Cosmetic surgery is on the table as part of the $848 billion health care reform bill. Why you may ask, when most plastic surgery is elective, meaning that people have to pay for it themselves? Getting a butt lift, nose job or tummy tuck could not possibly effect the money-draining health care system we have now. In fact, plastic surgery may be the only profitable arm of health care -- at least for doctors and hospitals as opposed to the health insurance companies that are currently getting over.

Despite this, it seems that a plastic surgery tax is coming, with the promise of generating $5.8 billion over the next ten years by adding a 5% surcharge to these procedures sought by the rich and vain. But are those who get elective plastic surgery really rich? And, given that mostly women have these procedures, is this surtax fair? I am not usually pumping a fist on the side of those who have thousands in disposable income to spend on such things, but USA Today outlines some fairly compelling reasons to battle this tax:

•The tax would unfairly target middle-class women. Eighty-six percent of cosmetic surgery patients are women, and 60% have an annual income of $30,000 to $90,000, according to the American Society of Plastic Surgeons. Women face much more pressure than men to maintain a youthful appearance, says Jill Filipovic, 26, a lawyer and blogger in New York. "It's an easy choice for senators who are overwhelmingly male to tax something they probably aren't going to use," she says.

•The tax would be difficult to enforce. While the bill excludes surgery used to correct deformities stemming from an injury or disease, the distinction between cosmetic and reconstructive surgery isn't always clear, says Dr. Phil Haeck of Seattle, ASPC president-elect. For example, a nose operation to clear an individual's airways wouldn't be taxed, he says.

But if the surgeon also straightens the patient's nose, a common procedure when a patient's nose has been broken, that's considered cosmetic, he says. Such cases, Haeck says, "are going to be very difficult for the government to decipher."

•The tax would drive cosmetic surgery abroad. After New Jersey adopted a 6% tax on cosmetic surgery in 2004, many patients went to New York or Pennsylvania for procedures, says Dr. Renato Saltz, president of the American Society for Aesthetic Plastic Surgery. A federal excise tax would have the same effect, but patients would go to Thailand, Mexico or Costa Rica, he says. "We already see a lot of complications from surgeries performed overseas," he says.

While lobbyists for the cosmetic surgery industry are fighting this 5% plastic surgery tax, it looks like it will pass. It is not a hot button issue that legislators are bothered by, as opposed to abortion.

Not that I can afford it, but if I could, I would not like the idea of having to add a hefty 5% to an operation I have to pay for already in order to subsidize health care. Reports show that health care in America could significantly improve through savings generated by merely ridding the industry of its notoriously waste. To the tune of $505 to $850 billion a year. Why target middle class women for additional funds? Is it just laziness on the part of these lawmakers, or a real desire to make life harder for women?