should insurance and medicaid cover routine circumcision

[Palo Verde]

There was an article in the NY TImes this weekend (I can't give you an exact page reference) saying that more insurance companies want to drop coverage for routine circumcision. If there is a medical necessity for it, then it would be covered, but under normal circumstances it is considered cosmetic surgery and the parents can pay for it themselve.

A little medical background, most medical groups from the Canadian Paediatric Society to the American Medical Association to the American Academy of Pediatrics do not recommend routine neonatal circumcision

The American Academy of Family Physicians "Most parents base their decision whether or not to have their newborn son circumcised on nonmedical preferences (i.e. religious, ethnic, cultural, cosmetic)"

So... if it's cosmetic issue, why should insurance and Medicaid pay for it?

[WV_Woman]

Because insurance pays for a lot of cosmetic stuff.

Ever hear of breast implants?

[december]

Originally posted by WV_Woman
Because insurance pays for a lot of cosmetic stuff.

Ever hear of breast implants?

My impression is that health insurance will normally cover breast re-construction of enhancement after breast removal surgery, but not for purely cosmetic purposes.

[Mr2001]

Insurance and Medicaid should classify circumcision with clitoridectomy, bloodletting, and phrenology.

[Colinito67]

First off, it surprises me that Canadian and American medical authorities do not recommend circumcision.

I thought it was a matter of cleanliness. I have always heard that circumcision was healthier, anyways. I admit, however, that I haven't done much reading on the subject. There was a recent Straight Dope (I think) on penile cancer, and I think Cecil said that circumcision reduces the risk of that cancer.

At any rate, I am all about healthcare. As much as possible. I don't think it should cover purely cosmetic surgery, however. Breat implants, for example, one should pay for by herself (if it is recreationally cosmetic and not due to a masectomy (sp?) or something like that). But, if there is reason to believe that said surgery is preventative medicine, then insurance companies should pay for it.

Is there information on why not being circumcized is better?

Sidenote: Many of the Jewish prohibitions (in Exodus and Leviticus especially) were prescribed to keep the wandering, exiled people from being sick. Shellfish is a great example. I was taught in theology school that eating shellfish (especially in the exile from Egypt) was potentially dangerous, and that was why it was forbidden. It just kind of stuck around. Same with the milk and meat thing. Since water was not plentiful, it was common practice to cook meat in its own milk. Cruelty and health issues were abound, and that was forbidden. But, to this day, kosher Jews will not drink milk at the same meal with meat.

If circumcision can follow this logic, then perhaps (back then atleast) circumcision was a healthier and thus safer alternative.

Am I wrong about my assumptions of really old Testament prohibitions/prescriptions? Is this a remnant still lingering from my Lutheran theology school days that is totally untrue?

As the SD prescribes, I would like to end my ignorance on this issue. Can somebody drop some science on me?

colin

[Hazel]

"Is there information on why not being circumcized is better?" you ask? Do you really not know the arguments vs. circumcision?

Well, to keep it short, one, it's not necessary. If something isn't necessary, why do it? To avoid healh risks, males simply need to be careful to keep the area in question really clean. Two, it is very widely believed that circumsision reduces sexual pleasure. Three, there is the danger of something going wrong with the operation. This is very rare, but a VERY major disaster for the victim, so why take the chance? Four, there is the danger that, years later, your teen or adult son will annoy you with a lot of whining about how you, out of abysmal ignorance and superstition, mutliated him, and how can he ever forgive you? etc. Why let yourself in for that?

And to answer the OP, I'd say, no, insurance should NOT pay for this proceedure.

[GIGObuster]

FWIW here in Arizona the budget crunch forced the state to stop funding free circumcisions! So I am confused: if Medicare funded that, why was the state paying for it?

Oh, and Hazel said what I think.

[Palo Verde]

One site gave this info without saying where they got the information:

"In most states, Medicaid tax dollars are used to cover non-therapeutic neonatal circumcision. Currently, California, Nevada, North Dakota, Oregon and Washington do not pay for routine neonatal circumcision through Medicaid."

They don't mention Arizona, but it could be dated.

I don't know how it works, but it sounds like the states can at least partially determine how to use the Medicaid money sent by the federal government.

[zev_steinhardt]

Originally posted by Colinito67

Sidenote: Many of the Jewish prohibitions (in Exodus and Leviticus especially) were prescribed to keep the wandering, exiled people from being sick. Shellfish is a great example. I was taught in theology school that eating shellfish (especially in the exile from Egypt) was potentially dangerous, and that was why it was forbidden. It just kind of stuck around. Same with the milk and meat thing. Since water was not plentiful, it was common practice to cook meat in its own milk. Cruelty and health issues were abound, and that was forbidden. But, to this day, kosher Jews will not drink milk at the same meal with meat.

If circumcision can follow this logic, then perhaps (back then atleast) circumcision was a healthier and thus safer alternative.

Am I wrong about my assumptions of really old Testament prohibitions/prescriptions? Is this a remnant still lingering from my Lutheran theology school days that is totally untrue?

As the SD prescribes, I would like to end my ignorance on this issue. Can somebody drop some science on me?

colin

Speaking from the Orthdox Jewish perspective, the reason we keep the commandments is because God commanded us to. Period.

There may have been some side health benefits that arose from keeping the commandments (the famous "not eating pork is a defense against trichinosis"), but they are not the main reason. Thus, even if, for example, trichinosis was wiped off the face of the earth tomorrow, we could continue to keep the commandment to not eat pork.

As for the OP: I don't think routine circumcision is a necessary medical procedure and therefore should not be covered. Of course, where it is deemed medically necessary, it should be covered. Why is this even a debate? This is common sense, no?

Zev Steinhardt

[SuaSponte]

Originally posted by GIGObuster
FWIW here in Arizona the budget crunch forced the state to stop funding free circumcisions! So I am confused: if Medicare funded that, why was the state paying for it?

Because Medicare wasn't funding it; Medicaid was.
Medicare is the health insurance program associated with Social Security Old Age, Survivors, and Disability Insurance (OASDI). Medicare is 100% paid for by the federal government, although Medicaid will cover co-pays, non Medicare-covered services and the like for certain low-income OASDI recipients.

Medicaid, OTOH, is the health insurance program associated with (state and federal) welfare programs. It is funded 60% by the feds, 40% by the states, and the states have some leeway as to which services are covered.

Sua

[Eonwe]

Originally posted by Hazel
Four, there is the danger that, years later, your teen or adult son will annoy you with a lot of whining about how you, out of abysmal ignorance and superstition, mutliated him, and how can he ever forgive you? etc. Why let yourself in for that?

I disowned my parents for having me circumcised.

Two, it is very widely believed that circumsision reduces sexual pleasure.

And this isn't IMHO. It was also widely believed that the Earth was flat. So what?

As far as the OP is concerned, if circumcision is shown at all to be preventive care (anyone have a cite?) then sure it should be covered. Otherwise, no.

[smiling bandit]

Circumcision has been shown to be a likely reducer of several nasty male "problems" and diseases. It probably does pay for itself over all of society.

[Mr2001]

Proper hygiene also reduces those "nasty male problems". Which is better: giving your kid wooden teeth at birth so he won't have to worry about cavities, or just teaching him how to brush?

[zev_steinhardt]

Hazel,

Is it your position that circumcision should never be done (or even outlawed) then? The OP simply asked if it should be paid for with public money, but you went well beyond that in your response.

Zev Steinhardt

[Dangerosa]

Originally posted by Eonwe


I disowned my parents for having me circumcised.

Yeah, but you're no JDT



(oh, come on, someone had to bring him up).

And no, insurance shouldn't pay for circumcision, unless it is deemed medically necessary. And most nasty health problems related to circumcision are related to poor hygiene, not leaving the foreskin intact. Its simply easier to clean a circumcised penis.

[MsRobyn]

First of all, insurance does not cover circumcision done for purely cultural reasons. If I have a moyle circumcise my son, the insurance company will not pay for it. I have to pay the fee myself.

Circumcision in the routine, noncultural setting should be covered because it is a medical procedure that requires some measure of skill, not to mention anesthesia. If you don't want it done, then don't have it done. In any case, the actual cost of circumcision is relatively inexpensive. (I think the moyle's fee is around $300, but that's the circumcision and the ceremony.) However, if it's not covered by insurance, that effectively takes the choice away from people with insurance but no cash to pay the doctor.

One possible solution is to include it in the cost of the normal newborn care given while in the hospital.

Robin

[Mr2001]

Originally posted by MsRobyn
Circumcision in the routine, noncultural setting should be covered because it is a medical procedure that requires some measure of skill, not to mention anesthesia. [...] However, if it's not covered by insurance, that effectively takes the choice away from people with insurance but no cash to pay the doctor.

An unnecessary medical procedure should be paid for by insurance and tax dollars simply because some people wouldn't be able to afford it otherwise? I disagree.

Does this logic also apply to giving a newborn baby shiny wooden teeth so he'll never have to brush? How about cosmetic breast enlargement?

If someone came up to me asking for money for either of those procedures, I'd say "learn to brush" and "live with what you've got", respectively.

[MsRobyn]

Originally posted by Mr2001

An unnecessary medical procedure should be paid for by insurance and tax dollars simply because some people wouldn't be able to afford it otherwise? I disagree.

Does this logic also apply to giving a newborn baby shiny wooden teeth so he'll never have to brush? How about cosmetic breast enlargement?

If someone came up to me asking for money for either of those procedures, I'd say "learn to brush" and "live with what you've got", respectively.

Lots of "unnecessary" procedures are paid for by insurance and tax dollars, some of which are far more expensive and dangerous than a circumcision. Colonoscopy comes to mind, for one. Most of these are performed for routine purposes, yet it's suggested that they be given. There are other routine procedures that are done on a purely preventive basis that insurance covers merely because they are. If you look at it from a certain perspective, circumcision is also a preventive procedure.

As for purely cosmetic procedures like breast enhancement, they are almost never covered by insurance, and as far as I know, never have been except when the patient has had a mastectomy or some other disfigurement. Nor are most cosmetic procedures, although, again, there are exceptions for disease and disfigurement, or if the procedure is a necessary part of another surgery (for example, tummy tuck during breast reconstruction). So these procedures aren't really equivalent to circumcision, at least not as far as insurance coverage is concerned. And as for your example of artificial teeth, if someone needs them, they're covered, because it's known that there is a correlation between dental health and overall health.

Now let me ask you this. Do you think that voluntary, surgical sterilization (vasectomy or tubal ligation) should be covered by insurance? They're not necessary for life or health, and there are other means of accomplishing the same thing. So why should insurance pay for these?

Robin

[Hazel]

Originally posted by zev_steinhardt
Hazel,

Is it your position that circumcision should never be done (or even outlawed) then? The OP simply asked if it should be paid for with public money, but you went well beyond that in your response.

Zev Steinhardt

I was answering the question in the OP (the one I quoted in my post). To answer your question, plainly it can't be outlawed. But, for the reasons I listed, my advice to parents would be not to have this done to their sons. Do teach them good hygene habits; don't subject them to unnecessary surgery they are way too young to give informed consent to.

[Mr2001]

Originally posted by MsRobyn
There are other routine procedures that are done on a purely preventive basis that insurance covers merely because they are. If you look at it from a certain perspective, circumcision is also a preventive procedure.

Medical evidence for that is sketchy at best, and from what I've seen it's only preventive in the sense that you don't have to worry about washing a body part that you don't have, or getting cancer in it.

And as for your example of artificial teeth, if someone needs them, they're covered, because it's known that there is a correlation between dental health and overall health.

If someone needs them, yes. And I have no issue with insurance and Medicaid covering circumcision when it's needed--but most of the time, it isn't, it's just a cosmetic or pseudo-preventive decision.

Now let me ask you this. Do you think that voluntary, surgical sterilization (vasectomy or tubal ligation) should be covered by insurance? They're not necessary for life or health, and there are other means of accomplishing the same thing. So why should insurance pay for these?

If insurance also pays for birth control and childbirth, it becomes an economic question: will our money be better spent buying birth control for the next few decades, delivering an unintended child, or providing a one-time sterilization?

Also, sterilization has a well-defined medical purpose, and it fits in as one more option among the various choices for birth control. I don't know of any other procedure where body parts are routinely removed without solid medical evidence (especially at birth); even tonsils aren't removed unless something goes wrong.

[Mr2001]

Originally posted by MsRobyn
There are other routine procedures that are done on a purely preventive basis that insurance covers merely because they are. If you look at it from a certain perspective, circumcision is also a preventive procedure.

Medical evidence for that is sketchy at best, and from what I've seen it's only preventive in the sense that you don't have to worry about washing a body part that you don't have, or getting cancer in it.

And as for your example of artificial teeth, if someone needs them, they're covered, because it's known that there is a correlation between dental health and overall health.

If someone needs them, yes. And I have no issue with insurance and Medicaid covering circumcision when it's needed--but most of the time, it isn't, it's just a cosmetic or pseudo-preventive decision.

Now let me ask you this. Do you think that voluntary, surgical sterilization (vasectomy or tubal ligation) should be covered by insurance? They're not necessary for life or health, and there are other means of accomplishing the same thing. So why should insurance pay for these?

If insurance also pays for birth control and childbirth, it becomes an economic question: will our money be better spent buying birth control for the next few decades, delivering an unintended child, or providing a one-time sterilization?

Also, sterilization has a well-defined medical purpose, and it fits in as one more option among the various choices for birth control. I don't know of any other procedure where body parts are routinely removed without solid medical evidence (especially at birth); even tonsils aren't removed unless something goes wrong.

[Mr2001]

Could a moderator please delete one of those?

[MsRobyn]

Originally posted by Mr2001

Medical evidence for that is sketchy at best, and from what I've seen it's only preventive in the sense that you don't have to worry about washing a body part that you don't have, or getting cancer in it.


If someone needs them, yes. And I have no issue with insurance and Medicaid covering circumcision when it's needed--but most of the time, it isn't, it's just a cosmetic or pseudo-preventive decision.


If insurance also pays for birth control and childbirth, it becomes an economic question: will our money be better spent buying birth control for the next few decades, delivering an unintended child, or providing a one-time sterilization?

Also, sterilization has a well-defined medical purpose, and it fits in as one more option among the various choices for birth control. I don't know of any other procedure where body parts are routinely removed without solid medical evidence (especially at birth); even tonsils aren't removed unless something goes wrong.

Well, the appendix is frequently removed "just because". And so are wisdom teeth. (I should point out that the appendix is removed during some other abdominal procedure.)

Insurance companies will likely do some statistical numbers-wrangling before making a final decision; that's what they do. I, for one, hope they keep coverage on circumcision. It wouldn't be any loopier than some of the things they won't drop.

BTW, with Baby Doors' impending arrival, I will be happy to do a comparative study on taking care of a circumcised vs. uncircumcised penis.

Robin

[Eva Luna]

Originally posted by Mr2001

If insurance also pays for birth control and childbirth, it becomes an economic question: will our money be better spent buying birth control for the next few decades, delivering an unintended child, or providing a one-time sterilization?

Also, sterilization has a well-defined medical purpose, and it fits in as one more option among the various choices for birth control. I don't know of any other procedure where body parts are routinely removed without solid medical evidence (especially at birth); even tonsils aren't removed unless something goes wrong.

Anyone out there who has ever had an insurance plan that paid for any kind of birth control besides the Pill? I've had several different ones over the years, and out of the ones that paid for birth control at all (many didn't, but odly enough were happy to pay for sterilization, and some would even pay for abortions but not contraception, which is just WRONG!), none covered anything besides the Pill.

The problem with that is that many women are unable to use birth control pills for medical reasons (I had to fight big-time with my doc to use it, months after a post-surgical blood clot, by reasoning with her that it wasn't that I had a clotting problem in general, it was just that I was on the Pill when I broke the damn leg and spent a month on my butt in bed, and you're supposed to go off the Pill before anything which will require you to convalesce in bed. Unfortunately, life didn't give me that choice.) And for many who are able to take the Pill from a medical standpoint, it's just not the best option.

So I guess at least insurance companies are consistently inonsistent.

[matt_mcl]

To clear it up, the Canadian medicare system pays for a great deal of things, but definitely does NOT, repeat NOT, cover breast implants.

[sailor]

>> Well, the appendix is frequently removed "just because". And so are wisdom teeth.

No, and NO respectively. The appendix is removed wheen there is a good medical reason and so are the wisdom teeth. No doctor is going to tell you to have them removed "just because". Coloncospies and otehr preventive procedure are just that, "preventive", and therefore recommended. The AMA and not needed in any way. The *only* reason is cultural or "just because" and, as such, if you want it you should pay for it yourself just as is you want a piercing or a tatoo.

[Lynn Bodoni]

Originally posted by WV_Woman
Because insurance pays for a lot of cosmetic stuff.

Ever hear of breast implants?

I would be interested in knowing just which insurance companies pay for breast implants, and under which circumstances.

One moderator has already warned you about posting inaccurate medical information in GQ. You may consider that warning to be boardwide, applicable in all forums.

Lynn Bodoni
For the Straight Dope

[Squish]

Here's a site that debunks a lot of circumcision myths and gives information on the care of the intact penis. I've linked to the FAQ page, but if you go farther up the tree there's loads of information (a reference library, etc.).

My intact boyfriend goes crazy when I stimulate his frenulum (which circumsized males don't have) and his glans seems a lot more sensitive than the cut males I've known. So, no, it's not medically necessary (in fact, it became widespread in America as an attempt to keep boys from masturbating , not for health reasons) and should not be covered by insurance.

BTW, Arizona doesn't have Medicaid. We have a far less generous program called AHCCCS (Arizona Health Care Cost Containment System).

[MsRobyn]

Originally posted by sailor
>> Well, the appendix is frequently removed "just because". And so are wisdom teeth.

No, and NO respectively. The appendix is removed wheen there is a good medical reason and so are the wisdom teeth. No doctor is going to tell you to have them removed "just because". Coloncospies and otehr preventive procedure are just that, "preventive", and therefore recommended. The AMA and not needed in any way. The *only* reason is cultural or "just because" and, as such, if you want it you should pay for it yourself just as is you want a piercing or a tatoo.

Then please explain incidental appendectomy (which is generally not billed for) and prophylactic wisdom-tooth extraction (which I had at the Navy's order.)

Robin

[sailor]

Since I have no idea what an "incidental appendectomy"is I went to google and searched for "incidental appendectomy". The first link I got says:

Incidental Appendectomy
Removing a normal appendix incidentally during a surgical procedure done for reasons other than abdominal pain is associated with a small but definite increase in adverse postoperative outcome. In this respect incidental appendectomy has been found to increase the incidence of postoperative septic complications (wound infection). It is neither cost-effective as an estimated 36 incidental procedures would be needed to prevent one case of appendicitis

In other words:
a) It is done for very specific medical reasons in the course of some other operation and not "just because".
b) that paper says it is better not to do it.

Please provide cites of any healthy person who had the appendix removed "just because" and for no other medical reason.

>> prophylactic wisdom-tooth extraction

So "prophylactic" now means "just because"? huh? Ok, I'll make a note of that. Everybody I know who had their wisdom teeth removed had a good reason to do it. I had my wisdom teeth for many years until they were full of cavities and causing problems and I had them extracted. In all the years that they were healthy not one single dentist suggested I take them out "just because". Please provide cites of any doctors who recommend pulling healthy teeth "just because".

As has been pointed out by the mods, medical advice is better left to the people who know what they are talking about which is neither you or me. If you are going to make such assertions I hope you can have very solid foundations. I do not think *any* doctor would recommend pulling an appendix or a tooth "just because". If you say the contrary, please find a doctor who will support that view.

[doreen]

Then please explain incidental appendectomy (which is generally not billed for) and prophylactic wisdom-tooth extraction (which I had at the Navy's order.)

Neither one is these is really "just because". Incidental appendectomies are performed when surgery is already being done in the area (and I believe the reason is to avoid an assumption (and misdiagnonsis ) later that the appendix has been removed, when in fact it hasn't ) Maybe not the best reason, but different from removing it in a separate surgery "just because" it's there and might cause trouble. And in my experience, at least, prophylactic removal of wisdom teeth occurs when the tooth is not causing trouble yet, but it is obvious that it will. They are not simply removed with no sign of future problems.

[MsRobyn]

First of all, I read medical reports for a living that have included the phrase "incidental appendectomy" (and I should have clarified that I meant "incidental in the sense that the surgeon already had the patient open and removed the appendix while he was there", not "separate surgery for the purpose of removing a healthy body part", which is mutilation by any standard). I also know that this procedure is almost never billed for because it is "incidental".

As for wisdom teeth, they are occasionally removed for preventative reasons, whether there is the expectation that they'll cause problems or not. Military people (at least this was true 10 years ago) come to mind, because they're subject to conditions that are less than ideal for oral surgery IF they do go bad.

Robin

[sailor]

doreen, the page I mentioned, if I understood it correctly, seems to imply an incidental appendectomy is done sometimes when an operation is done in that are to prevent a cause for infections. It is not related to any later assumptions that the appendix was removed or not. In any case, the point is that an appendix is never removed for no reason other than "just because".

[tracer]

Originally posted by Mr2001
Insurance and Medicaid should classify circumcision with clitoridectomy, bloodletting, and phrenology.

Just FTR, some evidence has recently come to light that circumcized penises might have less of a chance of getting infected with HIV during unprotected sex than uncircumcized penises do. (Two 1999 studies from Africa, where HIV infection among heterosexuals has reached epidemic proportions, claim to show a positive correlation between HIV infection and a lack of circumcision. They're still controversial; see http://www.circumstitions.com/HIV.html for a counterargument.)

[Palo Verde]

Originally posted by WV_Woman
Because insurance pays for a lot of cosmetic stuff.

Ever hear of breast implants?

Insurance does not cover breast augmentation and may not cover reoperation (additional surgery) and additional doctor’s visits following augmentation.

www.plastic-surgery.net even says that usually obtaining 2 letters of medical necessity will not be sufficient in getting insurance to pay for breast implants. You have to prove one of a very few medical conditions (for example, after a mastectomy
for breast cancer).

So, what is the rational for insurance paying for circumcism?

[doreen]

As for wisdom teeth, they are occasionally removed for preventative reasons, whether there is the expectation that they'll cause problems or not. Military people (at least this was true 10 years ago) come to mind, because they're subject to conditions that are less than ideal for oral surgery IF they do go bad.

Are you saying that all members of the military have their wisdom teeth removed ? Because I'm not at all saying they won't be removed prior to causing problems if there simply isn't enough room in the jaw for them to grow in properly (and to my understanding, that can be seen on X-rays). I am saying I have never heard of wisdom teeth being removed that were not causing problems and weren't expected to cause them in the future. That's precisely why I still have one that hasn't erupted yet. If it ever does erupt, there is enough room for it (unlike the ones that were removed.)If I do have it removed my insurance absolutely will not pay for it, as no problem will show on the x-rays that the company will demand. I'm not even really saying it never happens. I had a dentist remove four of my baby teeth when I was 12 "just because" I was too old to have baby teeth. The fact that one dentist did it, even if he did it to every patient of his, doesn't make it a frequent occurence.

[sailor]

>> Are you saying that all members of the military have their wisdom teeth removed ?

Make your own jokes about the military and having wisdom removed.

Reminds me of: Military music is to music what military intelligence is to intelligence.

Sorry for the interruption. Please continue the interesting discussion. It does not much concern me as I am planning on keeping my penis as it has been all along. It seems to work pretty well as it is and i see no need to make any changes.

[sailor]

>> Are you saying that all members of the military have their wisdom teeth removed ?

Make your own jokes about the military and having wisdom removed.

Reminds me of: Military music is to music what military intelligence is to intelligence.

Sorry for the interruption. Please continue the interesting discussion. It does not much concern me as I am planning on keeping my penis as it has been all along. It seems to work pretty well as it is and i see no need to make any changes.

[TVAA]

Originally posted by tracer

Just FTR, some evidence has recently come to light that circumcized penises might have less of a chance of getting infected with HIV during unprotected sex than uncircumcized penises do. (Two 1999 studies from Africa, where HIV infection among heterosexuals has reached epidemic proportions, claim to show a positive correlation between HIV infection and a lack of circumcision. They're still controversial; see http://www.circumstitions.com/HIV.html for a counterargument.)

Given the immense cultural bias in favor of circumsicions in Africa, which is responsible for the viewing of uncircumcised adults as outcasts (and occasionally to assaults and forced circumcisions), I wouldn't trust any data from a study done in that country.

[Futile Gesture]

Originally posted by tracer

Just FTR, some evidence has recently come to light that circumcized penises might have less of a chance of getting infected with HIV during unprotected sex than uncircumcized penises do.

And castrated penises are even less likely to be infected. Doesn't really make it a justified operation, does it?

Amputed toes never get corns. Cut a bit off you and you remove all risk of it infecting you in future.

[psychobunny]

The reason that "incidental" appendectomy is not usually billed for is that insurances will not pay for it. Traditionally, if surgery was done in that area, the appendix was also removed so that if further problems arose, appendicitis would not be missed because of an assumption that a scar was due to appendectomy. Also, preventative care undertaken by the military is different from that covered by other insurances. Preventative wisdom tooth extraction is not covered under most health plans unless there is a medical reason for it. Therefore please put me on the side on not having insurance pay for a purely elective procedure. Circumcision is elective and whether done in the hospital or during a religious ceremony, IMO the parents should pay.

[Jojo]

I was under the impression (although I have no cite to hand) that people who are about to set off to Antartica in order to work there for several months often have their appendix removed beforehand, even though it is perfectly healthy.

The reason being that they may develop appendicitis out there. If the appendix were to burst (and they develop peritonitis), they would not be able to make it back to a hospital in time and could die.

In this case it is justifiable removing a healthy appendix (in terms of cost/benefit analysis).

Apart from exceptional circumstances such as this, I think they tend to leave appendices alone on the basis that "if it ain't broke, don't fix it".

[Cat Fight]

I've been waiting for Female circumcision to come up, but it's taking a while. Is it conceivable for this monstrous procedure to be made legal, let alone be paid for by medicare (in Canada) or insurance? No. It is horrific, I don't care who's culture's toes I'm stepping on. Male circumcision is seen horrific, too, by some people, including doctors (there's even a group called Doctors Against Circumcision). Have you ever seen a photo of a baby getting circumcised- or the real thing? It's only logical that it will reduce pleasure later on (for him and his partner)- millions of sensitive nerve endings are being removed.

Given the immense cultural bias in favor of circumsicions in Africa... I wouldn't trust any data from a study done in that country.

Let's just keep in mind that Africa is a CONTINENT, not one massive country. Policy and beliefs vary enough from state to state, let alone from Egypt to Somalia.

[Cat Fight]

(Of course by "who's" I meant "whose". Natch.)

[Palo Verde]

So if everyone around here agrees that it shouldn't be covered... why do most private insurance plans (and some Medicare) pay for it?

[zev_steinhardt]

Originally posted by autz
So if everyone around here agrees that it shouldn't be covered... why do most private insurance plans (and some Medicare) pay for it?

Because they didn't consult us...

Zev Steinhardt

[Palo Verde]

Originally posted by zev_steinhardt


Because they didn't consult us...

Zev Steinhardt

Yeah, but it seems like insurance companies are always looking for ways to cut costs. This is an obvious one.

I looked on the web to see how much it costs, and this site says "HCIA-Sachs reports that the total cost of an in-hospital non-therapeutic neonatal circumcision in the United States has risen from $1154 in 1992 to $1869 in 1999, an increase of 62%"

That's a lot of money!

[Palo Verde]

Hmmm... maybe it's not so much. Another web site says "Average circumcision fees in each of ACOG's nine geographical districts range from $204 in the middle-Atlantic states to $98 in the West. " This doesn't have a date on it so maybe it's old info, or maybe the other site was including costs of staying in the hospital during the proceedure.

Even so, in my experience insurance companies fight tooth and nail over every penny, so why do they willingly pay this?

[MsRobyn]

It sounds like one is the hospital charge for supplies, room, disposal of the foreskin, etc, while the lower figure is for the doctor who actually does the procedure. Most doctors are not hospital employees; they belong to private practices and can bill accordingly.

Insurance companies pay for this because there's a demand for the procedure, and because they've always covered it. Just because circumcision has been declared unnecessary doesn't mean people don't want to have it done. In any case, if you think insurance companies pay $2K for this, you're nuts. The actual figure is a LOT less, because it's based on "reasonable and customary" charges.

I also found out that my insurance company will cover routine circumcision done on an outpatient basis. Maybe I'll submit the bill for my son's bris.

Robin

[BeatenMan]

Medicare should not pay for circumcision. The doctors should work for tips.