Back on November 19, Democrats proposed enacting a five percent tax on elective cosmetic procedures as a way to raise six billion dollars to pay for the nation’s healthcare system overhaul. Immediately dubbed the “Botax” by pundits, the idea drew instant fire from cosmetic surgeons, dermatologists and women who enjoy free access to the cosmetic procedures that enhance their appearances and often their self-esteem.
One of our areas of greatest interest and academic study is the intersection of beauty and the brain. A great deal of research has shown that having cosmetic improvements improves one’s mood, self-image and quality of life. It’s not known yet whether that improvement is purely due to greater confidence and pleasure in seeing oneself looking younger and more attractive, or whether there is a mechanism that affects brain function (akin to reports from women with Botox injections that they have a harder time crying). What remains clear is that improvements in beauty tend to correlate with improvements in mental state. So what does lawmakers’ willingness to tax breast implants and tummy tucks say about our attitude toward beauty?
Let’s use other popular taxes as a parallel. The most common tax on elective “lifestyle” choices is the “sin tax” placed on cigarettes and hard liquor in most states. These taxes are levied in part because smoking and drinking are perceived as potentially harmful activities that are basically recreational luxuries; the taxes are, in part, a way of the government saying, “If you’re going to do these things and cause potential problems such as drunk driving and lung cancer, we’re going to tax you for the privilege.” So, by this logic, is Congress saying that cosmetic procedures are equally frivolous and harmful choices made primarily by women (who, by the way, make up only 91 of the 535 seats in the legislative branch)?
That might be overstating, but it’s clear that the message being sent is that Botox and the many other procedures upon which women (86 percent of patients are women) spend billions per year are a somewhat frivolous luxury primarily enjoyed by rich people with too much time on their hands. This could not be more wrong. First of all, according to the American Society of Plastic Surgeons, 60 percent of women who get work done have household incomes between $30,000 and $90,000 a year. These are not the idle rich, and a five percent levy would have a real impact on their lives.
More importantly, while a small minority of cosmetic procedures may be playthings for desperate cougars trying to defy time, most women are simply trying to look and feel their best, correct what they see as defects, and enhance the quality of their lives. Beauty matters; it shapes our self-image, our relationships and our career opportunities. It is not an idle luxury nor a socially costly habit like smoking two packs a day, and it should not be forced by a tax into the “sin” category. Beauty, and the doctors and patients who pursue it, should be given their proper respect.