just added to the burden of healthcare seekers and their families.