And Then the Government Came for Your Nose Job

Call it the Botax. Congress is considering a tax on cosmetic surgeries, a $12 billion industry, to help pay for health reform. That's a significant mountain of money to grab deficit-fighting bucks, and as Catherine Rampell notes, the Botax could also be seen by parents as a so-called "sin tax"  to reduce needless cosmetic surgeries for their daughters. But really: Taxing breast augmentation? Instapundit counters: Why not tax abortion?


Cosmetic surgery and abortion: They're mostly both elective procedures by doctors for women (according to Cosmetic Plastic Surgery Research, women accounted for 91 percent of all plastic surgeries in 2007). So what's the difference? Well, the law for one thing. As Jonathan Adler, a professor at the Case Western Reserve University School of Law, writes at the Volokh Conspiracy blog:

My own view is that, under current law, a tax targeted at abortions would be difficult to sustain. Under Casey, states may not impose regulations that place an "undue burden" on a woman's constitutional right to terminate her pregnancy. A law creates an "undue burden" where it has "the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus." Any abortion tax large enough to raise a meaningful amount of revenue would likely increase the cost of abortions sufficiently to constitute an "undue burden" under this test.

The most important similarity I see between taxing nose jobs and taxing abortions is that neither is likely to happen. A Democrat-sponsored abortion tax is out of the question, and proposing a tax on cosmetic surgeries will -- as we have seen -- stir the ire of plastic surgeons and their patients just as Obama is trying to calm the hysterics among wealthy Democratic districts and doctors' lobbies.

If we're going to see Botaxes, they will likely be state Botaxes. New Jersey has passed a 6 percent tax on certain procedures such as Botox and nose jobs in 2004, while excluding less elective procedures like reconstructive surgeries. How has it worked out on the revenue side? Disappointingly. Malcolm Roth, vice president for health policy and advocacy at the American Society of Plastic Surgeons, said a botax in New Jersey raked in only a quarter of the expected revenue, according to the LA Times.

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Derek Thompson is a senior editor at The Atlantic, where he writes about economics, labor markets, and the entertainment business.

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