Senate Bill Includes New "Botox Tax"

You know the government is desperate for solutions to pay for it's health care program when they propose a tax on cosmetic medical services and surgery (see the legislation below).  This has been attempted by the legislatures in several states, and was enacted for a time in New Jersey before being rescinded.  It cost more for the state government to administer it than it took in in revenue...not to mention that it was a public relations nightmare.  But maybe the heavy hand of the Federal Government will make it stick this time - and no bother if it costs more to administer than it brings in in revenue, which is virtually guaranteed.  The Federal government is expert at wasting money. 

As some of you know, I have a keen interest in politics and free market economics.  It is often difficult for me to keep this blog focused on plastic surgery related issues when I see what is going on with issues of the economy in general and health care policy in particular.  This issue obviously crosses into my field of plastic surgery, so allow me to rant a little...

It's not just that I abhor a tax on services that I provide because it will hurt my business.  I would be against it if it was a tax on, for example,  plumbing or accounting services.  And I will support my professional societies when they come out with a statement against it , which I am sure they will do soon if they haven't already.  I would imagine the professional societies of accountants and plumbers would rail against a tax on their services too, if the government foisted it upon them.

But there are bigger issues at stake here.  A tax like this is simply one symptom of the disease that is the Total State.  It reflects the hubris that emanates from hundreds of our elected representatives in Washington that think they know how to manage our lives better than we do, and think they can plan the economy better than the private sector can.  More programs, more spending, more borrowing, more taxation.  One can imagine how they justified this as a tax on "rich" people.  Nevermind that the vast majority of those choosing to get these services are part of the ever-shrinking middle class.  Or one could imagine the legislators and their scribes sitting around the conference table, weighing the fallout from different tax proposals, and perhaps determining that the plumbing lobby and the accountant lobby had more squeeky wheels than the cosmetic medical procedure lobby, so let's leave them alone. 

In Washington, nothing is done on principle anymore.  When the Constitution has been trampled and ignored, what follows is favoritism, vote-buying, gerrymandering, pandering, collusion...the list goes on.  Because so many special interests need to be paid off, what results is larger government with a shrinking, more burdened private sector trying to pay for it.  It can't, so the government raises taxes and tries to say it's not raising taxes while it's simply taking taxes from other places.  The Health Care Bill is a good example of this pattern.  But it can't raise what it needs to fund it's ravenous appetite from these hidden and not-so-hidden taxes.  So it borrows and prints.  But lendors tend to have a limit as to how much they are willing to lend to the borrower.  So our president travels to China and bows and grovels to keep the money flowing.  And back home Bernanke and Geitner keep printing more money, although it's always called something else - think "quantitative easing". 

The only thing that will turn around our economy is a massive reduction in government spending and a return to productivity in the private sector of the economy.  Increased productivity will produce jobs.  But increased productivity cannot happen until government gets out of the way, and lowers taxes and repeals regulations. This will not happen as long as the government is hell bent on costly legislation such as Cap and Trade and Health Care Reform.  The notion that the government can spur productivity by spending borrowed money into the economy is a flawed Keynesian pipe dream that will fail.

Below is the text of the relevant section of the Senate Health Care Bill.  Oh, and notice that the tax would be effective January 1, 2010...  better get your cosmetic medical services or surgery done before the beginning of the year!!

Douglas J. Mackenzie, M.D., F.A.C.S.

Page 2045

SEC. 9017. EXCISE TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.

(a) IN GENERAL.-Subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by adding at the end the following new chapter:

''CHAPTER 49-ELECTIVE COSMETIC MEDICAL PROCEDURES ''Sec. 5000B. Imposition of tax on elective cosmetic medical procedures.

''SEC. 5000B. IMPOSITION OF TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.
''(a) IN GENERAL.-There is hereby imposed on any cosmetic surgery and medical procedure a tax equal to 5 percent of the amount paid for such procedure (determined without regard to this section), whether paid by insurance or otherwise.
''(b) COSMETIC SURGERY AND MEDICAL PROCEDURE.-For purposes of this section, the term 'cosmetic surgery and medical procedure' means any cosmetic surgery (as defined in section 213(d)(9)(B)) or other similar procedure which-
''(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.
''(c) PAYMENT OF TAX.-
''(1) IN GENERAL.-The tax imposed by this section shall be paid by the individual on whom the procedure is performed.
''(2) COLLECTION.-Every person receiving a payment for procedures on which a tax is imposed under subsection (a) shall collect the amount of the
tax from the individual on whom the procedure is performed and remit such tax quarterly to the Secretary at such time and in such manner as provided
by the Secretary.
''(3) SECONDARY LIABILITY.-Where any tax imposed by subsection (a) is not paid at the time payments for cosmetic surgery and medical procedures are made, then to the extent that such tax is not collected, such tax shall be paid by the person who performs the procedure.''.

(b) CLERICAL AMENDMENT.-The table of chapters for subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by inserting after the item relating to chapter 48 the following new item:
''CHAPTER 49-ELECTIVE COSMETIC MEDICAL PROCEDURES''.

(c) EFFECTIVE DATE.-The amendments made by this section shall apply to procedures performed on or after January 1, 2010.