The healthcare reform bill not only plans on taxing medical device manufacturers, it is also proposing to apply a 5% tax for cosmetic procedures. The tax would be paid by patients and collected by doctors. Surgery that would fall under the tax umbrella include procedures that are "not necessary to address deformities arising from congenital abnormalities, personal injuries resulting from an accident or trauma, or disfiguring diseases," according to The New York Times. Critics of the tax proposal argue that it will further contribute to the decline in nip and tuck procedures, and will drive patients to foreign countries where they can pay a fraction of the price for cosmetic surgery (as well as pay a potential price for sacrificing safety). Other groups, such as the National Organization for Women, say the tax will hit middle-age women the hardest.