Dermatologists celebrated a significant victory in the debate over healthcare reform as the Senate agreed to a 10 percent federal excise tax on indoor tanning services instead of a proposed tax on cosmetic surgical procedures.
"The indoor tanning tax, as proposed to Senate leadership by the American Academy of Dermatology Association (AAD), furthers its goal of promoting wellness and prevention, and removes the harmful intended consequences associated with a tax on cosmetic surgery procedures," the AAD states in a news release.
"The pending health system reform legislation provides an ideal opportunity for Congress to take a needed step forward in battling skin cancer by requiring a federal tax on indoor tanning services," states dermatologist David M. Pariser, M.D., president of the AAD. "A tax on indoor tanning services would serve as a signal from the federal government to everyone, especially young people, that indoor tanning is dangerous and should be avoided."
Suggesting the indoor tanning tax as an alternative to the proposed tax on cosmetic surgery was seen by insiders as a particularly adroit maneuver to eliminate a troubling and costly provision for cosmetic surgeons and their patients.
"This tax inserts the federal government into the physician-patient relationship in a new way - specifically, the Internal Revenue Service will become an arbiter of what is cosmetic and what is medically necessary," Dr. Pariser wrote in a letter outlining the AAD's views on the proposed "Botax" to Senate Majority Leader Harry Reid (D-Nev.).
"Under the proposed language, an HIV-infected patient with severe and stigmatizing lipoatrophy (loss of facial fat) resulting from their antiviral medications might be taxed for seeking to reduce their social stigmatization and return their face to a normal shape," Dr. Pariser states.
The AAD was able to rally support from other surgical specialties in opposition to the proposed tax on cosmetic surgery. The American College of Surgeons (ACS), in a letter to Reid, says the tax "discriminates against women and the middle class." It says experience at the state level has demonstrated that it is a "failed policy" and will not generate the amount of revenue projected.
"Further, this provision is arbitrary, difficult to administer, unfairly puts the physician in the role of tax collector, and raises serious patient confidentiality issues," the letter states.
Meanwhile, as the debate over healthcare reform moved toward a conclusion, the AAD pressed Congress on a number of other key issues, some of which were eventually included in legislation approved by either the House of Representatives or Senate and subject to negotiation by House-Senate conferees who would shape the final bill. Those included:
"Our nation's doctors and patients are in need of healthcare system reform - reform that can happen if we work together to create a system that embraces the principles of quality care, efficient use of resources and a patient-centered approach to practicing medicine," Dr. Pariser says.
Bob Gatty, former congressional aide, covers Washington for businesses specializing in healthcare and related issues. Contact him at firstname.lastname@example.org