A transformação da tributação nos serviços médicos : antes e depois da reforma tributária
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Tipo
TCC
Data de publicação
2024
Periódico
Citações (Scopus)
Autores
Vieira, Gabriela Doriguello
Orientador
Marins, Daniel Vieira
Título da Revista
ISSN da Revista
Título de Volume
Membros da banca
Programa
Resumo
Já se sabe que nosso Sistema Tributário é muito complexo, com diversos tributos, com fatos
geradores, bases de cálculo e competências diferentes. Com o propósito de simplificar este
sistema, se pensou em uma Reforma Tributária, que foi concretizada em 20 de dezembro de
2023 através da Emenda Constitucional nº132, depois de várias propostas cuja finalidade era
promover um sistema de tributação mais simples. A principal mudança trazida pela Reforma
Tributária foi a instituição do Imposto sobre Bens e Serviços (IBS) e da Contribuição sobre
Bens e Serviços (CBS). Desta forma, as empresas que prestam serviços de saúde, que eram
contribuintes do Imposto Sobre Serviço, e outros tributos passarão a ser contribuintes desses
novos tributos, e assim se questiona como será essa nova tributação aplicada na realidade
desses serviços. No caso do IBS, há previsão de um regime específico de tributação para os
planos de assistência de saúde, mas para que isso ocorra deverá haver a criação de uma Lei
Complementar. Da mesma maneira, há a necessidade de criar Lei Complementar para a
criação do CBS. Existe também a previsão nessa Emenda Constitucional de uma alíquota
favorável do CBS e do IBS para os serviços de saúde, mas que deverá ser instituída por uma
Lei Complementar. A preocupação é com a possibilidade do aumento da carga tributária para
os serviços de saúde. Em caso de haver um aumento em quaisquer serviços de saúde
particular, em decorrência do aumento da tributação, poderá ocorrer uma diminuição da
quantidade de pessoas que poderão arcar com o valor, resultando, assim, no aumento de
pessoas que irão necessitar do SUS. Desta maneira, temos que ter em mente que o SUS já
passa por grandes dificuldades, com problemas para atender a população que já o utiliza; com
o aumento da demanda de pacientes desse serviço, o cenário poderá piorar. Com isso, há uma
preocupação em como essas Leis Complementares irão aplicar esses tributos e se haverá um
aumento da carga tributária. O legislador complementar deve observar todas as
particularidades desse sistema e ter a compreensão de como ele se encontra. Se esse cuidado
não existir, essa mudança provavelmente causará uma crise no sistema de saúde brasileiro.
Desta forma, o objetivo desse trabalho é compreender o sistema atual de tributação para os
serviços médicos, bem como os possíveis impactos da Reforma Tributária. Para isso, utilizouse
o método de levantamento bibliográfico para análise das leis vigentes, que resultaram na
análise crítica dos possíveis efeitos da Reforma Tributária.
It is known that our Tax System is very complex, with different taxes, different taxable events, calculation bases and competencies. In order to simplifying this system, on December 20th, 2023 was implemented a Tax Reform through Constitutional Amendment No. 132. The main change that Tax Reform has brought was the institution of the Goods and Services Tax (IBS) and the Contribution on Goods and Services (CBS). Companies that provide health services, which were taxpayers of Service Tax and other kind of taxes, will become taxpayers of these new taxes, and so the question arises how this new taxation will be applied in the reality of these services. In the case of IBS, there is a provision for a specific taxation regime for health care plans, but for this to happen there must be a Complementary Law. Likewise, it is necessary to create a Complementary Law for the creation of the CBS. There is also a provision in this Constitutional Amendment for a favorable CBS and IBS rate for health services, but this must be established through a Complementary Law. There is a concern about the possibility of an increase in the tax burden for health services. If there is an increase in any private health services, as a result, there may be a decrease in the number of people who will be able to afford the amount, thus resulting in an increase in the number of people who will need the Brazilian Healthcare Public System known as SUS. Therefore, we have to keep in mind that the SUS is already experiencing great difficulties, with problems to serve the population that already uses it; with the increase in patient demand for this service, the scenario could worsen. Also, there is concern about how these Complementary Laws will apply these taxes and whether there will be an increase in the tax burden. The complementary legislator must observe all the particularities of this system and understand how it is at the moment. If this care does not exist, this change will likely cause a crisis in the Brazilian healthcare system. This paper purposed to understand how the current taxation system for medical services works as well as the possible impacts of Tax Reform on it. The method to analyze current laws is bibliographic survey, which resulted in a critical analysis of the possible effects of the Tax Reform.
It is known that our Tax System is very complex, with different taxes, different taxable events, calculation bases and competencies. In order to simplifying this system, on December 20th, 2023 was implemented a Tax Reform through Constitutional Amendment No. 132. The main change that Tax Reform has brought was the institution of the Goods and Services Tax (IBS) and the Contribution on Goods and Services (CBS). Companies that provide health services, which were taxpayers of Service Tax and other kind of taxes, will become taxpayers of these new taxes, and so the question arises how this new taxation will be applied in the reality of these services. In the case of IBS, there is a provision for a specific taxation regime for health care plans, but for this to happen there must be a Complementary Law. Likewise, it is necessary to create a Complementary Law for the creation of the CBS. There is also a provision in this Constitutional Amendment for a favorable CBS and IBS rate for health services, but this must be established through a Complementary Law. There is a concern about the possibility of an increase in the tax burden for health services. If there is an increase in any private health services, as a result, there may be a decrease in the number of people who will be able to afford the amount, thus resulting in an increase in the number of people who will need the Brazilian Healthcare Public System known as SUS. Therefore, we have to keep in mind that the SUS is already experiencing great difficulties, with problems to serve the population that already uses it; with the increase in patient demand for this service, the scenario could worsen. Also, there is concern about how these Complementary Laws will apply these taxes and whether there will be an increase in the tax burden. The complementary legislator must observe all the particularities of this system and understand how it is at the moment. If this care does not exist, this change will likely cause a crisis in the Brazilian healthcare system. This paper purposed to understand how the current taxation system for medical services works as well as the possible impacts of Tax Reform on it. The method to analyze current laws is bibliographic survey, which resulted in a critical analysis of the possible effects of the Tax Reform.
Descrição
Palavras-chave
tributação , reforma tributária , serviços de saúde , lei complementar , taxation , tax reform , healthcare services , complementary law