Video: ‘Botax’ unfair to women?

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    >>> know of yet.

    >>> well, it's been a trying week for women and health care . the mammogram debate, new recommendations for cervical cancer screenings and now something else. a proposed 5% tax on elective cosmetic procedures. it's being tubbed botax. it could be a huge moneymaker. last year more than $11 billion was spent on cosmetic procedures and the tax could genralterate, it is estimated, more than $5 billion over the next ten years to prop up health care reform . opponents say it is the most sexive idea and most are female and unfair burden on women and we're going to plow through those ideas. and karan davenport director of health policy at the center for american progress . mark, i'm going to start with you, welcome to both of you. but if there is a tax on any kind of plastic procedures, i'm going to assume you just pass that right on to the patient. it's not really a tax on you.

    >> that's one of the points here, the tax gets passed on to the women and from a sexism standpoint and also a discriminatory tax from the standpoint of most women who are cosmetic surgery patients are middle class people. this is not a tax on the rich and famous . that's a gross misconception of the "botax." it will be delivered directly on the middle class people which this segment vowed to protect.

    >> when i look at the procedures that they list as the most common, breast augmentation , number one, liposuction and, obviously, eyelids, rine ooplasty and tummy tucks and botox being injected right now. karen, dumb, certainly it caught me by surprise.

    >> i think it caught a lot of people by surprise. but, more importantly, we need to look at health care reform as an effort to improve the efficiency and value we get out of our health care system and this is a modest tax on a series of procedures that aren't doing much to improve health and certainly don't contribute to the efficiency of our system. i think it's a targeted tax, which makes sense in the context of the overall form debate.

    >> the idea is to target elective procedures that are not medically necessary in order to raise funds to help pay for things that are medically necessary, am i correct?

    >> yeah. i mean i think that, you know, i'm not so worried about women paying another $20 for their $400 botox treatment . i'm worried about women who have trouble getting preventive care who don't have health insurance and women who have trouble getting good prenatal care . that's what health reform is about.

    >> mark?

    >> well, i think that if you don't have an issue with small taxation on other products that are offered, i mean, if you can stretch that analogy a little bit, we can put 5% tax on nail salons and that could pay for hand-related injuries on the work site. one thing to look at is the fallacy that this tax is going to generate the revenue proposed. this tax has been tried t was tried in new jersey. it failed by most people's estimations. they estimated $21 million in revenue and it generated about $7 million which other opponents said was not enough to cover the administrative costs. so, when you look at the revenue this will generate, i think it's probably overestimated and, in fact, a poll i believe was just as recent as last week americans support 57% of americans support the only taxation to help pay for health care being increasing taxes on those people who make over $250,000 a year. i would argue that plastic surgeons , facial plastic surgeons and many other physicians because there are other physicians that offer these services, dentists, as well, cosmetic dentistry and those are people who will feel the decrease in the volume of their practices and their tax will go down and you will remove another tax base that americans are involved in. from a selfish standpoint, we won't feel it very much because my net take-home pay won't change. my volume will go down, but, again, those middle class americans will feel the brunt of this tax that's being placed on them to help pay for health care when we can stretch it out to a lot of different analogies that don't make sense.

    >> you should be on capitol hill , you talk about putting a new tax on the middle class . that will raise a lot of hackles. thank you to both of you.

    >> thank you, nancy.

updated 11/20/2009 3:05:39 PM ET 2009-11-20T20:05:39

They call it the "Botax."

The White House and Senate Democrats have turned to a proposal to tax breast implants, tummy tucks, wrinkle-smoothing injections and other procedures as they search for ways to pay for costly health care overhaul plans.

Vanity was an easy target as lawmakers scraped for cash for the nearly $1 trillion plan to expand health care to millions of Americans who lack insurance. But it's no joke to the drug makers and people who perform the cosmetic nips and tucks. And they're fighting back.

Skin-smoothing Botox injections could be hard-hit. There were some 4.7 million last year and an average cost per visit of about $400, some including several injections.

"It is a random hit on an easy target that is only punitive and not corrective," said Caroline Van Hove, a spokeswoman for Allergan Inc., the maker of Botox Cosmetic. "The bottom line is that taxing cosmetic procedures is unnecessarily punitive on people who have merely decided to enhance their appearance."

At issue is a proposal in the 10-year, nearly $1 trillion health care draft unveiled by Senate Majority Leader Harry Reid, D-Nev., that would slap a 5 percent excise tax on elective cosmetic surgeries and procedures. The plan, projected to raise $6 billion, wouldn't apply to surgery to fix a deformity or injury, but would include procedures such as face lifts, liposuction, cosmetic implants or teeth-whitening.

Easy target
The plastic surgeons may have seemed like an appealing bunch to pick on given that they had already been skeptical of the Democrats' overhaul proposal. But they say it will be a blow to countless American women — of every income level.

"The common misconception is that this is going to tax wealthy, suburban Republican women," said Dr. Phil Haeck of Seattle, Wash., the president-elect of the American Society of Plastic Surgeons. In fact, he said, of the 86 percent of cosmetic surgery patients who are female, 60 percent of them have incomes between $30,000 and $90,000.

In addition, he said the tax would be especially hurtful in tough economic times that have prompted many newly jobless women to look for ways to make themselves more marketable to prospective employers. He said, "They're competing with people 10 to 15 years younger than them and they want to look better."

Image: Woman getting a Botox treatment
Ron Heflin  /  AP file
Dr. Jeffrey M. Kenkel gives patient Amy Andrade a Botox treatment at his office in the Northpark Mall in Dallas, back in 2006. Should patients who get Botoxed be taxed to help pay for health care reform?

The emergence of the tax in the latest Senate health legislation shows what can happen when an industry or company that's in Congress' cross-hairs isn't vigilant enough.

Dr. Daniel Russo, the Birmingham, Ala., plastic surgeon who heads the American Academy of Facial Plastic and Reconstructive Surgery, said his group first heard of the cosmetic procedure tax idea over the summer. But after being assured by several lawmakers and senior congressional aides that it was not being seriously considered, the group opted not to engage in a major lobbying battle against it, he said.

"On multiple fronts, we were assured that this was not something that any one of the senators or representatives wanted to pursue. This is something that we did not foresee," Russo said in an interview.

"We feel it's unfair to those people who've saved hard-earned moneys to have something to improve their appearance, and now may not even be able to afford it," he said.

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His group isn't registered to lobby, although the American Society of Plastic Surgeons reported spending nearly $400,000 this year trying to influence Congress. The society, which has two in-house lobbyists, didn't list a plastic surgery tax among its legislative priorities in disclosures filed on Capitol Hill.

Haeck, president-elect of the society, said industry players whose products would be affected took the lead lobbying against it.

Allergan's shares were down more than 2 percent Thursday after news of the tax broke. The company, which recently projected net product sales for this year of more than $4 billion, expects the injectible wrinkle-smoothing medicine to rake in $1.3 billion in 2009. It has spent $1.4 million lobbying Congress on health care issues this year.

Shares sliding
Medical device and pharmaceutical giant Johnson & Johnson, a maker of breast implants, also saw its shares slide. The company has spent more than $3 million lobbying Congress this year on a wide range of issues, many related to the health overhaul. It was a major player in a successful fight by the medical device industry to get lawmakers to cut in half a proposed $40 billion tax on their products.

Lobbyists and aides familiar with the proposed 5 percent cosmetic surgery tax said Allergan and Johnson & Johnson along with others in the industry helped persuade lawmakers to slash it from a 10 percent levy, which had been projected to cost about $11 billion over a decade.

Accounts vary on who first dreamed up the Botax. It came out of a late-July meeting on health care that included Sen. Max Baucus, D-Mont., the Finance Committee chairman, and Peter Orszag, Obama's budget director, although neither man's staff acknowledges having hatched the scheme.

Now that it's in the Senate legislation, plastic surgeons and the cosmetic product industry are dusting off their arguments against it. Opponents cite as a cautionary tale a similar 6 percent tax in effect in New Jersey. Haeck contends that tax has cost the state $3.39 for every $1 collected.

Whatever money would be raised, he said, would come from doctors and patients at a time they can ill-afford it, given the recession and rising unemployment.

"These women come in, they've lost their jobs, they don't have the money for a facelift," he said.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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