There are TWO lessons embedded in this story.

Social comment: So sad. Every one of my wrinkles has a history—working with poor Peruvian farmers for many months in the wind at 14,000 feet; working for a couple of years in the sub-Arctic with its 60-below winters; decades in the sun producing healthy vegetables for kids to eat—why would I ever want those wrinkles to disappear? They are who I am. I don’t want to be someone else.

Economic comment: No Medicare, Medicaid, or other government money. No insurance in most cases. Yet these doctors are doing just fine for themselves in a totally free-market environment, utterly devoid of more than very basic government involvement with safety regulations. They’re meeting a perceived need, as sad as I find it, and they’re doing it at an effective market-clearing price. All medicine should work that way.

I think there is a difference between working out a payment plan for a $25,000 tummy tuck and a $1,000,000 heart transplant.  But I could be wrong.

Not to mention the fact that plastic surgeons can make a fine living limiting their tummy tucks to those who have 25k to pay for them, while all others are forced to endure living out their lives with their excess fat spilling over their belt buckle.  But if you limit life saving medicine to the people who can afford to pay for it out of pocket rather than use an insurance plan to spread the cost and risk across a large segment of the population, there would be a very large number of unnecessarily dead people.

What ever happened to growing old gracefully?

I wonder if as many patients would be amenable if they knew that some procedures will require blood transfusion, especially the lipos or high-volume lipos; the latter, in some cases, are really not that safe.

The million-dollar heart transplant is a red herring. A more appropriate example would be my wife’s $14,000 cancer surgery.

#6—Well, $14,000 might as well be a million if you don’t have it. And the point is life-saving and life-sustaining surgery versus elective, vanity-driven procedures. Should only financially secure lives be saved?

Since the original topic was the epidemic of cosmetic surgery, let me go back to that.  My neighbor, a woman fifty years old, has had two or three cosmetic operations on her face and neck, liposuction, and repeated laser treatments of her facial skin.  She is desperately fighting “old age” while she has two teenaged daughters in the house.  Imagine the effect on those girls of their mother’s obsession with her appearance.