Thursday, November 19, 2009
Harry Reid's health care bill includes a dancing plethora of new taxes, forcing the Obama administration to consider the important distinctions between broken promises, predictions that happen not to come true, and bare-faced lies. Among them is a new federal tax on comestic surgery, not simply the products used therein but the surgeon's fees for the procedure itself. This report from Oppenheimer addresses the various questions around the tax, including its impact on various of the public companies in the field.
Naturally, I have several reactions to the proposed tax.
First, all you plastic surgeons who voted for Barack Obama: Bwahahahaha!
Seriously, you had to know when you voted for the dude that he would target the rate of return of any industry that does not serve an important social purpose according to your average Harvard professor. You thought that oil, electric power, banking, Wall Street, pharmaceuticals and medical devices were all special cases? Fool.
Second, there are a great many customers of plastic surgeons, past and future, in Harry Reid's home state of Nevada. Singling out aesthetic surgery for a special tax seems like a dangerous move for him, but maybe I'm wrong. Do women with breast implants or Botox treatments not vote?
We admit, we're looking forward to the "I have breast implants, and I vote" bumper stickers.
Third, this tax will have a significant disparate impact on women, who purchase a disproportionate share [UPDATE: approximately 90% in 2004] of the aesthetic surgery in this country. Or is it OK to tax those women, because they are PNQLU*, dear? Perhaps the Democrats imagine that these women are Sarah Palin's base, so it will not hurt them to impose this tax. If so, they might do well to consider the many ads placed by aesthetic surgeons in Princeton's local "Town Topics" newspaper.
Fourth, what's the logic behind the policy? Aesthetic surgery is not covered by health insurance, so there cannot be "overutilization" expense that hits the federal health care budget. It is a luxury service, just like a gym membership, tickets to the World Series, an evening of gambling in Vegas, a fine dinner at a top restaurant, or a night at the opera. Other than sheer snobbery, why ought we tax aesthetic surgery to pay for health care any more than any other luxury service? What possible rationale could there be to tax aesthetic surgery (which, if anything, absorbs overhead that would otherwise burden "medically necessary" surgery that the government does pay for) and not these other luxury services?
In the end, the Democratic elite are using the excuse of health care reform to impose their own sense of aesthetics on American life. The proposed tax on aesthetic surgery is but one early example, quite obviously the mere tip of the iceberg, the camel's nose, and the slippery slope all rolled in to one. There is no rationale for the tax related to health care reform per se, only the desire to raise revenue at the expense of a class of people who are unlikely to raise much of a ruckus. Who, after all, will stand up and oppose the tax because they want their breasts enlarged (or, for that matter, reduced), their thighs re-shaped, or their tummy tucked? [UPDATE: Last year, a poll found that 48 percent of women "would be" interested in aesthetic surgery, and another 23 percent "might be." That's a pretty big block of voters, Senator Reid.]
MORE: CoulterLanche! Not had one of those before...
*People Not Quite Like Us
Well written and witty.
At least in my experience, the tax is probably much more regressive than they plan it to be. In my experience, a lot of lower-middle-class types, yea, even approaching upper-lower, suffer from and assuage pre-mature inflation envy.
This is all just too absurd. Obama claims that this bill is needed to control soaring medical costs to both consumers and the federal government (which pays for Medicare and Medicaid). So the bill to accomplish this has virtually no provisions that seek to reduce medical costs (e.g.,malpractice reform, requiring higher deductibles, etc.). Instead, it focuses on reducing insurance costs by adding the federal government as an insurer to "increase competition"--as if somehow the increase in medical insurance costs are unrelated to medical costs and are simply the result of greedy insurance companies reaping ever increasing profits. Then, to top it off, the bill imposes taxes on various medical devices so that the price of these will INCREASE and, of course, add to the cost of medical care. Got to love that cost control!
Hmmm. How else to fund this monster. Tax boob jobs (some risk of losing that Hollywood base, but what the heck) and for the first time abandon the concept (fictional as it may be) that payroll deductions somehow are buying the employee the right to future benefits. Have to use the Medicare tax, though, to leave room to increase marginal income tax rates without having the top rate look too European.
My head is about to explode.
Looks like Harry "Super Genius" Reid has just lost the votes of the adult entainment and cosmetic enhancement industries with this move.
Damn, I wish I were a Vegas bookie: anyone who bets that Harry Reid will still be a senator in January 2011 is an easy mark.
I don't see a problem here. Just use the "Tim Geitner, Kathleen selibus, fill in the _________ " tax dodge, err deduction. If you escape notice long enough, or don't have a position with Doh-bama you can get off scott free. Only the stupid people will pay the tax, or anyother tax for that matter.
Quick question, does this elective surgery also include the opposite of boob jobs - breast reduction? My wife has been interested in this for some time, I don't think it is medically necessary for now, but it certainly affects her workout routines and eventually will hurt her as she ages....will this also be taxed?
To all the plastic surgeons voting for Obama, I can't agree more. And may they also be forced to "participate" in the system and be mandated by law to accept as payment in full what Barry deems a reasonable fee. Automatic 95% reduction for you guys, welcome to the Barry's world of healthcare for all.
The South Florida real estate market just tanked a bit more! (Many women in that neck of the woods have had procedures done, and it is a major center for cosmetic surgery for residents and people flying in from elsewhere).
Anon 6:48, in all seriousness, breast reduction can have major orthopedic benefits, in terms of reducing the cause of back pain; I am aware of this because of, er, second-hand knowledge. I would guess reductions would be included in the tax unless the final terms require an insertion of a device for it to be considered elective and taxable. Even then, many reductions are also lifts and use a "pillow" as a support structure, and it is a small device that stays in the bottom of the revised breast.
By the way, the gay population in S. Florida, who overwhelmingly supported Obama during the campaign, are major consumers of cosmetic surgery -- calf implants and pec implants, etc., getting the results through surgery they can't get through pumping iron. The Body Nazi culture won't be happy about this proposed tax.
I would hope that breast cancer patients choosing post-surgical revision/augmentation would not be hit with this tax.
By the way, shouldn't the bumper sticker be "I want breast implants, and I vote." There isn't going to be a retroactive tax, is there?
Maybe there will be a rush on cosmetic surgery to beat the tax deadline.
This bill is easier to understand when you recall the hatred that leftists have for anyone who is not quite like them. Hatred is hard to understand and difficult to predict. Specifically, some segments of the left hate rich people, and therefore, a plastic surgery tax is what they want. It make sense if you see where they are coming from.
Most successful plastic surgeons that I know and work with are quite entrepreneurial and are happily independent of the insurance industries. All the cosmesis, botox, spas, massage therapy is cash on the barrelhead.
In other words, they are a perfect target for Obama and the Democrats...
As an aside, I suspect that the middle class will be quite surprised at how LUXURIOUS their lifestyles are when all of the additional "luxury" taxes hit home.
This bill is a disaster for our health care system, but the impact of the taxes will be felt all through the economy. Higher taxes= more unemployment.
Could it be that the Democrats just plain hate the working class?
"Could it be that the Democrats just plain hate the working class?"
I suspect that they are no more or less contemptuous of the working class than Communist Party members were in Russia in 1918.
Thier philosopical disdain is for the Free Market...and all that goes with it.