Orange County Register

A 5 percent tax on cosmetic medical procedures is part of the health-care reform bill unveiled yesterday by U.S. Senate Democratic leader Harry Reid (pictured).

This so-called “Bo-tax” proposal is a scaled-back version of a 10 percent tax on cosmetic treatments that the U.S. Senate Finance Committee reportedly considered during the summer,  then apparently dropped.

The tax would help pay for the overall health-care reform. An estimated $5 billion that the tax would raise “was needed to make the numbers work” in the health-care bill, according to an unnamed Democratic Senate aide cited on the Politico Web site.

Reid said that the bill would cost $848 billion over 10 years, but it would reduce projected budget deficits by $130 billion during that period because new taxes, fees, and a slowdown in the growth of Medicare would more than offset the costs.

The proposed tax would cover all “cosmetic surgery and medical procedures” that are performed by a licensed medical professional, excluding reconstructive surgery.  The bill defines cosmetic procedures as ones that are “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 cosmetic doctors oppose the tax, which make their services more expensive.

In the summer, area doctors’ arguments against the proposal included:

• The tax would burden women disproportionately. Malcolm Roth, vice president of the American Society of Plastic Surgeons, said the tax would discriminate against women, since they account for 86 percent of cosmetic patients.
• Separating purely cosmetic treatments from reconstructive procedures would be difficult and would penalize people seeking to correct deformities.
• The tax would stigmatize cosmetic plastic surgery and send the message, “It is bad, like cigarettes or alcohol and therefore worthy of scorn and punitive taxation.”

Plastic surgeon Dr. Donald Altman of Irvine commented, “There is a notion that cosmetic surgery is a frivolous gesture for individuals who haven’t anything better to do.

“Cosmetic surgery patients are hard-working individuals who suffer all of the ups and downs and health problems that face the rest of us – such as heart disease, cancer, depression, hypertension, and so forth. …

“[Should these patients] pay a premium during a cycle in their lives when they want to do something good for themselves?”

The tax plan is on Page 2,045 of the Senate’s 2,074-page bill. The text of the tax proposal is printed below.

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