The Senate, at the 11th hour, on a Saturday night while no one was watching tacked on a cosmetic procedure tax.


On every cosmetic surgery, botox injection, filler injection, and ??? what else.

The issues are multiple:
1. Never has the government taxed a patient for a medical procedure.
2. 90% of all “cosmetic” procedures are done by women.
3. This tax applies to procedures paid for by insurance, as well as by the patient. So if your insurance considers your breast reduction “medically necessary” (no small hurdle- see my blog on getting insurance to cover a breast reduction. It is as difficult as getting a child to eat broccoli over ice cream), the government will still consider it “cosmetic” and walah! You get to pay 5% more.  On a breast reduction surgery, this could amount to an additional $400-500.

4. The majority of plastic surgery patients are not the rich and famous.  They are, as I see in my practice, the soccer mom and the working mom.

This tax is effectively a “Soccer Mom” tax that will adversely impact mainstream American wives and mothers, who are the majority of plastic surgery patients,” said Renato Saltz, MD, President of ASAPS. “As doctors, we understand and appreciate the need for health care reform, but taxing physicians and cosmetic surgery procedures to pay for the reform is not realistic or beneficial,”

In a 2005 ASPS survey of people planning to have cosmetic surgery within the next two years, 60% of respondents reported an annual household income of $30,000-$90,000 a year. Most importantly, 40% of those reported a household income of only $30,000-$60,000. Only 10% of respondents reported a household income of over $90,000, which clearly refutes the suggestion that elective surgery taxes are “luxury” or”sin” taxes affecting a privileged few.

eeeek! I have on my website gone through the specific issues: breast reduction, diastasis after babies, botox.  And my biggest issue is why women.  WHY?  Let’s look at pure botox for wrinkles, pure elective cosmetic botox.  Why is my desire for botox as a 40 year old woman taxed, but a man’s desire for medications for his “erectile dysfunction” not taxed? Are there too few women making laws on Capitol Hill? Is it that doctors and women have poorer lobbies than men and pharmaceutical companies?

This is a broadly worded way for the government to try to get revenue.  If you think this is not a slippery slope to taxing more medical procedures and medications, think again.  Their definition is :

COSMETIC SURGERY AND MEDICAL PROCEDURE-  ”1. is performed by a licensed medical professional and 2. is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease.”

Many many surgeries are not congenital, related to injury from accident or trauma (though can I argue having an 8 pound baby constitutes trauma?), or disfiguring disease.  Mole removal? Hernia repair? Breast cancer reconstruction? Breast reduction? Under this broad definition, who determines what is “necessary”?

A tax was done on cosmetic procedures in New Jersey.  It has proved arbitrary and difficult to administer.  And the “projected revenue” was 59% lower than expected.  Eight other states have looked at taxing these procedures, and all did not do it.

As I said before, EEEEK.

If you would like to know what to do, go to my website. Why can’t medicine be about medicine? I am not a politician, nor a tax collector.  I really love being what I do best- a surgeon and doctor to my patients.