NCPA - National Center for Policy Analysis


December 14, 2009

Thanks to what wags are calling the Botax, Houstonians who love plastic surgery may find themselves asked to cough up a little more to help pay for health care reform, says the Houston Chronicle.  The Senate bill under debate in Washington contains a provision that would impose a 5 percent levy on cosmetic procedures not considered medically necessary -- the liposuction, nose jobs and hair plugs that weren't caused by disfiguring disease, congenital abnormalities or injury.

Predictably, the proposal is decried by plastic surgeons, many of whose businesses were hit hard by the recession.  They say it's onerous and discriminatory, targeting working women and suburban moms more than the rich people the Obama administration promised would bear the brunt of reform.

The Senate bill defines cosmetic surgery as any procedure which is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease:

  • Such surgery brings in $12 billion annually, according to the American Society of Plastic Surgeons.
  • There were 12 million procedures in 2008, minimally invasive ones the most popular.
  • Botox accounted for 4.7 million.
  • Breast augmentations, the most popular surgery, accounted for 355,000.

Because 85 percent to 90 percent of patients are women, plastic surgeons argue the proposed tax is discriminatory, an argument supported by the American Medical Association and the National Organization for Women.  Its president told the New York Times that "in a society that punishes women for getting older," such a tax would further burden them.

What does seem clear is that the women getting cosmetic surgery come from all walks of life, says the Chronicle.  According to ASPS surveys, 40 percent make $30,000 to $60,000.

"Elective cosmetic surgery is perceived as a luxury good and is therefore an easy target for reformers looking for means of funding health reform," says Devon Herrick, a health economist at the Dallas-based National Center for Policy Analysis.

Source: Todd Ackerman, "Senate bill's 'Botax' wrinkles noses in Houston; Proposed 5% levy on cosmetic procedures decried as discriminatory," Houston Chronicle, December 14, 2009.

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