Via Tyler Cowen, it turns out that the proposed tax on cosmetic surgeries (like Botox) might be highly regressive:

… look around. See that cosmetic surgeon down the street? The walk-in Botox clinic next door? That’s because cosmetic surgery spread from the rich and famous to the rest of us because of increasing access to credit. That’s right- the deregulation of banking that happened in the 1980s meant more and more Americans were taking out credit- either on credit cards or with medical credit companies like GE’s “CareCredit.”

What this means is that cosmetic surgery is now primarily consumed not by the rich, but by the working and lower-middle classes, sometimes even by the poor. According to the American Society for Aesthetic Plastic Surgery (ASAPS), about 1/3 of cosmetic surgery is consumed by people who make less than $30,000 a year. About 70% of it is consumed by people who make less than $60,000 a year. It is mostly women (90%) and mostly white, middle-aged women (80% and between 35-55 years old).

It would be interesting to know if these trends vary depending on the procedure. I would suspect, for instance, that nose jobs and facelifts are common among the affluent and highly-educated, whereas breast implants, which still carry something of a class-based stigma, are a more heavily downscale phenomenon. And I would imagine there are interesting regional variations as well. (Perhaps some of these questions are addressed in the forthcoming book from the author of the post quoted above.)

Riffing on the data, Tyler writes that “cosmetic surgery is not just a zero-sum game but rather it leads to better matches, more matches, and more people who are happy with their looks or with the looks of their partner(s).” I would go halfway with him, and say that it’s certainly a rational response to a culture where airbrushed images of perfect beauty flood the airwaves and supermarket aisles, where male instincts about sex are increasingly influenced by the siliconed imagery of hard-core pornography, and where high divorce rates (which are especially high among the working class) ensure that large numbers of women find themselves re-entering the dating pool in middle age. Whether it’s something to be welcomed, though, is another question entirely.

Question: Should Botox, Restylane, Juvederm, liposuction and cosmetic surgery be taxed like you luxury car?

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