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As health care reform is being rushed to a vote before Christmas, it is hard for anyone to say what the bill includes. However, as of this morning, it does not include a tax on cosmetic surgery. I want to personally thank those of you who read my previous post, and made the time to contact your representatives. While there is no organized Cosmetic Surgery Lobby, your voice was heard, and it has made a difference.

Organizations such as the American Society of Plastic Surgery, the American Society for Aesthetic Plastic Surgery, the American College of Surgeons helped motivate their members. These surgical societies and the American Medical Association continue to work to incorporate real changes to help improve access, patient safety and equity into the process of healthcare reform.

Corporations like Allergan (from whom I purchase Natrelle Breast Implants, Botox Cosmetic and Juvederm) also went on record to oppose this unfair tax. More can be read here in MarketWatch.

While these large organizations helped to get the word out, what made the difference ultimately was you. You got involved. You called you Senators and Representatives, and for that I say, “Thank You.” The nature of the excise tax on Cosmetic Surgery was revealed and rejected, but there are more than 2000 other pages included in the Senate version of the healthcare reform bill.

While the bill is nobly entitled, “The Patient Protection and Affordable Care Act,” it has of late become “The Anything That Will Get Us 60 Votes Act”. The push to a vote before Christmas has lead to radical daily changes, and confusion about what “Patient Protection and Affordability” means.

I am interested in the outcome for many reasons. I am a Physician and my livelihood is directly effected by whatever is included in the yet to be finalized version of this bill. I am a health care provider, and I want to be able to take care of my patients in the ways that my training has determined are the best. I want the freedom to use my experience to choose the path with highest chance of success and lowest risk of injury. Unfortunately, rules and policies can only deal with large groups, and the decisions I need to make daily are on the level of the individual. Sometimes the needs of the one are different than the needs of the masses, and trying to get approval for a necessary test or surgery can be daunting when it is not the “normal” treatment.

I am interested in the outcome because I am in Private Practice. I not only provide medical care, but I purchase health care insurance for myself and my family. Medical coverage that as an individual, I cannot negotiate. Medical coverage that is provided in a take it or leave it fashion.

I am also interested in the outcome of The Patient Protection and Affordable Care Act, because I am a parent. Good health is one of the most important attributes we can have in a quality life. After good genes, quality healthcare is the key to good health. It is important that health care is made available. Public policy/support is a big piece of the solution, but equally important is the ability for your doctor to make a decision based on your situation. I cannot make my decisions based on what is right for the majority, I have to make them based on what is right for you, the individual. The individual is being lost in policy. Be it an insurance policy or a public policy the tyranny of the majority has found its way into medicine, and the policy being formed today will outlive all of us.

Many good ideas are left to be explored, and some aspect currently included need revision or unintended consequences may result. The selective excise tax on cosmetic surgery was not a good idea, and (for now) has been eliminated. Please continue to be involved, and contribute. The locomotive of reform has a full head of steam, and we need to keep it on track. Its shape changes every day, and the “true plan” has not yet been revealed. It is our healthcare that is being reformed, and it needs our attention.

Every time I hear another redundant news article on Tiger Woods, I wish instead I was being informed about something that actually will effect my life. The healthcare reform bill will effect my life. It will effect how healthcare is delivered in the United States, and will effect all our lives … directly.

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