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.