Dear Patient,

The Healthcare plan in the Senate today will unfairly discriminate against you.

Raising the price of medical care.

I’m writing you today about an issue that affects not only plastic surgeons but everyone who utilizes our services for anything from Botox to Tummy Tucks.

No doubt, you’ve heard of the current healthcare bill before the US Senate? Page 2045 Sec. 9017, Excise Tax on Elective Cosmetic Medical Procedures included in the “Patient Protection and Affordable Care Act”. This dense legalese translates to a tax on all cosmetic procedures as partial payment for the healthcare overhaul our current administration is attempting to implement.

So what’s the problem? YOU would be paying this tax, the FIRST time this country has levied a tax on patients for medical procedures. What’s at stake?

• This is a discriminatory tax. According to the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons Annual Statistics, 91% of all cosmetic procedures are requested by women.

• This will not have considerable consequences on the wealthiest patients but, as usual, affects the middle class. Working women, soccer moms, and scores of others who carefully save and budget to improve their appearance and self esteem will be penalized for doing so. 90% of all cosmetic plastic surgery patients have an income of less than $90,000.

• Procedures such as breast reduction that have been cited in the literature for improving self esteem and quality of life would be taxed as well. The procedure relieves chronic pain and changes lives for the better. This is the best of what medicine has to offer.

• Procedures not performed by plastic surgeons, such as Lasik surgery to improve vision, would also be taxed. It is likely that all procedures where payment is denied would be subject to taxation.

• Your doctor as tax collector: This provision places physicians in the role of tax collector and holds physicians liable should an individual fail or refuse to pay the tax. Is that the relationship you want with your medical provider? It is not the relationship I want with my patients.

The bill is large, and every sentence effects your medical care.

Please help us stop this arbitrary and penetrative tax. To find your Senators please click here: http://www.senate.gov/general/contact_information/senators_cfm.cfm For your Representatives click here: https://writerep.house.gov/writerep/welcome.shtml

I urge you to personally inform the government that you are against this tax – together we can fight for your right to no government interference in medical care and stop this discriminatory measure against women!

You may recall that over the summer President Obama claimed he opposed any new taxes on households making less than $250,000 a year. According to the July 2009 issue of Gaurdian, while publicly making this claim, President Obama’s aides, and top Democrats were pushing for a cosmetic tax. According to Politico Treasury Department economic adviser Gene Sperling made the proposal. This cosmetic plastic surgery tax would be a tax on primarily women who earn less than $90,000 a year. A very small percentage earn more than $250,000 a year.

I can understand sin taxes on alcohol and tobacco which increase the cost of healthcare if those dollars are used for healthcare. It’s like forcing people to save for a known future expense (if they live that long). I cannot understand a tax on what the government decides is unnecessary surgery. Especially when the procedures relieve pain, improve vision, and otherwise decrease the need for further intervention.

My staff and I fight daily for patients’ rights to medical care. I debate with insurance companies about what is cosmetic and what is reconstructive surgery. There is no obvious line. Insurance companies are rewarded monetarily by denying claims.

If you are a proponent of the “public option”, you might be surprised to know that private insurance companies deny a smaller percentage of claims than government programs. Medicare currently denies more the six percent of claims. If they deny a claim, they don’t pay it. This saves them money. If they will get another 5%, or as originally proposed 10%, reward for denying claims, more procedures will be deemed unnecessary, and you, the patient, will be responsible not only for the cost of the procedure, but also for the tax on it.

The best thing about plastic surgery, both reconstructive and cosmetic plastic surgery, is that it helps people. It improves function, relieves suffering and makes people happier. And making people happy, makes those around them happier, and improves our society at its base. I would much rather spend my time doing that than talking about the above, but both are important.

Next week I will stop the politics, and get back to what I do best – Cosmetic Plastic Surgery in San Francisco’s East Bay Area community of Walnut Creek. In the mean time, get the word out. Inform your friends and tell your Senators how you feel.

To find your Senators please click here: http://www.senate.gov/general/contact_information/senators_cfm.cfm

To find your Representatives click here: https://writerep.house.gov/writerep/welcome.shtml

EDIT: Allergan has organized on online petition here. This is another good way to get your voice heard; however, the most important way is to contact your Senators and Representatives directly. The feedback I am getting is that not enough people are speaking up, and this law is scheduled to take effect January 1, 2010, only a few weeks from now.