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Taxing cosmetic surgery

As the overhaul of the nation’s health care system continues on Capitol Hill, some of the debate has the pop of prime-time medical dramas. One proposed five-percent tax on elective cosmetic surgery – not procedures to correct congenital defects, injuries resulting from trauma or disease – strikes some surgeons as egregious. Gordon Lee, MD, an assistant professor in Stanford’s plastic and reconstructive surgery department, also worries that the tax could have unintended consequences, ultimately leaving the nation with more costly health-care issues.

Echoing the concerns of colleagues nationwide, Lee, who is a member of the American Society of Plastic Surgeons, says the proposed tax might “drive patients to seeker ‘cheaper’ alternatives, such as unlicensed, uncertified, “discount” plastic surgery, either in the United States or outside the country.” Such so-called medical tourism, he argues, “is not a very good option.”

Some critics have suggested that the “Bo-Tax” would discriminate against women, who comprise the majority of cosmetic surgery patients. But Lee, who does breast and penis reconstructions, doesn’t share that concern. “Both men and women get plastic surgery, so I don’t think it is specifically targeting women.”

5 Responses to “ Taxing cosmetic surgery ”

  1. Arlen Meyers, MD, MBA Says:

    To support the conclusion that medical tourism is “not a very good option”, what evidence does Dr. Lee cite that the quality of cosmetic surgery performed by qualified,experienced surgeons outside of the US is inferior to that performed by similarly qualified surgeons in the US?
    Disclaimer: I am the cofounder and Chief Medical Officer of http://www.medvoy.com , a certified medical tourism faclitator, and Board Certified by the American Academy of Otolaryngolgy and the American Board of Facial Plastic and Reconstructive Surgery.

  2. G. Lee Says:

    Patients need to know the qualifications, experience, and training of the surgeon to whom they entrust their care, regardless of whether they are in the US or outside the US.
    In the US, training and certification are more consistent. Board certification by the American Board of Plastic Surgery (ABPS), or equivalent, and membership in the American Society of Plastic Surgeons (ASPS) or equivalent, are some examples of recognized and established achievements/qualifications.
    Several mainstream media (NBC, ABC) have had reports on cosmetic surgery disasters outside the US. If complications arise, it can be difficult for patients to get the help they need, and there is a lack of legal recourse in some cases.

  3. Arlen Meyers Says:

    Thanks for your comments. Sounds like we agree that:
    1. Patients need to carefully vet their surgeons, regardless of where they practice
    2. This is very hard to do for most patients, and
    3. There is little outcomes data comparing US v foreign providers.

    As far as cosmetic surgery disasters, I’ve observed that they are not limited by geography.

    The issues of follow up care and liability are certainly two of many barriers to adoption of medical tourism and need to be addressed by medical professionals and our international legal and insurance partners. For example, the policy statements concerning itinernant surgery and coninuity of care for specialy societies should be reassessed given the growth of medical tourism.

  4. Taras Kuzin Says:

    One should certainly exercise caution when traveling abroad. But “buyer beware” applies not only to plastic surgeons abroad but also to medical professionals in the States.

    Without a doubt, there are plastic professionals overseas who do not practice save medicine or may cut corners. Our company works only with board certified plastic surgeons. Moreover, the surgeons who are on our advisory board travel to meet and evaluate the doctors we work with and the facilities they operate in. We would not recommend a plastic surgeon that we were uncomfortable sending our friends and relatives to.

    I recognize that the example that I am about to use is not entirely relavent to this discussion about plastic surgery abroad. Nevertheless, I learned several days days ago about a tragedy that had happened in my friend’s circle. One of his best friends, otherwise a very health early forties former athlete, contracted an infection during a hip replacement surgery and later died from complications. This happened in a hospital in Tennessee. It is a tragedy and could happen even in a country like United States.

  5. Dr Bauer, plastic surgeons in Atlanta Says:

    Good thoughts here, but I would hope if a patient is considering a procedure they would not consider discount procedures — that’s the equivalent to letting someone other than a doctor or a midwife help you through the baby’s delivery.

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