Vive la revolucion, and all that... but I'm hard pressed to buy that massive protests and highly focused opposition to what is being called the "bo-Tax" on elective cosmetic medical procedures that's being used to fund parts of the Senate healthcare bill will amount to very much.
Conservatives have never met a tax they didn't like, so naturally they're prepared to stand up and fight for breast implants, collagen injections and liposuction... though, of course, they've often been the same people decrying Hollywood and the kind of fake, bought beauty represented by plastic surgery. Now it's all for one, all for implants.
Veronique de Rugy (I've always wanted to quote her name alone) makes the case today:
The Senate version of the health-care bill has a cosmetic tax. The idea is to make the rich (who are assumed to be the ones consuming plastic surgery) pay for the cost of the health-care reform. Wrong. First, according to Laurie Essig:
Cosmetic surgery is now primarily consumed not by the rich, but by the working and lower-middle classes, sometimes even by the poor. According to the American Society for Aesthetic Plastic Surgery (ASAPS), about 1/3 of cosmetic surgery is consumed by people who make less than $30,000 a year. About 70% of it is consumed by people who make less than $60,000 a year. It is mostly women (90%) and mostly white, middle-aged women (80% and between 35-55 years old).
Plus, why tax a good that increases people's happiness permanently? According to Will Wilkinsonvery serious academic research), plastic surgery (breast implants in particular), unlike expensive cars, increases people's happiness in the long run. (and based on
Like a number of reports, de Rugy cites a new statistic from the ASAPS - an organization, one might point out, devoted to selling more people on more plastic surgery - that suggests that "ordinary, working class folks" will be hurt by a tax on cosmetic procedures. That's all well and good... but one can bet that they're lumping about as many things as possible (Botox injections and other in house treatments costs hundreds of dollars, while a major procedure like implants or lipo starts around $5,000) into a stat of dubious usefulness. People with $30,000 may be getting something - they may even, with loans and long term payment plans, be having major surgery - but the industry is driven, most clearly, chasing after high levels of disposable income. Or disposable life savings.
Conservatives ought to be careful about who and what they're planning to celebrate here; this new celebration of "The Wonderful World of Boob Jobs" relies heavily on self-interested propaganda and marketing materials that generally try to disguise notions of pain, discomfort, never mind massive expense in support of notions about "perfection" and certainly some level of unhealthy body image and societal expectation that ought to be rejected more than embraced. It's lovely to think of plastic surgeons are doing sainted work bringing happiness to ordinary ladies as simple as an extra cup size... but that's not the reality, and I suspect many conservative agitators know it quite well.
And no, I'm not some angry anti-surgery advocate either; the women I've known with implants do indeed seem quite happy and healthy, comfortable with the choices they've made, and pleased with the results. So too the people I've known who've had lipo, breast reductions, lifts... you name it. Cosmetic surgery - even the occasional Botox injection - is not what I'm opposed to. But I think we should always be clear about what we're talking about: dangerous, possibly life threatening procedures involving risky chemicals and substances that shoud, preferably, be avoided. We should always ask, when repeating promotional statements handed out by plastic surgeons, what kind of self-interest motivates the information, and maintain a healthy skepticism. And we can and should do more to question why personal happiness depends, so much, on such expensive, potentially dangerous, possibly mutilating, work.
If there's a reason to question the "Bo-Tax" it's probably more on common sense fiscal grounds: given that, as New Jersey has demonstrated (with the only cosmetic surgery tax in the nation), that the tax will probably bring in less revenue than forecast and succeed, as taxes do, in reducing a particular activity or behavior, does it make sense to count too heavily on the tax as a moneymaker? Will the tax drive wealthy patients overseas or over borders to have work done... and will we, in turn, be creating a new "surgery scandal" over the Mexican border? It's not that an elective medical practice tax will "hurt the middle class" - many people, clearly, will simply have to factor in the added cost - but it's that a tax aimed at a luxury behavior of the wealthy often fails because the rich have so many discretionary spending options: travel elsewhere, trumping up "medical necessity" (it's the return of "deviated septum" nose jobs!) and the like... will probably take much of the punch out of any anticipated revenue stream.
And, yes, hurt plastic surgeons. Given the recession, we were always bound to see - and have seen - a crisis in an overabundance of cosmetic specialization; that pain, surely, drives a lot of the fear among the plastic surgeons about how much more harm a tax will inflict. But like so much of our health care crisis, the real problem here stems from the needless surgeries, the high rates of specialiazation, and the attraction of a quick, easy buck over the health care people actually need. That conservatives would be more concerned about cleavage, well... that's just par for the course these days... isn't it?
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