Unlike most of us, who carefully balance our budgets and spend within our means, our governmental bodies tend to spend recklessly and without regard to the consequences. Periodically, government officials will take a step back, say ‘Oops” and scramble to find more ways to wring money out of citizens. Sometimes this means handing out more traffic tickets; other times it may include adding new fees to public facilities; but most often it leads to increasing existing taxes or creating new ones.
One particularly distasteful tax is the Cosmetic Surgery Tax, which usually is proposed as a 5% to 15% excise tax on those people undergoing elective plastic surgery. The politicians who propose these taxes invariably say that the people having this surgery are rich and should be able to handle more taxes on such a luxury item. I believe this is a harmful and false belief for multiple reasons.
First of all, most people having plastic surgery are not extremely wealthy. In fact, the average person having this type of surgery tends to be in the middle class and often uses financing to help pay for surgery. The patients who come to me for plastic surgery in Phoenix are not fur-wearing, poodle-carrying socialites here for their fifth facelift. They are generally normal, next-door-neighbor types who simply have an issue that they cannot fix on their own with diet and exercise. For many of my patients in Phoenix, rhinoplasty and other cosmetic procedures are a way to improve their self-esteem or gain an advantage in the ever-increasing competition for jobs.
Secondly, a cosmetic surgery tax is discriminatory against women, as the majority of people seeking this type of surgery are female. This is simply not fair, and any sort of discrimination should not be condoned.
Thirdly, it is sometimes difficult to draw the line between cosmetic surgery and reconstructive surgery. Is a breast reduction in someone who is having back pain cosmetic or reconstructive? Different insurance policies will disagree on what constitutes a “necessary” breast reduction. What about a nipple reconstruction for someone whose breast was reconstructed after cancer? Is the nipple really necessary, or is it simply “cosmetic.” The lines can quickly become blurred, especially when they are being interpreted by politicians and not doctors.
Finally, and perhaps of most importance to politicians considering cosmetic surgery taxes: These laws simply don’t work! The first cosmetic surgery tax was instituted in New Jersey and only generated a small fraction of the revenue that was expected. What the state found out was that patients were traveling to New York and other surrounding states to avoid the tax. In the end, New Jersey was indirectly losing revenue, and the original designer of the tax admitted his mistake and called for its repeal.
Patients who have breast augmentation in Phoenix, or any other procedure, for that matter, deserve the right to improve their appearance and confidence without being judged or punished financially by the government. This is why plastic surgeons and patients have fought together to prevent these misguided taxes, and thankfully, it looks like most politicians are finally coming to their senses.