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Newborn Circumcision Shown to Be a Better Financial Choice in Medical Coverage

The views expressed are those of the author and are not necessarily those of Scientific American.


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Credit: CDC

Physicians have debated for years whether to cut foreskin. It’s unclear whether potential benefits of circumcision—greater prevention of health problems such as urinary tract and HIV infections, STDs and penile cancer—outweigh the risks of surgery. Many parents adhere to national guidelines from the American Academy of Pediatrics (AAP), which in 1999 deemed circumcisions as medically unnecessary. Florida and 11 other state governments also followed AAP’s stance when they decided to drop the procedure from Medicaid coverage.

These states, however, may have defeated their own cost-savings efforts, a Wall Street Journal report noted this week. A University of Florida Health study showed that between 2003 and 2008, a period just a few years after Florida stopped coverage, the number of older boys who required circumcisions rose sharply. Such surgeries often take place because of concerns about urinary-tract or penile infections, which are less common among their circumcised equals.

At the same time, statewide spending on circumcisions skyrocketed. The surgery for older boys can cost up to $6,000 compared with as little as $250 for newborns. The study found that Medicaid spending on circumcisions for patients up to age 17 climbed from $14.9 million to $33.6 million between 2003 and 2008. Beyond money, the procedure poses a greater risk of complications and causes more pain for older boys than for newborns.

Circumcision rates in older boys may have increased in Florida for a number of reasons. For instance, more parents may have simply decided against the procedure for their newborns in the wake of the AAP’s 1999 report. But many patients’ parents said they would have circumcised their sons at birth, rather than later in life, if Medicaid covered the procedure for newborns, according to University of Florida Health pediatric surgeons.

In 2012, the AAP revised its stance and concluded that, although it does not recommend routine circumcisions, the most recent science indicates that health benefits of circumcisions justify the risks. The AAP advised that families should have the option to circumcise their sons affordably and admitted that it “had not forseen that [the 1999] statement would lead to a decrease in insurance coverage,” said AAP member Douglas Diekema in the Wall Street Journal story. Whether Florida and other states will ultimately decide to reinstate Medicaid funds for newborn circumcisions—either out of concern for young males or for the government checkbook—remains to be seen.





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  1. 1. ChristineFulks 4:10 am 01/23/2014

    what Christine responded I didnt know that some one can earn $4835 in one month on the computer . take a look at the site here>>>> T­E­C­8­­0.C­O­M

    Link to this
  2. 2. JohnMH 8:06 am 01/23/2014

    It’s as little as $250 for newborns because they use no anesthesia.
    Removing a healthy part of the body from a non-consenting person just because it may have some small health benefits is reprehensible.

    Link to this
  3. 3. JohnMH 8:16 am 01/23/2014

    “causes more pain for older boys than for newborns.”

    I’d like to see a citation on this. How do you measure pain in newborns?

    It seems like there may be some sort of connection to low income in the study. Is it perhaps a public health education issue involving making sure little boys get taught to keep it clean to prevent infections? Why is the go-to remedy removal of the body part?

    Link to this
  4. 4. -kfa- 8:47 am 01/23/2014

    JohnMH is right.

    I wish to take this route to let Scientific American know, that this despicable propaganda piece for the circumcision lobby is the final straw for me to delete it from my bookmarks. Renewing a subscription I enjoyed some years ago is out of the question until these nether regions of politics get the boot and are promised to stay out for good. I’m beginning to suspect they might be paid for such publications from other sources now, anyway.

    Link to this
  5. 5. Ar U. Gaetü 9:17 am 01/23/2014

    1. It’s genital mutilation, plain and simple.

    2. 98% of the other 3 billion men on Earth are natural, many are healthier and have longer life expectancies than circumcised Americans. It could, also, be due to them having access to free preventive care via their national health care, and they can get diagnosed sooner.

    3. Removing the foreskin greatly reduces the sensitivity the glans. Most gays, men that intimately know other men, are very well aware of this.

    4. God doesn’t make mistakes. No need to fix God’s work after 100,000 years of successful procreation.

    Link to this
  6. 6. SpoonmanWoS 10:13 am 01/23/2014

    -kfa- There’s a circumcision lobby? Seriously? Is your tin hat on tight enough?

    Ar U. Gaetü: Which god would that be? The one worshiped by the Judeo-Xtians, of which I assume you’re a member because they’re the only dimwits the with temerity to call their god “god”, hates foreskins. He’s been insisting on their removal for millennial according to your ancient comic books. Which, of course, leads to the question…why did he put them there in the first place? I also have to ask that since those religions insist humans were created in its image, does your god have a foreskin? Is it a shower or a grower?

    Link to this
  7. 7. Jackieno 10:17 am 01/23/2014

    “outweigh the risks of surgery” The RISK is not at all ONLY risks associated with surgery. The risks relate to the 100% risk of losing important genital parts.

    It is always odd when people talk about male genital cutting and don’t talk about what is cut off. I guess so many people that don’t have the parts opine. IN a way that is like color impaired people having pushing their opinion on color sight.

    Isn’t the essential issue that of ones own body and the right to all of the NATURAL tissue — particularly the nerves, all of the function and all of the sensation of ones own natural body???

    The idea that cutting the parts off does not affect sexual pleasure is ludicrous. Only someone that does not have the parts could possibly say that. The parts move, so natural sex is fundamentally different from partial genital sex. The outer skin and inner mucosa (with THOUSANDS of nerves) provides space for an erection. The nerves touch inside the female. This is the sensory input as acute as a fingertip, the nipples or lips.

    The nerves are real. The dynamic action of the NATURAL genitals is real. Of course the cutting of these affects sexual pleasure and function. How could this not be the most essential issue? Why would any scientist ignore the tissue that is cut off?

    Link to this
  8. 8. FrederickNewman 10:26 am 01/23/2014

    To SpoonmanWoS:
    Follow the money. Circumcision nets the American medical community an estimated one billion dollars a year.
    Then, think about the number of circumcisions which are botched. The AAP admits to 1 in 500 requiring surgical correction. Pediatric urologists estimate it takes up about 50% of their practice. Then, think about what happens to some of the foreskins. They get sold to companies to make face cream, they get sent to Columbia to help cure male pattern baldness, they get sold to biogen companies, to make interferon, or grow replacement skin in cow collagen. kfa isn’t wearing a tin hat. some people are wearing blinders.

    Link to this
  9. 9. Jackieno 10:32 am 01/23/2014

    The health “problems” prevention stuff is contrived, it is BS.
    IN real populations (IN THE US), the partial genital men get HIV and STDs at the same rate as natural men. A cut male member is not cleaner than a natural male member. A study has noted that natural boys have natural bacteria (about the same as natural girls) and cut boys have different invasive bacteria (sometimes including Staph A).
    Natural boys get infections at the same rate as partial genital boys except in backward places (including parts of the U.S.) where they retract the foreskin to “clean” (which actually introduces problems into the otherwise sterile package and causes infection). Even the AAP now recognizes that the former “cleaning” practice was wrong for young boys. Children do not get phimosis as the inner foreskin is fused to the glans until about puberty (providing a sterile package). The cutting of young boys is not a medically needed procedure unless he was harmed by retracting his foreskin. The money spent is being wasted.
    The chance of penile cancer is very low for natural men (that have more genital tissue to get cancer on) and partial genital men. However, the incidence of penile cancer is almost non-existent as compared to botches and circumcision mishaps requiring follow up surgery. Look up meatal stenosis and MRSA. Also, look into the high percentage of circ redo. Doctors don’t really know what to cut off for babies and the results drastically vary.
    There is very clear data that cut men get ED at much younger ages than natural men.

    Link to this
  10. 10. -kfa- 10:35 am 01/23/2014

    PS – purely scientific: I am sure a significant drop in the occurrence of caries and a host of other issues related to dental hygiene will be observed if a policy is adopted to rip the teeth out of children as soon as they appear. It won’t hurt as much as the consequences of laziness.

    Link to this
  11. 11. cabhara 10:51 am 01/23/2014

    Such a nonsensical article. In societies, where intact is the norm, about 1 in 16,000 boys/men will need a circumcision for medical reasons. How can that be more expensive than circumcising most male babies, treating 10-30% meatal stenosis, wound infection etc, 10-20% follow-up surgeries, having to deal with kids which lost part of the organ (like the glans), at least 100-200 fatalities each year… In addition to the obvious human rights violation of conducting a cosmetic surgery on a newborn the shown cost analysis does not make any sense.
    I would bet that 90% of the kids which came to Dr.Islam did not need to get it done, the doctor just filed some reason for the insurance, and out of the kids which had actually issues, most were caused by wrong treatment of the the intact baby, like retraction and harsh cleaning.

    Link to this
  12. 12. -kfa- 10:55 am 01/23/2014

    @SpoonmanWoS: “Follow the money”, as was said. Plus, there are powerful religious groups with a strong interest in making their ancient practices look good any which way they can. No tin foil hat needed to find that out.

    Link to this
  13. 13. Tommy124 10:59 am 01/23/2014

    I wrote to the editors. This article is an affront to science. It cites one study, done by people who stand to benefit financially. They also chose the most intrusive, most expensive way to deal with the problems. Why is this not a problem in the other states which have stopped Medicaid paying for circumcisions? Why is this not a problem among the countries where circumcision is not routine?
    Where is the science here?
    Annie Sneed and Scientific American have done the public a disservice. Unneeded surgery is not shown to be a better financial choice.
    I suggest you write to the editors, if you agree.

    Link to this
  14. 14. TLCTugger 12:01 pm 01/23/2014

    With breast cancer affecting about 1 in 9 women, surely amputating breast tissue at birth would be more financially sound than letting women grow to suffer the consequences.

    We don’t do that, for good reason. The breast has value to its owner that only the owner is in a position to weigh at a rational age. SOME women do choose preemptive mastectomy.

    The foreskin has value that only its owner is in a position to weigh. Indeed the AAP made no attempt to factor in how circumcision alters sex dramatically, nor did they – by their own admission – factor in severe complications including deaths that regularly make headlines. They also included supposed benefits from later in life. The only things relevant to the decision to force amputation of healthy parts upon a child are those which would impact him before he can make a rational choice.

    HIS body, HIS decision.

    Link to this
  15. 15. FrederickNewman 12:31 pm 01/23/2014

    Is it just me, or is what they call science getting seriously dumbed down?
    My kids would not have believed this article, by the time they were in third grade. They would have questioned scores of premises, which didn’t occur to the author.

    Link to this
  16. 16. BillDonnelly 1:13 pm 01/23/2014

    Anybody else notice that Scientific American has a history of publishing pro-circumcision articles, with very little scrutiny? Not just this one, but a whole host.
    “Pediatricians Group Praises Benefits of Circumcision for Male Infants”
    This is the AAP, saying that circumcision lowers the chances of penile cancer, HPV, and HIV.
    The American Cancer Society doesn’t list having a foreskin as a risk factor for penile cancer. Penile cancer rates are lower in European countries where circumcision is rare. As far as HIV, UNAID has said that
    “There appears to be no clear pattern of association between male circumcision and HIV prevalence.” SciAm has multiple articles on HPV that point that there is no clear link between cervical cancer and having a foreskin.

    Yet, time and again, they keep printing articles which are clearly pro-circumcision.
    “Circumcision cuts risk of herpes, HPV”, neither of which is borne out in studies.
    “Clean-Cut: Study Finds Circumcision Helps Prevent HIV and Other Infections”. See UNAID studies. See “When Junk Science Kills, Or How To Spread AIDS”.
    “Circumcision Alters Penis Bacteria”
    No kidding. Would removing the vulva alter vaginal bacteria? Contains such scientific nuggets as “The bacterial die-off may be a good thing”, “From an ecological perspective, it’s like rolling back a rock and seeing the ecosystem change.” No aspersion there, just pure science, right?
    So, why is Scientific American trying so hard to influence public opinion, with articles so light on actual data? Why the prejudice?

    Link to this
  17. 17. JasonIng 1:30 pm 01/23/2014

    Oh, that’s so logical and rationale. Prevent sickness and disease and save money by cutting parts of our body out. The next step is that we should have girls remove their breasts and ovaries and boys to remove their colons and testicles to prevent possible future cancer. It’ll save their lives. And a lot of money too! They’re not able to tell us now, since they can’t speak for themselves, but I’m sure they’ll thank us later!

    Link to this
  18. 18. JBC239 1:48 pm 01/23/2014

    Ms. Sneed,

    I am responding to your thoughful article on the increased costs of young male circumcision in Florida.

    In 2011, the latest year of statistics available, the number of live births in Florida, was 213,237. If slightly less than half were boys, approximately 105,000 males were born. It is estimated that one in one hundred intact boys will develop a urinary tract infection during the first year of life. If none were circumcised the state would have avoided some 26 million dollars (using your cost of $250 for a circumcision). UTIs are relatively common in girls as well as boys and are generally cured with an antibiotic for a total cost of let’s say $200 an intervention resulting in a cost of some $200,000 for the first year. A 1% interest rate return on the money saved, $26 million, would provide slightly more than the cost of the interventions.

    The role of circumcision in the prevention of HIV in the US, is unclear at best. Of the new cases of HIV reported, only some 11% (2009 CDC statistics) can be related to men having sex with infected women. The remainder of the infections are attributed to men having sex with men, intravenous drug users, women, and babies born to infected mothers, none of whom receive any benefit from circumcision with respect to contracting HIV. It has not been reported as to the percentage of those 11 % of men who were circumcised and those who were not, but it probably reflects the national breakdown of all men in this country and not any marked tilt towards those not circumcised.

    The United States, with some 75 to 80% of all men being circumcised, has the highest rate of STDs in the developed world. Some protection, huh? Incidentally, a United Nations survey of 18 African countries in 2009, revealed that in 11 of those countries, HIV was more prevalent among circumcised men than intact.

    Finally, the American Cancer Society specifically rejects circumcision as a prophylaxis to prevent penile cancer, a disease, like cervical cancer, more closely associated with smoking and life-time number of sexual partners.

    Perhaps you may want to check out the above for yourself and your magazine to see if your article still makes any sense from both a financial and scientific point of view.

    Link to this
  19. 19. concerned cynic 2:40 pm 01/23/2014

    “Physicians have debated for years whether to cut foreskin.”
    ME. Not true. There is almost no discussion in USA medical schools of whether RIC is good or bad. Medical students are simply trained to do it, and are not given a thoughtful justification for the procedure.

    :It’s unclear whether potential benefits of circumcision—greater prevention of health problems such as urinary tract and HIV infections, STDs and penile cancer—outweigh the risks of surgery.”
    ME. There is ample anecdotal evidence of risks, but American medical and sexual research refuse to collect hard evidence. Hence we simply do not know the number of circumcision performed in the USA and Canada that are botched or lethal. This is an unconscionable situation.

    “Many parents adhere to national guidelines from the American Academy of Pediatrics (AAP)…”
    ME. Those guidelines are too intellectual to be of any value to the vast majority of parents.

    “…which in 1999 deemed circumcisions as medically unnecessary. Florida and 11 other state governments also followed AAP’s stance when they decided to drop the procedure from Medicaid coverage.”
    ME. 18 states have dropped Medicaid coverage.

    “These states, however, may have defeated their own cost-savings efforts, a Wall Street Journal report noted this week.”
    ME. The Wall Street Journal only served as a conduit. You should cite only the UF study, and ignore the WSJ.

    “A University of Florida Health study showed that between 2003 and 2008, a period just a few years after Florida stopped coverage…”
    ME. Florida stopped coverage in 2003.

    “…the number of older boys who required circumcisions rose sharply.”
    ME. Were these circumcisions truly “required” or were they done only because the parents insisted on them? It is a common practice in the European Union for Moslem parents to have their sons circumcised for religious reasons, but have the taxpayer fund the operation via a false diagnosis of “phimosis”. This could have happened in Florida as well.

    “Such surgeries often take place because of concerns about urinary-tract or penile infections, which are less common among their circumcised equals.”
    ME. Conservative medicine forbids operating merely because of “concerns”. The scalpel should only be resorted to to treat clear and present problems, not to prevent problems that might occur.

    In Europe and Japan, male UTIs and subpreputial infections are managed by antibiotics and antifungal preparations. The USA could follow their example.

    These concerns” are soothing pretexts. All too often, American boys are circumcised because their parents deem the male foreskin to be unsanitary and sexually off-putting.

    “At the same time, statewide spending on circumcisions skyrocketed.”
    ME. Again, were these circumcisions of older boys truly necessary?=

    “The surgery for older boys can cost up to $6,000 compared with as little as $250 for newborns.”
    ME. $250 is too low in most cases. Infant circumcision in the USA is cheap in fair part because it cuts ethical corners, by not using effective anesthesia, and dispensing with sutures. The circumcision of older boys is indeed more expensive, but there are almost no media reports of botched and lethal circumcision among boys over the age 3 or so.

    “The study found that Medicaid spending on circumcisions for patients up to age 17 climbed from $14.9 million to $33.6 million between 2003 and 2008.”
    ME. So what? This is not disturbing in itself, given the overall health care cost explosion occurring all around us.

    “Beyond money, the procedure poses a greater risk of complications and causes more pain for older boys than for newborns.”
    ME. This oft-made claim is utterly false. Moreover, pain cannot be compared across persons, or across stages in the life cycle.

    Circumcision rates in older boys may have increased in Florida for a number of reasons. For instance, more parents may have simply decided against the procedure for their newborns in the wake of the AAP’s 1999 report.

    “But many patients’ parents said they would have circumcised their sons at birth, rather than later in life, if Medicaid covered the procedure for newborns, according to University of Florida Health pediatric surgeons.”
    ME. This suggests to me that parents and complicit surgeons are gaming the system. It also does not explain why parents desire that their sons be circumcised in the first place.

    In 2012, the AAP revised its stance and concluded that, although it does not recommend routine circumcisions, the most recent science indicates that health benefits of circumcisions justify the risks.”
    ME. Not “justify” but “outweigh”. Regardless of the choice of verb, the AAP’s stance is nonsense. The risks of circumcision, including the number of botches, lethal outcomes, and adverse adult sexual outcomes, are simply not known. The AAP’s 2012 report admitted this. Alleged benefits cannot “outweigh” unknown risks.

    “The AAP advised that families should have the option to circumcise their sons…”
    ME. Why circumcise at all?

    “…affordably and admitted that it “had not forseen that [the 1999] statement would lead to a decrease in insurance coverage,” said AAP member Douglas Diekema in the Wall Street Journal story.”
    ME. The 2012 AAP report left me with the strong impression that an important ogoal of its authors was to maximise third party coverage of the cost of RIC.

    “Whether Florida and other states will ultimately decide to reinstate Medicaid funds for newborn circumcisions—either out of concern for young males or for the government checkbook—remains to be seen.”
    ME. Your article, the recent study at the U of Florida, and the AAP’s 2012 report, all ignore the fact that circumcision is a material alteration of the most sexual part of the male body. It removes tissue and part so the nervous system that come into direct and repeated contact with sexual partners. For intact men, the moving foreskin is a major player in masturbation, foreplay and penetrative sex. Sexually experienced women have come forward and testified that the male foreskin enhances their pleasure. Hence to advocate circumcision while ignoring its possible adverse sexual effects, is bad science and ethically unconscionable.

    Europe and Japan have never circumcised. The UK and New Zealand used to, but gave it up last century. In Australia and Canada, RIC over the last half century moved from a majority to a minority practice. There is no evidence that these nations have experienced endemic STD or urological problems.

    Link to this
  20. 20. StanBarnes 2:59 pm 01/23/2014

    How many of the older boys in the Florida study who “required” circumcisions met the following criteria?

    1. Had a diagnosed medical condition and effective, non-invasive treatments were tried and failed.

    2. Had a diagnosed medical condition and effective, non-invasive treatments were not tried.

    3. Did not have a diagnosed medical condition that required medical intervention.

    There are effective, non-invasive ways to prevent and treat the medical problems that male circumcision is supposed to prevent. If Florida doctors are not using these effective, non-invasive methods, it is medical malpractice.

    If Florida doctors are billing Medicaid for surgery when the problem could be treated with a lower cost, effective method, it is Medicaid fraud.

    Link to this
  21. 21. ml66uk 5:31 pm 01/23/2014

    The real question is why are Florida doctors diagnosing such a high rate of medically required male circumcision? It’s way higher than other countries where most men are intact.

    In Europe, almost no infants are circumcised unless their parents are Jewish (and some Muslim parents, though they tend to do it later). Almost no-one has a problem later though. The rate of medically-required male circumcision in the UK is down to 1 in 140 and dropping. Compare that to a rate of 5-10% for “revision” of neonatal circumcision in the US – effectively a second circumcision to correct the first one.

    Has the cost of botched jobs been factored in? The record payout for a botched circumcision is $22.8 million. It was said at the time that the victim “will never be able to function sexually as a normal male and will require extensive reconstructive surgery and psychological counseling as well as lifelong urological care and treatment by infectious disease specialists.”
    Sure, cases like that are very rare, but why should they happen at all? If you look up the galleries of botched jobs, one thing that may surprise you is just how many jobs were botched cosmetically, rather than medically. Skin tags, skin bridges, sideways curvature, and hair growing half way up the shaft are not normal, but would not be counted as medical complications.

    More botches:

    April 2009: A jury in Atlanta has awarded $1.8 million to a boy whose penis was severed in a botched circumcision five years ago. The Fulton County jury also awarded the boy’s mother another $500,000.

    July 2010: Atlanta lawyer wins $11 million lawsuit for family in botched circumcision

    July 2011: Boy’s botched circumcision leads to $4.6 million award

    November 2013: “After I went home and I discovered that my son’s penis was not there, I immediately froze, like, oh my God,” Rhodes recalls.

    Here’s a reason not to circumcise babies most people aren’t aware of:
    “For studies including boys born after 1995, there was a strong correlation between country-level (n=9) autism/ASD prevalence in males and a country’s circumcision rate (r=0.98). A very similar pattern was seen among U.S. states and when comparing the 3 main racial/ethnic groups in the U.S.”
    Bauer, Kriebel, 2013

    It’s not like it can’t wait. The USA (at 55% and dropping) and Israel are the only two countries in the world where more than half of baby boys are circumcised. Other countries circumcise, but not till anywhere from the age of seven to adolescence. Only about 10% of the world’s circumcised men were circumcised as babies.

    Link to this
  22. 22. singing flea 6:03 pm 01/23/2014

    Ever wonder why dildos are always circumcised? Its a female preference if marketing success is any indicator. Think about it from a sex appeal point of view. It would make an interesting study to see how females rate the issue.

    Link to this
  23. 23. Anna G. 7:46 pm 01/23/2014

    The Parliamentary Assembly of the Council of Europe (PACE) (Council of Europe is an organization than includes 47 countries, larger than the European Union which includes 27 countries) accepted with 77 to 19 votes a Resolution on the Report on the Children’s right to physical integrity.

    Strasbourg, 01.10.2013 – PACE has said it is “particularly worried” about certain violations of the physical integrity of children – including the circumcision of young boys for religious reasons, early childhood interventions in the case of intersexual children, and the coercion of children into piercings, tattoos or plastic surgery – which supporters tend to present as beneficial to the children themselves, despite clear evidence to the contrary.

    The Resolution requires from all member countries to change their legislation to ensure that the decision for such practices as circumcision could be made by the children themselves, i.e. made when they achieve some degree of maturity, so it would be

    1. absolutely forbidden before the age of 14

    2. between 14 and 18 years of age could be decided with the participation of the child and the parents.

    Link to this
  24. 24. Anna G. 7:48 pm 01/23/2014

    Many Jews in Israel leave their sons intact today.

    Link to this
  25. 25. ImproperUsername 9:50 pm 01/23/2014

    Genital cutting of infants and children is a human rights violation, whether the child is female or male. The time has come to end this cruel, horrific practice! If you deny that genital cutting of baby boys is cruel, please look up Stefan Molyneux’s video on YouTube that is titled “The Truth About Circumcision.” Be sure to view the sequence that shows a circumcision of an infant, and tell me that the screams of the baby don’t bring you to tears. What an absolutely horrible, medieval torture to perform on a helpless baby. Even IF there were some actual health benefits with circumcision (there aren’t), it would not be a justifiable exchange for the child’s peace and tranquility. “Welcome to the world, little one. Now, the nice doctor (or mohel) is going to mutilate your tiny penis.”

    This blog post makes me very angry. Shame on Scientific American! Shame on you, Ms Sneed!

    Link to this
  26. 26. DrakonVolk 10:57 pm 01/23/2014

    To distill this issue down to matters of of money is unconscionable. What possible role can money play in the life of a boy (and ultimately, man) who doesn’t even retain the unalienable right to retain his own healthy, functioning body parts? Money should never dictate ethics.

    We talk of money, while marginalizing and denying the rights of living, breathing human beings to decide whether they keep their own body whole. What a tragic loss of perspective.

    Link to this
  27. 27. Karl Johanson 2:27 am 01/24/2014

    “It’ll save us money.” That’s certainly justification to attack babies’ genitals with knives.

    Link to this
  28. 28. Jackieno 9:33 am 01/24/2014

    “22. singing flea
    6:03 pm 01/23/2014
    Ever wonder why dildos are always circumcised? Its a female preference if marketing success is any indicator. Think about it from a sex appeal point of view. It would make an interesting study to see how females rate the issue.”
    HA – LOL, but they aren’t all partial members. In fact many/most have ridged band areas (see also ribbed condoms) that are/mimic the foreskin. You just don’t know what a natural erect member looks like! LMFAO

    There is a geat body of evidence that natural sex is better for women (natural being better is a logical concept as that is the sex we evolved to have). IN any case, it is the owner that should decide what is best for HIM.

    EVERY HUMAN (male and female) has the RIGHT (a human right) to reach adulthood with all of the tissue (particularly all of their erogenous tissue) that THEIR genetic code provides.

    Link to this
  29. 29. jonhuie 10:58 am 01/24/2014

    It is very disappointing that Scientific American is advocating for genital mutilation.

    Link to this
  30. 30. Roland75 12:33 pm 01/24/2014

    The original article clearly is a work of art designed to get government medical money to pay for religious ritual circumcision.

    It is highly flawed.

    The increase in costs reported by Florida Medicaid is due to failure of Florida Medicaid to put adequate controls on the payments for an elective non-therapeutic surgical procedure, for which they have been paying without questioning the medical necessity thereof.

    Male circumcision is an operation that is highly subject to medical fraud. I think that the claims for post-neonatal circumcision are mostly fraudulent. Unfortunately, the taxpayers are getting stuck with the bill due to Florida Medicaid not monitoring the claims.

    Post neonatal circumcision should be by prior approval only in which evidence of medical necessity is submitted for approval prior to the operation.

    Link to this
  31. 31. craiggarrett@gmail.com 1:11 pm 01/24/2014

    More information about the flaws with the AAP’s 2012 statement:
    http://coloradonocirc.org/files/handouts/AAP_2012_statement_critique_table_color.pdf

    Link to this
  32. 32. dreamer_fla 1:50 pm 01/24/2014

    What doctor Islam -perhaps naively- uncovered is something different, Ms. Sneed. While he argues for newborn circumcision, what his study shows is that many doctors are abusing medicaid by referring children older than 1 year for circumcision without real medical necessity.

    One does not operate children’s hearts preemptively to save costs on a possible future heart operation.

    Most of these children are not circumcised because they have a medical necessity. They are circumcised because the parents request it and the doctor writes a note saying they have “congenital adherent prepuce”, which is a false diagnostic, just to appease their and his own desire to see circumcision justified – thus charging taxpayers for an unnecessary amputation of normal healthy tissue.

    Doctors outside the United States recognize the difference between pathological phimosis and physiological phimosis – physiological being a natural stage in the development of the genitals, and phatological being the result of scarring. Physiological phimosis needs no treatment and will be overcome given enough time and without any type of action.

    It is my position that circumcising minors under the diagnosis of phimosis or congenital adherent prepuce constitutes medical fraud and should be prosecuted.

    Link to this
  33. 33. RicardoD 3:39 pm 01/24/2014

    “Better Financial Choice” Really? Did you factor in the costs of botches? US medicine says there are none, which makes circumcision unique as the perfect surgery, the only one which is never botched. The many circumcision malpractice lawsuits in progress at any given time say US medicine is not practicing truth-in-advertising, as is required by law of commercial endeavors without “professional” status. If they don’t get a lawyer, medicine requires parents to pay for repairs of botches. Google “CBS Ch 6 Richmond, VA circumcision botches” to read about one metropolitan area in the US where the documented botch rate is from 15% to 30% depending on whether the only pediatric urologist interviewed gets all the botches or half of them. Some botches require sex change surgery and therapy for your son-oops-daughter. Read As Nature Made Him, by John Colapinto, available at amazon. In countries such as Finland, Japan, Norway, and Sweden there is no circumcision at all, yet males have better genital health than mostly circumcised US males. Why not figure out what they do without dangerous, useless surgery rather than doing superstitious, prehistoric blood letting on your sons? Seriously, the “benefits” claimed by US medicine are seen as clearly delusional once you do a little research.

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  34. 34. David Marjanović 9:16 am 01/25/2014

    Physicians have debated for years whether to cut foreskin.

    I was going to say “only in America, folks, only in America”. Then I read comment 19.

    Circumcision was introduced in the US in the late 19th century as part of the general panic about masturbation that was fueled by religious “reasoning” and also brought us Kellogg’s Cornflakes: amputating the foreskin makes masturbation a bit harder. When that became too embarrassing, the “medical” “reasons” shifted to hygiene, a bizarre idea seeing as how I don’t seem to know any man who ever got a urinary-tract infection and how nothing ever gets under my foreskin.

    Finally, to cite the Wall Street Journal instead of the study it cites is… just… I completely fail to understand why a science journalist would ever do such a thing.

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  35. 35. olivierpascal 6:26 am 01/26/2014

    I don’t know if this was already written but why is there no mention of the following content from the Wall Street Journal article: “The Florida Agency for Health Care Administration, which administers Medicaid, said in a statement that the study “contains interesting points for discussion, but does not appear to provide conclusive medical evidence to allow for coverage of elective circumcisions.”

    Using a different database, the agency provided data showing circumcision costs under the traditional “fee-for-service” system in Medicaid dropped to $1.2 million last year from $2.3 million in 2002.” http://online.wsj.com/news/articles/SB10001424052702304419104579327013566659736

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  36. 36. ramfroggie 9:10 pm 01/27/2014

    While I do realize that anecdotal evidence is just that, I have in 53 years only known two men with UTIs. One was circumcised and slept around with people who made me think he was lucky that’s all he got, and the other was uncircumcised and basically filthy all over. He’s lucky he still had a penis left if the rest of his was any indication of his level of hygiene.

    By the way, dildos have nothing to do with real genitals. A plastic uncircumcised penis would look weird because what stage would be where you would want to use? Erect, limp, halfway erect? The real uncut penis responds appropriately to stimulation, and that means it comes out from hiding in the protective foreskin to expose the sensitive head. It gets lubricated and is perfectly clean if the owner showers. Many women do indeed prefer a natural penis that performs as nature intended and is clean, but since they didn’t get a choice in their partner’s circumcision did you want them to point and laugh or cry? And some say they like a cut one, but don’t really know much about the feel and function of the natural one to judge. Seeing it in the foreskin not erect when one hasn’t before is no way to judge which is “better”.

    But more to the point, this is a really incomplete and poorly written article. I am disappointed that I would see such a blatant article with only one side presented. And no, cost is NOT a reason to mutilate a penis. Seriously? And no, the author didn’t present plenty of evidence to balance out what she did write. I am actually fairly horrified.

    I worked in a pathology lab years ago and saw tiny foreskins every day. I saw the only cancerous penis we got from surgery and guess what? It had no foreskin. I have worked in several aspects of the medical fields and can tell you that many times it’s easier to just cut than actually work at fixing a problem with medicines, hygiene, or education. A study should compare equalized according to type of subject compared, and which of those were really medically necessary? How many were botched? How many were from lazy parents, kids, or doctors who didn’t want to deal with it and freaked out or had new husbands who wanted that kid cut like he was? We just don’t know, and whatever the case, cutting kids just because something might happen instead of educating them makes no sense.

    I won’t repeat all the stats and comments above since they cover what I would say, except to say that this article does a disservice to the reputation of Scientific American and the general public. Now some doctor or father or relative can quote this article and make it sounds as if the prospective parents should get the newborn cut..I mean SA said it was better. Most natural, uncut men do just fine, and many women obviously do like natural penises just fine. Let’s research the facts a bit more and present the rest of the story…this is one article and the study isn’t that great a study.

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  37. 37. rshoff2 11:37 am 01/28/2014

    There are many ways we can mutilate a human body for financial gain. Why write an article that implies circumcision is good because it saves money? The only moral approach to supporting mutilation is if it is of human value to the individual being mutilated. On those merits alone should the discussion be waged.

    Has anyone done studies on the unwanted pregnancy rate of sexually mutilated females? It may save money to support the practice. That’s how absurd it is to declare circumcision is good because it’s a financially sound decision.

    And mutilating one individual to benefit everybody else is immoral. If you want to reduce STDs, then don’t expose yourself.

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  38. 38. PeterA 6:18 pm 02/3/2014

    Hospitals and physicians have been charging Medicaid for circumcision since 1965, but it’s against the law. So one does not reach any of the policy questions discussed above such as whether it saves money.

    The fundamental principle of federal and state Medicaid law, in place since 1965 and affirmed by the United States Supreme Court, is that Medicaid only covers services when a physician correctly certifies that it is medically necessary.

    In the case of surgery, physicians must correctly diagnose a medical condition, recommend surgery, and determine that the surgery is likely to be effective. Surgery also must be the last resort after all more conservative options have failed. Medicaid law explicitly excludes elective surgery.

    Circumcision is elective, almost always performed on healthy boys, and parents usually choose it for reasons having nothing to do with medicine (e.g., for religious, cultural, and personal reasons). It is, of course, unnecessary, non-therapeutic, elective cosmetic surgery. Circumcision is also unlikely to benefit any specific boy at all, so it is not effective. For example, it does not prevent HIV (at best it might prevent HIV in 1 man out of 67 for a limited period of time), while condoms are almost 100% effective.

    Hospitals and physicians are prohibited by law from charging Medicaid for the circumcision of children, except in extremely rare cases of medically necessity, and when the surgery is likely to be effective. So hospitals and physicians using Medicaid to pay for circumcision have been making false claims against the government since 1965, and unlawfully making claims on taxpayers’ money.

    See my article, which has not been criticized by anyone to my knowledge since publication: Peter W. Adler, Is it lawful to use Medicaid to pay for circumcision? 19 J Law Med 335-53 (2011).

    I mention also that Brian Morris, a staunch circumcision advocate, requested a copy of my article shortly after it was published in Australia, and I sent it to him. Some people believe that Dr. Morris was the unnamed consultant helping The American Academy of Pediatrics produce its 2012 circumcision policy statement. If so, the AAP likely asked him to obtain a copy, and the members of the task likely read the article, or had it available before issuing its opinion in 2012 that Medicaid should pay for circumcision.

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  39. 39. ShellyMD 4:13 pm 02/5/2014

    Another incredibly biased, one-sided, inaccurate diatribe most likely promoted by Morris, Gray, Wawer, Halperin, Wiswell, Schoen, the AAP’s misguided task force on circumcision, etc. to make sure that the pot is stirred up again..promoting fear over the dreadful intact penis. Something those pro-circ advocates have likely had little or no contact with, so how do they know it is so bad? The AAP’s statement is so poorly written and researched, it can hardly be called evidence-based, as those of us who know the medical literature will attest. It is all about the money and maintaining the status quo of cutting on babies. It is designed to protect those religious groups with power in this country. Physicians are unfortunately taught little or nothing in medical school or residency training about the penis, or the value, anatomy and function of the foreskin. I was taught that circumcision is a social custom that is medically unnecessary. The circumcisions I witnessed and performed convinced me that it is medicalized torture. Those baby boys were in extreme pain. The issue in Florida is likely about physicians and parents who know nothing about the care and function of the foreskin promoting its removal for very specious reasons. Plus, there are likely many Jewish physicians there, based on the population being served. The foreskin doesn’t cause UTI’s, or lead to increased rates of any STD’s. It does lead to sexual dysfunction for males and females. Get the science right for once. Do the research. Other countries are banning it. Eventually, it will fall to the wayside here too as more males are left alone. Thankfully.

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  40. 40. PeterA 5:31 pm 02/14/2014

    The American Academy of Pediatrics is calling for more Medicaid coverage of non-therapeutic circumcision. But as discussed in my comment #38 above, the AAP is advocating breaking the law. Medicaid does not cover elective cosmetic non-therapeutic surgery.

    Perhaps the writer Annie Sneed and Scientific American were not aware of that when they published this article (“Newborn Circumcision Shown to Be a Better Financial Choice in Medical Coverage”). But now they know.

    Unless they can refute my argument, I call upon them to withdraw this article.

    Link to this

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