Senate bill includes the Botox tax

[Eric Johnson]

For example....

I receive (about 5 times a year) Botox injections for a conditiion known as benign bi-lateral blepherospasm. In short, this is an uncontrolled contraction of the eyelids. I am functionally blind without the treatment bcause essentially my eyelids close and can't be opened for periods of 1-10 seconds. The frequency of spasms is increased in the presence of bright light....like headlights or the bright sun. Driving becomes very interesting under these conditions.

The treatment is about $600 each time.

When we read the provisions of the Senate bill, we find that I've been singled out to pay a special tax....5% of the treatment cost.

Obviously Senator Reid is meddling in things he doesn't have a clue about. Senator Reid may be a good lawyer. However, he and his minions can't have a handle on everything there is to know about the practice of medicine. This is an example of the idiocy he advocates. The reason for the provision is that, in the words of a staffer, "...was needed to make the numbers work..."

***********

Page 2045

SEC. 9017. EXCISE TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.

(a) IN GENERAL.-Subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by adding at the end the following new chapter:

''CHAPTER 49-ELECTIVE COSMETIC MEDICAL PROCEDURES ''Sec. 5000B. Imposition of tax on elective cosmetic medical procedures.

''SEC. 5000B. IMPOSITION OF TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.

''(a) IN GENERAL.-There is hereby imposed on any cosmetic surgery and medical procedure a tax equal to 5 percent of the amount paid for such procedure (determined without regard to this section), whether paid by insurance or otherwise.

''(b) COSMETIC SURGERY AND MEDICAL PROCEDURE.-For purposes of this section, the term 'cosmetic surgery and medical procedure' means any cosmetic surgery (as defined in section 213(d)(9)(B)) or other similar procedure which-

''(1) is performed by a licensed medical professional, and

''(2) is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease.

''(c) PAYMENT OF TAX.-

''(1) IN GENERAL.-The tax imposed by this section shall be paid by the individual on whom the procedure is performed.

''(2) COLLECTION.-Every person receiving a payment for procedures on which a tax is imposed under subsection (a) shall collect the amount of the
tax from the individual on whom the procedure is performed and remit such tax quarterly to the Secretary at such time and in such manner as provided
by the Secretary.

''(3) SECONDARY LIABILITY.-Where any tax imposed by subsection (a) is not paid at the time payments for cosmetic surgery and medical procedures are made, then to the extent that such tax is not collected, such tax shall be paid by the person who performs the procedure.''.

(b) CLERICAL AMENDMENT.-The table of chapters for subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by inserting after the item relating to chapter 48 the following new item:

''CHAPTER 49-ELECTIVE COSMETIC MEDICAL PROCEDURES''.

(c) EFFECTIVE DATE.-The amendments made by this section shall apply to procedures performed on or after January 1, 2010.

[ducknwork]

Your treatment does not sound elective or cosmetic. Did I read something wrong, because I don't believe the tax would apply to your situation?

[dnf777]

Your condition is neither cosmetic nor elective. The law doesn't apply.

[Eric Johnson]

Read it again. Neither the words "elective" nor "cosmetic" appear in the definition of what is not covered. The plain language of what it applies to reads: ..."(2) is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease."

Sure. I can afford the tax and will pay it as it beats the alternative. The point is that medicine is a horribly complex biz and things are changing frequently and in unpredictable ways. Harry Reid and the idiots in Congress have no reason to mess with things they know nothing about except to seize control.

[Hew]

Read it again. Neither the words "elective" nor "cosmetic" appear in the definition of what is not covered. The plain language of what it applies to reads: ..."(2) is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease."

Not germane to the the discussion, really, but the wording of the above is large enough to drive a truck through. "Congenital abnormality?" Wouldn't that cover nearly everything that people get work done for? You were born with a body part(s) that you consider abnormal...there's your out.

[Buzz]

This is exactly the problem with people pulling things out of context without reading everything and putting it together.

There is a definition of cosmetic surgery as referenced by this text in your quote:

(b) COSMETIC SURGERY AND MEDICAL PROCEDURE.-For purposes of this section, the term 'cosmetic surgery and medical procedure' means any cosmetic surgery (as defined in section 213(d)(9)(B)) or other similar procedure which-


Here is section 213(d)(9)(B):

(9) Cosmetic surgery. -
(A) In general. -
The term ''medical care'' does not include cosmetic surgery or other similar procedures, unless
the surgery or procedure is necessary to ameliorate a deformity arising from, or directly related
to, a congenital abnormality, a personal injury resulting from an accident or trauma, or
disfiguring disease.
(B) Cosmetic surgery defined. -
For purposes of this paragraph, the term ''cosmetic surgery'' means any procedure which is
directed at improving the patient's appearance and does not meaningfully promote the proper
function of the body or prevent or treat illness or disease.

Your procedure promotes the proper function of the body...
So it's not cosmetic surgery at all.
Just because botox is used to improve appearance doesn't make any procedure using botox a cosmetic surgery.
But the misinformers are implying that.

No tax for you!

[Eric Johnson]

Buzz-

Point taken. Can you tell me where you found the full text of the bill? All I can find in the Thomas version (S.1796) which requires me to open link after link after link after..... I'm not even certain that S.1796 is the correct bill as it's so hard to wade through it in that format.

Eric

[Eric Johnson]

Found "amendment by substitution of HR3590" which is called the "Reid Amendment" or the ‘‘Patient Protection and Affordable Care Act’’. However, it doesn't have a section 213 and the document text doesn't contain the text you referenced. It does contain the text I referenced.

Have I found the wrong bill or are you citing the bill being amended. If the latter, that bill seems to be amended in it's entirety and thus the section you referenced is no longer there. However, while the amendment is called the ‘‘Patient Protection and Affordable Care Act’’ the preamble reads..."To amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes."

Eric

[Buzz]

Eric, I'm looking at the bill here:

http://democrats.senate.gov/reform/p...e-care-act.pdf

But to your other question, from your quote:

SEC. 9017. EXCISE TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.

(a) IN GENERAL.-Subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by adding at the end the following new chapter:

So what you have here is text that is to be inserted into the Internal Revenue Code of 1986. The text refers to section 213 of the internal revenue act. So, I went on line and looked up the internal revenue act, and cut out the part referred to in this amendment to the act.

The thing that has bothered me in this whole debate is watching people on TV waiving paper around and asking - "have you read the bill? I have, and this is what is says!" Reading these bills is NOT easy stuff. It is so easy to misunderstand what you're reading, and it is really easy to deceive people with selective quoting that I've seen happening on the TV machine.

The only reason I was able to easily pick this up and find the definition in question is, I have had a lot of practice with this stuff. I used to represent Siemens on the (NEMA) National Electrical Manufacturers Association Energy Policy Committee. We used to read and comment on language written by the Department of Energy. I also used to represent NEMA on committees with the (IEC) International Electrotechnical Commission and analyzed & commented on international standards. If you suffer insomnia, you would do well to dig into some of my old files and browse awhile! The most insane thing I ever saw was a sentence written by a Department of Energy lawyer that was 2 1/2 pages long. I was reading and reading, and all of a sudden I thought, JEBUS - am I still reading the same sentence? I went back and carefully looked for a period. There was none!

Peace...