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A plastic surgeon prepares for surgery on the stomach of a patient. - 

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Kai Ryssdal: The more you read a 2,000 page piece of legislation, the more you learn. Like this tidbit: there is a 5 percent tax in there on optional cosmetics procedures. Stuff like botox treatment and nose jobs and tummy tucks. The proceeds are supposed to raise almost $6 billion over the next decade to help pay for health-care reform. But as you might imagine, plastic surgeons have their knives out for this idea. Here's our senior business correspondent Bob Moon.


BOB MOON: Leading plastic surgeons we spoke to today sought to shed the glamorous image their profession gets from Hollywood, on shows like "Nip/Tuck."

TV CLIP: Since 1987, the one luxury business that has always seen annual growth has been plastic surgery.

DR. RENATO SALTZ: Contrary to popular belief, cosmetic surgery is no longer a exclusive luxury for the wealthy.

Salt Lake City plastic surgeon Renato Saltz is head of the American Society for Aesthetic Plastic Surgery. He says the Senate plan would unfairly target patients who already pay full price. Cosmetic procedures aren't covered by insurance.

SALTZ: Over 80 percent of our patients are really middle class. We feel that a tax like this would discriminate against women -- 86 percent of total cosmetic surgery is performed on women.

At the American Society of Plastic Surgeons, Seattle-based president-elect Dr. Phil Haeck says now isn't the time to single out those who see a need for his services.

Dr. PHIL HAECK: I have had any number of patients come through lately and say, I just lost my job, I haven't had to go out and apply for a job for 10 years, I want to look a little better. Should we penalize that patient with an additional 5 percent tax? I don't think so.

Haeck doubts the measure will raise the billions lawmakers expect -- especially since members of his organization have been reporting their business is off as much as 30 percent this year. He also says distinguishing between what's optional and what's necessary reconstructive surgery would be very tricky in many cases.

Plastic surgeons argue their procedures aren't any more frivolous than laser-eye surgery or other popular medical procedures that wouldn't be taxed.

I'm Bob Moon for Marketplace.