Tax deductions for health in the Income Tax people Singles (IRS) will be reduced in a drastic but some doctors and experts warn taxation since the measure may have perverse effects, leading to an increase in tax evasion and simultaneously , a decrease in the use of the private sector, with a consequent overload of the National Health Service (SNS in Portuguese).
The fact is that ignoring these effects, the reduction of deductions from taxable income on health - a maximum of 30% to just 10% - will allow the state to increase tax revenue by more than 439 million euros, taking into account the values registered in 2009, calculates the Health Regulatory Authority (ERS) in its recent study on the financial sustainability of the SNS.
In 2009, according to data from the Directorate General of Taxation, more than two thirds of households (4.4 million) had health expenses in the statements of IRS. The value of deductions from taxable then totaled 659 million euros. With the new rules, this amount would be by 219 million, completes the ERS. Moreover, the proposed state budget for 2012 is establishing a ceiling on deductions (838.44 euros) and two levels with higher incomes can no longer provide health expenses.
But there are factors which are not included in this account - and that can change it substantially. You can, for example, return to the old story - with a receipt so much without receipt is both - that a few years ago it was common in doctors' offices, admits a specialist. Obviously, when there is mutual interest in the passage of bills, although this procedure is illegal, there is a potential for tax evasion, recognizes Orlando Monteiro da Silva, chairperson of the Order of Dentists.
Another perverse effect predictable, says, goes through a possible decline in demand for private health care and the consequent increase in the use of public services. An increased risk in the area of dentistry, because at this level there is virtually responses within the SNS. It is likely that there is a contraction in demand, with people postpone more complex treatments, admits the chairperson. In 2010, there was already a decrease from 20% to 30% and this year we are going down the same path.
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It is expected that the Minister of Health urgently bring forward solutions that the SNS will adopt in the field of dentistry, taking into account the private sector's inability to adapt to the needs of the population in times of economic crisis. Do not fall on the population effects of oral health policy completely disastrous followed in Portugal in recent years.