With all due respect to Slate 's Christopher Beam, I don’t agree that the " botax " tucked into the Senate health care bill is a bad idea . Much as it pains me to swallow conventional wisdom, the obvious conclusion in this case-that taxing elective cosmetic surgery is a great way to raise revenue for health care reform-also happens to be the correct one.
Tax-policy buffs generally analyze taxes along three dimensions: equity, efficiency, and economic stabilization. Beam goes for the triad, arguing, first, that a tax on elective plastic surgery would unfairly penalize the lower-middle-income consumers who make up the bulk of the market. (Though, with the prevalence of cosmetic procedures among teens and young adults whose parents foot the bill, I question the persuasiveness of his statistic that one-third of plastic surgery consumers earn less than $30,000.) Second, the tax would harm the cosmetic surgery industry and dampen its stimulating effect on the economy. Third, due to the hazy boundary between "reconstructive" and "elective" plastic surgery, high administrative costs would render its enforcement economically inefficient.
These points would be valid for an income or payroll tax. They are almost entirely irrelevant when scrutinizing a sumptuary, or "sin" tax, which is what this one is. The point isn’t to make wealthier people pay more. It’s to discourage some morally questionable or socially harmful behavior. Cigarettes are the paradigmatic example.
One could also argue that the surprisingly paltry average income among plastic surgery recipients actually presents a more potent argument for the botax. This is one instance of paternalism where father Obama knows best. If the majority of those going under the knife cannot afford to do so, the government should dissuade its low-earning citizens from frittering away their scarce resources on larger breasts and firmer calves and encourage them to invest in education instead.