The government has gone mad.
I get why they would want to tax elective medical procedures. They need money. They have gone wild on spending, and they need new revenue. This new tax is proposed to go into effect January 1, 2010 (!!!).
5%.
They are going to tax every “cosmetic” procedure by 5%. What is truly scary is their definition of cosmetic procedure is broad, and includes whether paid by insurance or otherwise (!!!) Their definition:
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.”
I understand many of the surgeries I do are not going to save the world. So government thinks “Hmmmmm…. we need money. Cosmetic procedures are a growing business. Let’s tax it.” But taxing cosmetic procedures is a slippery slope. When I do a breast reduction and insurance actually covers it as “medically necessary” (which is tough to get covered these days), will this be taxed? When I do a tummy tuck and repair the muscles, so my patient no longer has back pain, is it cosmetic? One of my general surgery colleagues calls the diastasis a “ventral hernia” and insurance covers it. Am I being discriminated against because I call it what it is- a diastasis, not a hernia? Will my patients pay the tax, but his won’t? Oh but wait. They said they will tax it even if insurance does cover it. So maybe they will tax me AND the general surgeon.
WHAT IS COSMETIC? Is having twins which blow out your belly so you look 5 months pregnant every day of your life a cosmetic repair? or is it reconstruction to get you back to where you were, so you won’t have chronic back pain? Do we just need more women in Congress who have had kids, so they can understand us better?
What is cosmetic? Botox patients who do botox injections to treat migraine headaches- cosmetic or not? Instead of living for months headache free, will they, must they go back to medications which they take after they already have the headache?
1. women are the majority of plastic surgery procedures and patients.
2. this tax won’t affect the wealthy. they’ll do things anyway. this tax will affect much of my patient base- my moms, who are in the middle class.
3.Will this create artificial distinctions between specialties? Looking at botox injections– if it is done to treat wrinkles will you be taxed, but to treat headaches it won’t? Will it only be taxed if I do it, a plastic surgeon for their headaches, and not if done by a neurologist?
4. The bill specifically states if done by a medical professional. Will this spur nonmedical people doing injections (an already scary trend)?
This is a horrifying step. Why should my 40 year old woman’s desire for botox be taxed, and a 50 year old man’s desire for medications for his “erectile dysfunction” not be?
Ahhh. the slippery slope. Once they tax cosmetic procedures, do you think others are not steps behind?
Is a hernia repair cosmetic? If a man has a bulge in his groin from a hernia which reduces easily (means it isn’t stuck, and therefore not a medical emergency) is that a cosmetic repair? It is not a congenital deformity, it isn’t an injury from an accident or trauma, and it isn’t disfiguring. I would argue a hernia is no more disfiguring than breasts which touch your waist and cause you incredible back pain, neck pain, tingling in the fingers, and a hunched posture. Oh. But women asked for that when we had kids and breastfed them to make them healthier.
Forget the removal of that mole. Or sebaceous cyst on your cheek. Those are not disfiguring, congenital, or a result of injury.
Do not tax procedures. It will create a slippery slope, it disproportionately and unfairly affects women, and it will cause weird practices and loopholes which have no business in medicine.