Health Reform Update
Friday, 11 December 2009
THE SENATE MADE GREAT STRIDES YESTERDAY TO REMOVE WHAT HAS BEEN CONSIDERED A MAJOR ROADBLOCK TO THE LEGISLATION. THE SENATE IS NOW MOVING EVEN CLOSER TO A CRUCIAL AND IMMINENT VOTE. SENATE MAJORITY LEADER REID PLEDGES A FINAL VOTE BEFORE CHRISTMAS. THUS, YOUR ACTION IS NEEDED NOW! IF YOU DO ONE THING TODAY, MAKE SURE YOU READ THIS EMAIL AND TAKE ACTION!!! ONE STEP IS NOT ENOUGH -- PLEASE TAKE ACTION ON ALL ITEMS LISTED BELOW.
ASPS has launched a hotline and a comprehensive web site for our members and their patients to contact their Senators on the 5% cosmetic tax. Senators say they are not hearing from you and your patients.
WHAT YOU MUST DO
Step 1: Please click on www.capitolconnect.com/asps/login.aspx to be directed to a sample letter you, the physician, can send to your Senators and Representatives.
Step 2: Please call our toll-free hotline at 1-877-221-8207 and urge your Senators to block this tax (you will be prompted to enter your zip code and then be directed to your Senators).
Step 3: Please visit www.plasticsurgery.org/Media/Press_Kits/Cosmetic_Surgery_Tax.html
Please print the page and provide it to your patients so they may follow the steps and take action as well.
Step 4: Please email the link to your patient lists. www.plasticsurgery.org/Media/Press_Kits/Cosmetic_Surgery_Tax.html
It is vital that patients take action to stop this tax!
Use the following talking points in your communications:- Discriminates against women. Cosmetic surgery taxes discriminate against middle class women. According to the American Society for Aesthetic Plastic Surgery, 86% of all cosmetic procedures are requested by women and 91% are working women.
- Taxes Middle-Class. The provision violates President Obama's promise to not tax individuals making less than $250,000 annually. ASPS found that 71% of plastic surgeries were for individuals making less than $60,000 a year.
- Violates Patient Privacy. This provision invites the IRS into the exam room. Enforcement of this provision will include IRS audits of medical practices to determine whether procedures were elective and/or cosmetic.
- Physicians should determine medical necessity, not the Government . The line between "cosmetic" and "reconstructive" surgery is not always clear and leaves the decision of medical necessity up to tax auditors---a completely inappropriate proposition.
The New Cosmetic Surgery Tax Affects the Middle Class!
Friday, 4 December 2009
THE UNITED STATES SENATE HAS A PLAN PENDING TO REFORM HEALTH CARE. THE PLAN INCLUDES A 5% TAX ON COSMETIC MEDICAL PROCEDURES. THIS TAX DISCRIMINATES AGAINST YOUR PATIENTS, WOMEN, AND THE MIDDLE CLASS. THE STATE EXPERIENCE HAS DEMONSTRATED THAT IT IS A FAILED POLICY, ONE THAT WILL NOT RESULT IN THE PROJECTED REVENUE. CONGRESS NEEDS TO HEAR FROM YOU AND YOUR PATIENTS. PLEASE SHARE THE TALKING POINTS BELOW WITH YOUR PATIENTS, SO THEY MAY ALSO TAKE ACTION. CONGRESS IS STATING THAT THEY ARE NOT HEARING ANY OPPOSITION TO THE COSMETIC TAX; MAKE SURE YOUR VOICE AND THE VOICE OF YOUR PATIENTS IS HEARD TODAY!
HEALTHCARE PLAN IN THE SENATE TODAY WILL UNFAIRLY DISCRIMINATE AGAINST YOU!
Perhaps you've heard of the current healthcare bill before the US Senate, Page 2045 Sec. 9017, Excise Tax on Elective Cosmetic Medical Procedures included in the "Patient Protection and Affordable Care Act. This section institutes a tax on all cosmetic procedures as partial payment for the healthcare overhaul our current administration is attempting to implement.
So what's the problem? YOU would be paying this tax, the FIRST time this country has levied a tax on patients for medical procedures. What's at stake?
This is a discriminatory tax. 86% of cosmetic surgery patients are working women.
This will not have considerable consequences on the wealthiest patients but, as usual, affects the middle class. ASPS, found that 71% of plastic surgeries were for individuals making less than $60,000 a year. Working women and scores of others who carefully save and budget to improve their appearance and self esteem will be penalized for doing so. The tax clearly violates the President's pledge to only tax persons making over $250,000 a year.
The tax compromises patient safety. The provision is limited to procedures performed "by a licensed medical professional" -- establishing a tax loophole to avoid paying the tax by seeking elective cosmetic and medical procedures from non-medical personnel at salons, spas and other locations.
Procedures such as breast reduction that have been cited in the literature for improving self esteem and quality of life would be taxed as well.
Your doctor as tax collector: This provision places physicians in the role of tax collector and holds physicians liable should an individual fail or refuse to pay the tax. Is that the relationship you want with your medical provider?
What you can do: Take action today and tell your Representatives that medical care should not be used as a tool to fix broken finances. Contact your Members of Congress and request that they oppose a cosmetic tax.
Call your Members of Congress in their Washington, DC and District offices. Please call your Members of Congress in both their Washington, D.C. offices and district offices. Call early and call often. The U.S. Capitol switchboard is 202-225-3121 where you can be connected to your Members of Congress. NOTE: You must know the name of your Member of Congress prior to calling the switchboard; they will not be able to tell you who your Member of Congress is. If are not certain who your Senator is, go to http://www.senate.gov/general/contact_information/senators_cfm.cfm and scroll by state. You can also determine the name of your Representative by going to www.house.gov and enter your zip code in the top left hand corner.
Cosmetic Tax Update.
Patients needed!!
In light of the recent cosmetic surgery tax proposal, ASPS is implementing a multi-layered grass roots campaign to combat the tax. We’re asking specific members of the ASPS Spokespersons Network for their help!
We would like you to help us identify patients who would be adversely affected by such a tax, and who would be willing to share their stories for use in future public relations/media and grassroots efforts. These patients would also need to make themselves available for media interviews.
>Criteria for these patients include those who oppose a 5% tax on cosmetic procedures (average income women & men) and those who will have a procedure that falls into the respective ‘gray area’ of cosmetic vs. reconstructive surgery classification. Examples of “gray” procedures include, but are not limited to: breast reduction, body contouring after massive weight loss, removal of benign skin lesions, gynecomastia, port wine stain removal, preventative mastectomy followed by breast reconstruction, etc. The link below will take you to a recent news article that gives an example of the ideal patient.
Cosmetic surgeons, patients fight proposed 'Botax'
http://www.tennessean.com/article/20091125/COLUMNIST0304/911250365/
As you probably already know, this tax could be implemented as soon as Jan 1, 2010, so time is of the essence. That’s why we’re asking that you get back to us with names and contact info. for patients that meet this criteria as soon as possible next week or if you could get back to us by Monday, December 7, that would be even better. Our goal is to secure as many patients as possible. While we understand that this may be a time-intensive process, this is a vital component in our efforts to have this tax removed from most recent healthcare reform proposal, and the deadline to do so is quickly approaching.
Thank you for your help!
The One Thousand Most Influential Londoners - Health
Wednesday, 11 November 2009
Went to London Evening Standard Party for 1000 Most Influential Londoners at Burberry's new worldwide headquarters. I was named as one of only two Plastic Surgeons. Great fun, a little too much champagne. But at least it was the expensive kind.
The Evening Standard 1000 Most Influential People in London
Wednesday, 28 October 2009
Dr Laurence Kirwan is invited by Geordie Greig Editor of The London Evening Standard to celebrate the 1000 Most Influential Londoners on Tuesday 10 November 2009 at Burberry, Horseferry House, Horseferry Road London SW1.
LAST WORD
Wednesday, 21 October 2009
Cosmetic Surgery & Aesthetics Magazine Sepetember-October 2009
'LAST WORD'
Laurence Kirwan MD FRCS FACS
The main difference between the US and the UK is that in the US, patients are looking at who hasn’t had it done and in the UK, they are hoping no-one will look at them and guess they did it.
The British are quite aggressive in terms of early face-lifts and if anything, are more adventurous than their American counterparts. Sometimes, and in a rather scary way, the British will travel abroad for surgery or choose doctors on the day of the procedure, with nigh a second thought. Americans are, to-a-tee, better informed and better researched, although the British are catching up.
Patients on both sides of the Atlantic tend to follow the same referral route to their plastic surgeon – i.e. Internet, existing patients and friends; sometimes doctors and even more rarely GP’s (almost unheard of). Non-plastic surgery doctors are, in general, poorly informed about the options and benefits of plastic surgery.
The differences are that the UK is a chatty, gossipy country that reads its tabloids and equivalent magazines so that print media seems to be more effective in attracting patients to my office in the UK – as opposed to the USA, where the Internet and patient referrals are bigger factors. TV is a terrifically powerful medium but I am hardly on it or in it. TV make-over programs are generally based on the idea of taking someone who is well past their sell-by date and converting them into something with an indeterminate shelf-life. I think this is often a leviathan enterprise with unnecessary medical risks.
The British are, of course, famous for their bad teeth and the almost complete absence of orthodontia. Jamie Oliver, but one example, whereas the Americans are famous for their perfect teeth and orthodontia. Orthodontia is still a largely undiscovered art in the UK.
Plastic surgery is often performed in private surgical centres in the USA and most surgery is performed under sedation (versus general anaesthesia) and the patient goes home to their own bed, rather than remain in the hospital - as they need to in the UK.
Nurses in an American operating theatre, are trained assistants whereas in the UK, they are usually only trained to the level of surgical scrubs nurses who pass instruments and are unused to assisting surgeons. In the USA we also have ‘physician assistants’ who assist in surgery and can help ‘close’ the wound.
British anaesthetists (known as anesthesiologists in the USA) have more facility with a breathing tube known as the laryngeal mask, which can reduce soreness of the throat after a general anaesthetic. However, American docs are better at doing cosmetic surgery under sedation thus avoiding the necessity for a tube in the throat in the first place.
Lastly, US hospitals recognise that plastic surgery is a profit centre and generally attract it by keeping their fees low. UK hospitals seem to view it as a necessary evil and take any opportunity to charge large fees. Maybe this is a reflection of the English view of cosmetic surgery. LK
Cosmetic Surgery & Aesthetics Magazine September-October 2009
New Events and Happenings
Wednesday, 7 October 2009
A few notes: Currently in London. I gave a presentation tonight (7th October) to a Launch Evening for The Eye Spa at Eye to Eye, Knightsbridge. A great new concept embracing the best in eye frame design (I plan on getting one) with international consultants on micro-pigmentation, Laser refractive correction, Skin Care and of course Plastic Surgery. I am their dedicated consultant. They are located on Montpelier Street in Knightsbridge just opposite Harrods. Eye To Eye, 3A Montpelier Street London SW7 1EX+44 (0) 20 7581 8828 I have been invited to give an Instructional Course at the next meeting of The American Society of Aesthetic Plastic Surgery in Washington D.C. in April 2010. Maybe I'll get invited to the White House? This will be the second course I have given to the Aesthetic Society. I understand I will be in the next edition of Beyond Black's Guide to Top Plastic Surgeons, world-wide. As you know we are moving to an even more beautiful new office in Norwalk, Connecticut with great view of the Connecticut River. This new office will allow us to create the Kirwan Aesthetic Center which will offer not only Surgical Rejuvenation but the full range of Non-Surgical treatments such a Sculptra Aesthetic (see below), Restylane, Perlane, Radiesse, Botox, Dysport, Fraxel, Thermage, Endermologie, Laser Light Sheer Hair Removal, Aura Laser treatment of broken blood vessels in the face and injection compression sclerotherapy of spider veins and varicose veins in the legs. Prof. Kirwan is an accredited trainer for Sculptra Aesthetic and he was recently flown out to Santa Monica, California on September 25th to complete a two day Training for Trainers at the Loews Hotel, on the latest techniques and information.
