Tax Plastic Surgery To Pay For Affordable Health Insurance

The Senate has proposed multiple methods of paying for healthcare reform. Majority Leader Harry Reid has promised that his bill will actually reduce the national budget deficit over the long run. How is that possible? He has proposed several tax increases as part of the solution to provide affordable health insurance. One of these proposals would levy a 5% tax on elective plastic surgery. Since over 12 million cosmetic surgery procedures were performed in 2008, such a tax would bring in significant revenue. This so-called "Bo-Tax" may appear relatively benign, but has resulted in a surprisingly large amount of controversy.

According to the Senate's bill, the tax will not apply to plastic surgery performed to fix deformities resulting from an injury or disease; nor will it be levied on surgery on congenital abnormalities. Therefore, surgeries like post-mascectomy breast augmentation and cleft palate repair wouldn't be affected. However, some advocacy groups fear that the definition of necessary plastic surgery is too vague. Plastic surgeons also believe that they are being unfairly singled out with the tax, which they will have to collect from customers themselves. Currently, elective plastic surgery is not considered a tax-deductible medical expense--but this sales-tax like expense means extra cost and responsibility for these specialists.

Vanity taxes on liposuction, rhinoplasty, or a breast lift are more palatable to the general public than a general tax hike for those above a certain income level, which is most likely why Reid decided to include this excise tax absent in the House of Representatives' bill that does the latter. The American Society of Plastic Surgeons claims that such an attitude is most likely a result of misconceptions regarding the average plastic surgery patient. They claim that, far from being wealthy society ladies, over half of those seeking elective plastic surgery earn under $90,000 annually. In addition, since virtually all health insurance plans don't cover such procedures, those individuals are paying for it out-of-pocket.

There have also been accusations of sexism hurled at this tax. Most plastic surgery consumers are women, many of whom are middle-class. Negative stereotypes about middle-aged women present in the workforce--more so than men of the same demographic--have led quite a few to undergo eye lifts or Botox injections in order to find or keep jobs. Again, their health insurance will not cover such elective procedures. That desperation has become even more palpable during this recession, since there is more competition in the business world and appearance-based discrimination is perfectly legal. The president of the National Organization for Women claims that the plastic surgery tax will have a disproportionate impact on women for that reason. It is awfully strange that a representative of NOW would effectively condone such surrender to a patriarichal society as opposed to trying to change it, to say the least. Nevertheless, the tax was first proposed by the Finance Committee as a health care-related way to pay for affordable health insurance reform.

Plastic surgeons are understandably concerned about losing some business, but most people determined to spend thousands of dollars on a procedure are unlikely to forgo it due to a tax of five percent. Moreover, losing some plastic surgery specialists may actually be preferable. Part of America's affordable health insurance crisis is caused by a shortage of primary care physicians. After getting expensive medical school educations, many doctors choose to go into lucrative specialities--such as plastic surgery--to pay off their loans instead, where the average yearly salary is at least double of that of a primary doctor. The demand for primary care physicians is then higher than the supply, allowing everyone to charge more. This cost is passed onto health insurance companies. Some plastic surgeons who feel that the tax is eating away at their profits too much for their liking can re-enter residency and become certified in general care or another speciality suffering from a dearth of providers. Less plastic surgery would also result in fewer complications that are normally paid for by health insurance. Granted, there are some worries that people will travel overseas for less expensive (and possibly less safe) procedures, but in most cases the cost of travel is more than the amount of the tax.