The Senate yesterday unveiled its version of a complicated and sweeping overhaul of the health care system in the U.S. The bill is a mammouth 2,074 pages and will likely be in debate for at least the remainder of this year.
We’ll have time to further dissect the bill in the coming days. Meantime, upon quick review, some physicians — particularly cosmetic surgeons — might be interested to start reading from the back. On page 2,045, the Senate outlines its plans to charge a 5% tax on certain elective cosmetic procedures. The tax would be paid by the patient to the physician performing the procedure. If the patient does not pay the tax, the physician is responsible the tax.
Here’s the provision:
SEC. 9017. EXCISE TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.
(a) IN GENERAL.-Subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by adding at the end the following new chapter:
”CHAPTER 49-ELECTIVE COSMETIC MEDICAL PROCEDURES ”Sec. 5000B. Imposition of tax on elective cosmetic medical procedures.
”SEC. 5000B. IMPOSITION OF TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.
”(a) IN GENERAL.-There is hereby imposed on any cosmetic surgery and medical procedure a tax equal to 5 percent of the amount paid for such procedure (determined without regard to this section), whether paid by insurance or otherwise.
”(b) COSMETIC SURGERY AND MEDICAL PROCEDURE.-For purposes of this section, the term ‘cosmetic surgery and medical procedure’ means any cosmetic surgery (as defined in section 213(d)(9)(B)) or other similar procedure which-
”(1) is performed by a licensed medical professional, and
”(2) is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease.
”(c) PAYMENT OF TAX.-
”(1) IN GENERAL.-The tax imposed by this section shall be paid by the individual on whom the procedure is performed.
”(2) COLLECTION.-Every person receiving a payment for procedures on which a tax is imposed under subsection (a) shall collect the amount of the
tax from the individual on whom the procedure is performed and remit such tax quarterly to the Secretary at such time and in such manner as provided
by the Secretary.
”(3) SECONDARY LIABILITY.-Where any tax imposed by subsection (a) is not paid at the time payments for cosmetic surgery and medical procedures are made, then to the extent that such tax is not collected, such tax shall be paid by the person who performs the procedure.”.
(b) CLERICAL AMENDMENT.-The table of chapters for subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by inserting after the item relating to chapter 48 the following new item:
”CHAPTER 49-ELECTIVE COSMETIC MEDICAL PROCEDURES”.
(c) EFFECTIVE DATE.-The amendments made by this section shall apply to procedures performed on or after January 1, 2010.
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I am a Plastic, Reconstructive, & Hand Surgeon. Half of all my ER calls are entirely indigent, paying me nothing. Since I have been on call every third day and night for the past 21 years, that adds up to a huge amount of uncompensated care I have given, well over two million dollars. Now the government proposes to tax me on my legitimate earnings, hire a bureaucrat and two inspectors, then trickle back a meager portion to pay me for that which I already do for free. What constitutes “cosmetic” versus “reconstructive?” How about a rhinoplasty on a 25 year old girl with a history of unilateral cleft lip with minimal stigmata from the cleft but a large dorsal hump? Very small breast on one side with a form fruste of Poland’s syndrome, but with a normal arm and hand on that side and a near-normal pectoral muscle? An ophthalmologist friend returned from a mission in North Korea in which he restored many to sight but stated emphatically he would never return. Everywhere were signs which read, “This medical care is given to you by our “Glorious Leader.” It appears that a similar socialist goal is mirrored in our government’s seizure of one sixth of our economy. If we ask for socialism we will get it. You might not get me, however.
William D. Strinden MD Lufkin, Texas