During the Senate’s debates over who should bear the cost of the nearly $900 billion health care bill, there emerged a surprising suggestion: plastic surgery patients. A proposed tax, dubbed the “Bo-Tax” after the wrinkle-reducing injections, would add a five percent additional charge to elective cosmetic procedures. The tax could help raise $6 billion over the next 10 years. Apparently, breast enhancements and liposuction can benefit the public good.

Plastic surgeons have decried the tax with much ferocity. It’s not just Playboy bunnies and Hollywood starlets who get breast enhancements, liposuction and face-lifts; according to the American Society of Plastic Surgeons, which is lobbying against the proposed tax, nearly 90 percent of people seeking cosmetic surgery are women, and 60 percent of them earn between $30,000 to $90,000 a year.

APPARENTLY BREAST ENHANCEMENTS AND LIPOSUCTION CAN BE CHANNELED TO BENEFIT THE PUBLIC GOOD.

That plastic surgeons oppose the Bo-Tax is not surprising. But that the head of the National Organization for Women (NOW), has come forward to oppose the bill certainly is. NOW has railed against silicone breast implants and cosmetic surgery in the past.

These harsh economic times, however, call for a different ideology, says Terry O’Neill, NOW’s new president. Middle-aged women are struggling to compete in the job market. “They have to find work,” she told the New York Times. “They are going for Botox or eye work, because the fact is we live in a society that punishes women for getting older.”

By framing affordable access to face-lifts as a women’s issue, NOW’s president has given cosmetic surgery giants like Allergan, which makes Botox, one of its strongest arguments. The Bo-Tax, Allergan’s spokeswoman explained to me without detectable irony, is about “a woman’s right to choose.”

In 1991, Naomi Wolf’s The Beauty Myth argued that society promoted unrealistic images of female beauty to keep women locked in place, forlorn and self-hating. Her book encouraged women to mobilize and helped launch Third Wave feminism. Today, disturbingly, NOW’s president is not decrying the “beauty myth” but is accepting a “beauty reality.”

The real issue is not whether women should have the choice to get plastic surgery. It is not a ban on plastic surgery that has been proposed, only an excise tax. Of greater concern is that the leader of the most prominent feminist organization in the U.S. could speak out on a topic of such minor concern when there are issues at stake in the health care debate like reproductive rights and insurance coverage of mammograms. Aligning feminism with the cause to keep plastic surgery costs low reinforces the notion that feminism is a movement for white, middle-aged, middle-class women. Feminism has needed to lose that label for more than a century.

As a young woman, I identify as a feminist and have great respect for NOW, but many of my peers do not. They feel that feminism can’t bring them professional success, good pay, recognition for their work, happy relationships. The health care debate – and feminists’ success at proving they can represent women’s interests in the legislation it produces – will be a critical test of feminism and its relevance.

By getting caught up in a debate over plastic surgery, feminists are losing this opportunity to advance women’s real (not cosmetic) rights. Feminism is about fighting a discriminatory society, not accepting that discrimination and making it more cost-effective for women to capitulate. It’s about imparting in young women the ethic that they can be judged for their work and talent, not their breasts and wrinkle-free skin. If the foremothers of feminism have given up on these principles, they can’t expect young women to join their cause.

ALEXANDRA SUICH served two terms on NOW’s Young Feminist Task Force.