SANTA MONICA, CALIF. When state coffers get low, legislators go hunting for cash.
Lately, in states such as Maryland and New York, lawmakers have been considering taxes on "luxury" items from upscale cars to aesthetic surgery offices, Dr. Ron Wheeland said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation.
"This is not a new idea," he said, citing longstanding sales taxes on cosmetic surgery procedures in New Jersey and Minnesota.
In New Jersey, in fact, a Senate bill seeks to repeal the 2004 sales tax on cosmetic procedures because it generated far less money than expected.
But that experience hasn't stopped other states from trying.
In Tennessee, it's the same tune with different lyrics, as legislators consider a tax on devices and equipment used in cosmetic procedures, rather than targeting the consumers who pay for laser procedures and facelifts, he said.
Aesthetic procedures are also in the legislative spotlight with regard to safety and oversight, Dr. Wheeland said during a talk on the "new truths" in dermatology.
Restricting procedures and imposing tighter oversight measures are seen as "white hat" moves for legislators, who like to be seen protecting constituents, even in cases when not all the facts are in, said Dr. Wheeland, director of dermatologic surgery at the University of Missouri-Columbia.
In Virginia, House Bill 1399 would establish as a professional entity "laser light technicians" who would report not to the state boards that oversee physicians or nurses but to the board that oversees barbers and cosmetologists.
"I can only hope that that bill is defeated," he said.
In Georgia, Illinois, and California, proposed legislation would require preoperative examinations prior to laser or cosmetic surgical procedures. In Arizona, a bill is being considered that would allow nonphysicians to perform aesthetic procedures with lasers or light devices without physician supervision if they pass a 40-hour course.
Another bill in Illinois, which was referred to the rules committee in April, would permit only board-certified plastic surgeons to inject Botox, perform chemical peels, or perform aesthetic laser procedures.
"This one bothers me the most," said Dr. Wheeland. "When you think of these three procedures in particular, the first thing that ought to pop into your mind is that all three were developed by dermatologists."
It behooves dermatologists to be alert to themes and patterns in legislative proposals and to become involved when their own states are considering laws that would have a direct impact on the practice of dermatology, Dr. Wheeland said.
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