Tax cosmetic surgery to fund children's health care

By Harvey Carp of Portland, Oregon. Dr. Carp is a physician practicing in Portland and SW Washington.

From my viewpoint as a physician, as well as a patient, our health care system is a study in contrasts. While some patients take advantage of the most advanced care, others, particularly children, lack the most essential, basic care.

I believe, this difference in care is highlighted by the popularity of cosmetic surgery in the U.S. It is estimated that over 7 billion dollars are spent, nationally, on cosmetic surgery, including breast augmentation, tummy tuck, cosmetic botox, face lifts, liposuction etc. Furthermore, over 3 billion dollars more are spent on nearsighted vision correction procedures. I am not trying to deny the benefit that cosmetic surgery provides to patients. However, it is disturbing to realize that this 'luxury-type' of medical care is being provided at the same time that basic medical needs of children, elderly and the poor are not being met, for lack of resources.

Therefore, I propose that a 10% surcharge be placed on all luxury-type medical procedures, including cosmetic and vision correction surgery. The revenue generated from the surcharge could be placed in a fund that would be used to underwrite basic medical care for children.

A 10% surcharge added to the more than 10 billion dollars spent on 'luxury-type' medical care, nationally, would generate at least 1 billion dollars in revenue. Although, this amount is small in comparison to the total needed to assure universal medical care; it would however provide a start to this process.

It may appear to be unfair to single-out cosmetic surgery patients for taxation. However, cosmetic surgery is indirectly supported by tax dollars, in the sense that physician training and medical facilities are ,in part, tax supported. My modest proposal would re-direct some of these tax dollars back into areas where they were intended to support basic, essential, medical care. Enlarging breasts is a luxury item, not essential medical care.

This program is not intended to provide a grand solution to the 'health care problem' in America. It will not generate enough revenue to guarantee universal access to health care nor will it be able to change the inherent illogic of the health care system. The goal of this modest proposal is more limited in scope. This program is designed to generate a stable, though limited, source of funding capable of contributing to the solution of a single, limited-in-scope, problem focused on children's health care. The devil will be in the details of choosing a program to support, that is limited-in-scope, but still important to children's health care. We want to be a big fish in a small, but important pond.

In summary, my 'modest proposal' would place a 10% surcharge on all cosmetic surgery procedures. The revenue generated would be used to underwrite programs that provide basic health care to children. This proposal could help some children gain better access to basic healthcare.

  • k (unverified)

    I wouldn't have a problem with it so long as reconstructive plastic surgery would be exempt (someone recovering from a mastectomy or having their face rebuilt shouldn't be taxed).

    While we're at it, can we add a surcharge to studded snow tires to help pay for roads? I've been driving in Oregon snow/slush since I was 16 and have done just fine without studded snow tires (I grew up in an area that regularly got snow & I'm a skiier). Half the people here get them for the 1 day we might get snow and then stay home that day to avoid driving in it. They should, at least, be responsible for some of the damage they cause to our roads.

  • THartill (unverified)

    Sounds good, but why corrective eye surgery? There is no way to twist the numbers that show corrective eye surgery will cost more in the longrun. In terms of "wasteful medical spending" contacts and glasses for life seems to be 10 times the cost of corrective surgery. Seems like a better idea to tax contacts and glasses.

  • Bob (unverified)

    What the hell? I am a nearsighted person, and would be blind without glasses or contacts. Having corrective eye surgery to - gasp - allow people like me to see like normal people would be a wonderful thing. I currently have to spend approximately $100 plus eye exam costs (another $100+) every time I lose a contact, it gets old, or wears out. Glasses also cost a ton of money. Furthermore, there are many situations where I cannot wear either of them - ie, swimming, heavy dusty situations, etc. Rain also sucks. Ever had a drop of rainwater knock a $100 contact out of your eye while you're waiting for the bus at midnight? Not fun.

  • (Show?)

    Yeah, as someone who's been spending a few hundred dollars a year on eye correction for the last fifteen years, the idea of permanent corrective surgery is not one of vanity, but of financial practicality and convenience. Of course, if/when I get it done I'll probably go to Canada anyway (since even without taxes it's significantly more expensive in the US), so it won't likely affect me anyway. Otherwise, I think that's a great idea.

    Oh, and k is right on with the snow-tires thing. That pisses me off so much. There should be a $500/year surcharge for studded snow-tires. They're such a nuisance, do so much damage to the roads, and are completely unnecessary for 99% of Oregonians.

  • Kathleen (unverified)

    Great idea!

  • JW (unverified)

    I really don't get this proposal. I personally have no desire to have vanity surgery, but a luxury tax on those who do? Sorry, you're just coming off as another sanctimonious moral scold. We've already got Bill Bennett and the "Christian" wing of the GOP for that.

  • pdxskinjob (unverified)

    Puzzling suggestion.

    Many plastic surgeons provide health care, including surgery, for children. Cleft palate repair, congential hand defect repair, craniofacial syndrome management, to name a few.

    The cosmetic procedures one does in practice can be viewed as a revenue supplement for many of the non-paying or partial paying pediatric patients that Plastic Sugeons already care for.

    I think Plastic Surgeons contribute to their 'debt to society' every day they come to work.

    <h2>A 'cosmetic tax' is an ineffective way to support pediatric health care, and I think its supporters do not have a grasp on the fiscal realities of surgical care.</h2>
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