I found this pretty outrageous at first as well, as did many other bloggers I read. But this letter posted at the National Review's blog (they were harrumphing about it over there as well) brought some needed perspective, I think:
I apologize for the anonymity, but as I am a military doc I would prefer to lay a bit low. If you want, I can provide bona fides separately.
However, there are some points of contention regarding the fact impaired New Yorker-via-Reuters story you referenced. I don't have access to the New Yorker article, but have seen it summarized on line. From these, I would like add some facts that make the story pretty dang benign and hardly the shocking waste of taxpayer dollars the spin of the article seems to be. The tenor that Sergeant Baggadonuts and/or Mrs. Major Zotz can just waltz over to the nearest military hospital and get nipped, tucked, vacuumed, or pumped up, is both bogus and irksome. I am a little weary of lies and misdirection regarding the military.
1. The Army, Navy, and Air Force have teaching hospitals.
2. These hospitals have plastic surgery programs.
3. For these programs to be accredited, the residents must perform the same procedures their civilian counterparts perform.
4. To become board certified and maintain currency, military plastic surgeons must perform the same procedures as their civilian counterparts.
4. The article mentions that between 2000 and 2003, there were 496 breast enlargements and 1361 lipos done on "soldiers" (only Army personnel are Soldiers) and their dependents. Assuming they were done at a constant rate, that is a whopping 165 breast enlargements and 457 lipos per year.
5. There are about 1,400,000 active duty military, and about an average of 3 dependents/servicemember. Completely disregarding eligible reserve component personnel and their dependents, as well as eligible retirees, that makes an eligible population of over 4, 200,000.
Do the math, and as you can see, this falls damn short of a cosmetic surgery stampede. Show me any U.S. city of 4.2 million in which the plastic surgeons only do 165 breast enlargements and 457 lipos a year, and I'll show you a town with starving plastic surgeons, or with only one moderately busy. Show me a town of 4.2 million with only one plastic surgeon, and I'll show you a town outside of the U.S. I won't bore you with the hoops and wickets one has to go through to get someone one a rare referral for these or other "elective cosmetic" procedures - trust me, it isn't the same pulling out the Yellow Pages, turning to the physicians pages, picking an ad, and calling up old Dr. Young for an appointment - there has to be some kind of justification other then "I want it".
In addition, as odd as it may seem, military and their dependents do get sick and injured - if a spouse or a soldier needed, for example, a breast reconstruction after mastectomy, I think most sentient persons (I know that whittles the pool down a fair bit) would agree that docs who have actually performed a few cases, even if those were strictly cosmetic, would be preferred over those doing OJT. Same thing goes for nose jobs or any other "elective cosmetic" procedure - the bottom line is that skills maintained by doing these procedures are helping heal servicemembers injured in combat, past and present.