Bloomberg's Nicole Gaouette has written an insightful news piece that details how New Jersey's tax on cosmetic surgery — begun in 2004 — is being held up by some as an example of failed health care policy in light of the proposed 5% "Botax" now before the US Congress. The levy is included in the Democrats’ health-care overhaul, now being debated in the U.S. Senate.

The New Jersey tax hasn’t been worth the controversy that followed, said Joseph Cryan, the assemblyman who proposed it. It has spurred sometimes angry debate from doctors over the medical necessity of procedures, and chased customers out of state, he said. It also prompted charges of discrimination against middle- class women, who make up the majority of patients, according to the American Academy of Cosmetic Surgery.

”It was a real education,” said Cryan, a Democrat who now wants the levy repealed, in a telephone interview. “We essentially discouraged the business from happening at all.”

Susan Hughes, a Cherry Hill, New Jersey, facial surgeon, said her business dropped by 10 percent when patients began crossing the state line to Pennsylvania. Administering the tax strained relationships with patients, and created extra work and costs for her office, she said.

‘You Idiots’

“We become the tax collector,” Hughes said in a telephone interview. “Now you’re going to repeat that on a national level? You idiots!” Hughes’s office manager, Jaime Castle, said she’s also concerned about layering the taxes, making New Jersey residents pay a combined 11 percent.

In the U.S., about 12 million people spent $10.3 billion in 2008 on cosmetic procedures and products, according to the American Society of Plastic Surgeons, based in Arlington Heights, Illinois. About 90 percent of patients are females, the Society said on its Web site.

Americans paid $391 on average for a treatment with Allergan Inc.’s brow-smoothing Botox, $3,348 for breast enlargements using implants made by Allergan Inc. and New Brunswick, New Jersey-based Johnson & Johnson, and $6,012 for facelifts, according to online data from the society.

Senate Majority Leader Harry Reid, a Nevada Democrat, proposed the U.S. cosmetic care tax without specifying which products or procedures would be taxed. The levy is included in the Democrats’ health-care overhaul, now being debated in the U.S. Senate.

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