Washington » Cosmetic surgeons are trying to rally their patients in opposition to a new tax on tummy tucks, face-lifts and breast augmentations that Senate Democrats are proposing to help pay for overarching health reform.

And leading the charge is Utah physician Renato Saltz, president of the American Society for Aesthetic Plastic Surgery.

"The society is not against health care reform, but we don't believe our patients should pay for the bill," said Saltz, who runs a private practice in Holladay.

Politicians first floated the idea of imposing a 5 percent excise tax on elective cosmetic surgeries this summer as they debated a number of ways to pay for what could be a $1 trillion health care bill.

At that time, Senate leaders shelved the idea along with others -- such as a proposal to tax sugar-filled sodas -- in favor of a tax on high-end insurance plans.

The cosmetic surgery tax, which some in Washington have labeled the "Botax", surprisingly resurfaced when Senate Majority Leader Harry Reid unveiled the Democratic bill that the Senate is now debating. They expect it to raise $6 billion in the next 10 years. The tax would not apply to procedures that are reconstructive in nature, necessitated by such things as a traumatic accident, breast cancer or a birth defect, though it would hit all kinds of elective procedures from Botox injections to teeth whitening.

"We needed money to make the bill work," said Reid spokesman Jim Manley. "The idea was to find a funding mechanism within the health care area."

The announcement caught Saltz's society and other cosmetic surgery groups flat footed and in the past few weeks they have tried to ramp up their lobbying efforts in a bid to strip the tax from the bill. They've sent blast emails to former patients asking them to contact senators and surgeons have started pushing federal lawmakers themselves. The American Medical Association is backing the cosmetic surgeons in their fight.

Opponents' main message is that this tax will largely affect only one gender.

"This is discrimination against women," said Saltz. "To me that is the strongest argument."

It is an argument Utah Sen. Orrin Hatch also uses.

Hatch, who strongly opposes the health reform proposal, said it was wrong to target one group of medical professionals with a new tax and, like Saltz, he said this is "a tax primarily against women."

Republicans such as Hatch, and Utah Sen. Bob Bennett, have repeatedly criticized the variety of tax increases included in the Democrats' bill. Those new taxes, which include levies on complex medical devices and a boost in the Medicare tax for the wealthy, would help pay for federal subsidies that low- and middle-income Americans could use to buy insurance.

Democrats see this as the financially responsible way to expand the social safety net, while Republicans looks at the tax increases as poor fiscal policy in pursuit of expanding the government's role in health care.

Bennett suggests Democrats were searching for a funding source "that probably isn't very popular with most Americans and cosmetic surgery is as good as the next thing."

"I think it's very close to being random and very hard to justify as sound policy," said Bennett, arguing Senate leaders could just as easily have taxed motorcycles or second cars.

He also said it could put surgeons in a tough spot when a procedure is partially reconstructive and partially for aesthetics.

Only New Jersey has a similar tax, though it has been proposed and rejected in a handful of other states.

The industry argues that proponents of the levy see it as a luxury tax that will only hit the wealthy, but they say most of their customers are well within the middle class, so adding an extra $500 to a $10,000 procedure will impact them.

Elective cosmetic surgeries have declined as a result of the economic recession; with Saltz estimating that Utah's 80 plastic surgeons having experienced a 25 percent drop in their patients in the last year. But he insists his opposition to the tax goes far beyond the impact it will have on his bottom line.

"You are right, plastic surgery is where we make some money," he said. "But I don't think that is the main issue."

He says a tax targeting only one group of physicians is unfair and he argues that elective surgeries help men and women gain self-esteem and foster more active public participation.

"It is already expensive for a mother of four who just wants to feel better about herself," he said. "It is really going to affect a lot of people."

mcanham@sltrib.com

Tribune reporter Thomas Burr contributed to this article.