Some interesting tweet conversations yesterday which made me think. Suggestion made to me was that non life saving surgery should attract Value Added Tax just as other non-essentials in life do. The wonderful reward of well performed aesthetic rhinoplasty in well chosen patients is a profound improvement in self-confidence and happiness as illustrated by the comments of a mother of one of my patients recently. As Paddi Lund, a dentist in Brisbane discussed in his book Building A Happiness Centred Business, making our patients happy and the privilege of gaining in return an increase in personal happiness is an example of what being human beings is all about. Happier, more confident individuals will contribute more to society too. I think therefore that society should have as a fundamental goal increasing profound happiness in each other. This is a different happiness than is transiently found from buying a new pair of shoes or a bigger, flatter TV. Society through it’s elected government should then encourage activity that helps people develop real increases in happiness. So VAT on aesthetic surgery misunderstands the motivations of those seeking it and the rewards it provides to individual patients and society as a whole.