WASHINGTON — If you’re considering Botox to erase frown
lines or liposuction to get rid of love handles, you might want to move fast.
The “botax” may be on the way.
The $848 billion health care bill that Senate Majority
Leader Harry Reid, D-Nev., unveiled Wednesday includes a 5 percent tax on
cosmetic procedures and surgeries. The tax, which would take effect in January,
would raise an estimated $5 billion over the next decade to help pay for
extending health care coverage to millions of Americans.
Plastic surgeons decried the proposal, saying the recession
has battered their practices and they’re just beginning to recover.
“This will be devastating to doctors who do cosmetic
surgery,” said Dr. Angela Cuzalina, a Tulsa, Okla., cosmetic surgeon.
“You’d be surprised how price-sensitive people are to
this. … It’s a tax against women and the baby boomer generation having these
procedures.”
Some worried that the tax would be applied to more and more
procedures. “It’s cosmetic surgery today, laser eye surgery tomorrow, then
who knows, maybe it’s the knee-replacement surgery to help you play golf,”
said Dr. Gary Smotrich, a plastic surgeon in Lawrenceville, N.J.
Other critics said the proposed tax also would hurt the
growing number of medical spas that offer Botox and other injectables.
“Many clients are receiving Botox and fillers to
maintain a competitive edge in this youth-oriented and dismal economy,”
said Bonnie Marting, the director of medical aesthetics at the Anushka
Cosmedical Centre Spa & Salon in West Palm Beach, Fla.
Diane Archer, the director of the health care project at the
Institute for America’s Future, a liberal policy organization, isn’t
sympathetic.
“We pay taxes on virtually every good and service, and
luxury goods and services should be taxed even higher,” she said.
“This is not a medical service. It’s the equivalent of a facial or a
massage. It’s something that’s nice to have but not necessary.”
About 12 million cosmetic procedures and surgeries — which
insurance typically doesn’t cover — were performed last year, at a total cost
of $10.3 billion, according to the American Society of Plastic Surgeons. The
vast majority, 10.4 million, were minimally invasive services such as Botox
injections and chemical peels. The most common surgeries were breast
augmentation, liposuction and tummy tucks, but all those procedures declined at
double-digit rates last year.
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It’s unclear exactly which services the proposed tax in the
Senate bill would cover. The Senate legislation refers to the Internal Revenue
Service definition of cosmetic surgery: “Any procedure which is directed
at improving the patient’s appearance and does not meaningfully promote the
proper function of the body or treat illness or disease.” There’s no
comparable provision in the bill the House of Representatives passed.
New Jersey, where a 6 percent levy on cosmetic procedures
and surgeries took effect in 2005, is the only state with such a tax. Doctors
there say many patients go to neighboring New York or Pennsylvania for the most
expensive procedures to avoid the tax, which has brought in about $11 million a
year, only about half as much as expected.
“It’s hurt all of our practices,” Smotrich said.
Plastic surgeons said the proposed federal tax would be
troublesome because it would be difficult to determine which procedures were
elective and which were medically necessary.
The New Jersey tax applies to such procedures as hair
transplants, cosmetic injections, dermabrasion, laser hair removal, laser skin
resurfacing, laser treatment of leg veins, cosmetic dentistry and breast
augmentation. It doesn’t apply to everything; for example, post-cancer
reconstructive breast surgery isn’t subject to the tax.
Plastic surgeons reject the notion that only the rich get
plastic surgery, saying that many middle-class people are having the
procedures, especially given the wider availability of less costly and invasive
procedures and increased financing options.
Dr. Andrea Hass, a plastic surgeon in Palm Beach Gardens,
Fla., said the tax wouldn’t affect just the wealthy.
“This hurts the people who save money to make the down
payment to help themselves look better,” she said. “People will start
to think twice about it.”
Via McClatchy-Tribune News Service.
