Discussions up to 6th july 2017

Dr.nageswr Gokul:
Question on GST : I am a practicing Clinical Doctor. I purchase medicines from suppliers and in the process pay them GST (previously called as VAT) on the bills received from them. I then dispense medicines to my patients and issue them receipts including consultation+dispensing fees. It goes without saying that the cost of medicines so dispensed to medicines includes the GST component too. Am I covered under the GST Act ? To what extent are healthcare services covered under the GST Act ? Are healthcare products covered under the GST Act ? How are products different from services as per the GST Act ? Do I have to register for a GST number under the GST Act, 2016 ? Can I recover 'input tax credit' (as paid to suppliers vis-a-vis when collected from patients while dispensing medicines to them) under the GST Act ?

Answer: 1. Healthcare services are exempt from GST under the GST Act, 2016. Healthcare products are not exempted, however. Healthcare products are chargeable. 2. Healthcare services include services rendered for treatment at a healthcare facility. Healthcare prodcts include medicines, instruments, machines, equipments, infrastructure, etc. 3. When a Doctor dispenses medicines, they form part of healthcare services (as per the GST Act) and for a reasonable period of time (as per IMC Rules, 2002), they are nevertheless 'healthcare services' as a whole and are therefore not chargeable to GST. Please note that 'services' are defined under the GST Act, but 'reasonable period' is not defined by either the GST Act, 2016 or the Indian Medical Council Rules, 2002. 4. Dispensing is not same as selling. Selling is not same as dispensing. When a Doctor charges a fees for services rendered that includes fees+medicines as a whole, it is a service (as per GST Act) and called dispensing (as per IMC Rules). It is not called as selling medicines. This is exempted under the GST Act. 5.. However, if a Doctor charges for medicines/other healthcare products solely, these are chargeable for GST. 5. There is no need for Doctors to register under the GST if they are providing only healthcare services. 6. If they are selling, then only one needs to register. Anyways, a Doctor cannot sell medicines unless he is involved in a trade of medicines/healthcare products. 7. In short, GST does not change anything for practicing Doctors. GST is Goods & Services Tax, and replaces many taxes like VAT, etc as they were in use previously. 8. Input tax credit can be availed by Doctors if they are involved in a trade of medicines/healthcare products, not while dispensing medicines to their patients. -
Gokul Ayurvedaic Hospitals , Anantapur

Dr Manik Dixit:
Is it true that, need not bother about taxes if annual turn over is less than 20 lakhs ?

Dr.pradp Noori:
Strong ayurvedic foundation for an ayurvedic vision.
Today's subject
1.Panchabhoota and doshas
2.Where does the treatment fail?
3. Normal functions of dosha dhatu and malas it's applied aspect
4.Importance of dosha vikalpa,
Symptoms and  doshas corelation.

Vinaya Ballakur:
Why Ashtanga Hridaya was chosen?
Its the latest from the Brihattrayi and its speciality is नाति संक्षेप नाति विस्तार:

An example of applied Ayurveda in terms of Panchamahabhuta.
We know, शब्द , स्पर्श,रूप, रस, गंध are associated with, Akash, Vaayu, Agni, Ap and Pruthvi.
In badhirya it is aakasha and vayu mahabhuta ie. Vata that is to be treated. Similarly we can treat, loss of sensation, loss of sight, loss of taste and loss of smell by treating the respective mahabhutas or the doshas that make up the mahabhutas.

Vata Pitta Kaphascheti trio doshah samasataah. Tridoshas are nothing but energies. The energies of the physical world manifesting as bioenergies in our body.

Going to the fundamental shlokas from Ashtanga Hridaya sutra 11 th chapter

Dosas , dhatus and malas are the basic components of the body. The functions of doshas differ sharply in states of equilibrium and in equilibrium.
Understanding natural functions of the doshas is therefore important

Prakrita vata

Theory --- तम् चल:----  responsible for movements
Applied aspect --- The चल गुण is affected in vata disorders.
In paralysis this chala guna  is compromised due to some obstruction ( avarana). So that also must be treated.
In Parkinson's there is excess of chala guna due to increase of vata.
Increase of vata is related to dhatukshaya and decrease of vata is related to avarana. So accordingly treatment must be planned.

Theory --- उत्साह --- enthusiasm, motivation

Applied aspect -- patient complains of lack of motivation but has bala, energy, treat for vata,

Similarly prakrit vata is responsible for uchvasa nishvasa, cheshta, vegapravrithi

samyagatya cha dhatunam( maintenance of dhatus) and akshanam patavena( maintenance of sense organs .

In respiratory disorders, locomotory disorders treat vata but take into account the other doshas also that are affected.
Maintenance of dhatus requires proper cell division. Unregulated cell division as in cancers indicates vata vitiation. Vata can be equated with the controlling mechanism of the body. Any sense organ disorder needs vata correction

Eg. Why is oil applied to skin?
Sparshanendriya, the skin is the biggest vata organ in the body. Hence thaila abhyanga is advised as a dinacharya to pacify vata

Coming to formation of dhatus, the first dhatu rasa is nothing but kapha swarupa. When pitta joins it , it results  into rakta.
Kshaya of dhatus is vikruta vata manifestation where as proper formation of dhatus is a prakruta function. Eg.Mamsa kshaya or emaciation is a pure vata disorder.

In sandhivata, there is rukshatvam due to kshaya ( vata vriddhi) so oil appln. helps. In Amavata the situation is different. There is obstruction. So most oils cannot be applied because the obstruction can increase.
( Chickungunya can be treated well by applying amavata and vatarakta treatment aspects)

For instance, I just realised I missed  Vegapravrithi as a prakrit function of Vata. What could be the state of Vegas in vikruta vata and how to deal with it?

Vatanulomana in vegadharana and vatashamana in vegatipravriti.


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