One of my pet peeves is cost-benefit analysis as it pertains to infant circumcision. Ditto benefits vs. risks. I just don't think it's appropriate in this context to view the only downsides as being cost or risk. There are genuine health and functionality considerations to being intact, so the true comparison would be advantages vs. disadvantages.
Nevertheless, there are strong arguments to be made that neonatal male circumcision in any first-world setting is cost-INeffective. Enormously cost ineffective, when one factors in the cost of the original surgery (fee plus related materials and charges), the cost of do-overs, and the cost of treating future disease based on the statistical averages for cut and intact males from various studies.
One doctor who has written extensively on this issue and who has excellent credentials -- an MD from a leading medical school, a Master's of Public Health (MPH) in population statistics from another leading university and over 25 years of clinical practice in Pediatrics -- has floated this interesting idea: the United States could improve health outcomes and lower our overall medical spending if we gave parents $500 per newborn boy not to circumcise. The actual figure is around $612 to break-even, but offering $250 or $300 or $500 is still a win for the insurance companies, policyholders, and taxpayers.
I just got off the phone with him and he said his thinking is this: many parents choose circumcision because they think they're getting something "for free". To pass up on this insured benefit would be to leave value on the table -- but that is only because most parents don't fully understand that circumcision does not improve health outcomes in the aggregate and that the rate of complications is ridiculously high, and the cost of fixes is also high, compared with other routine procedures. Almost all parents who choose circumcision look only at what they perceive as a net benefit for free, instead of what it really is... a net health and cost loss. Other developed nations have figured this out and would never go back to offering free or mostly subsidized infant circumcisions.
So, my question is whether dangling a few hundred bucks in cold hard cash would substantially alter the decision-making process for parents. My personal view is that merely de-insuring circumcision would do the trick under either private insurance, HMOs or Medicaid, since the data points we have from every other English-speaking country is that parents miraculously lose their enthusiasm for newborn circumcision when it has a perceived cost with it. But would a carrot work as well as a stick?
Anecdotally, I have some friends who have in fact offered their siblings and cousins money not to circumcise, and in every single case it was accepted.
I'd be interested in your thoughts. Would your relatives/friends/neighbors jump at the chance to collect cash not to circ, or are they too personally invested in the procedure?
Nevertheless, there are strong arguments to be made that neonatal male circumcision in any first-world setting is cost-INeffective. Enormously cost ineffective, when one factors in the cost of the original surgery (fee plus related materials and charges), the cost of do-overs, and the cost of treating future disease based on the statistical averages for cut and intact males from various studies.
One doctor who has written extensively on this issue and who has excellent credentials -- an MD from a leading medical school, a Master's of Public Health (MPH) in population statistics from another leading university and over 25 years of clinical practice in Pediatrics -- has floated this interesting idea: the United States could improve health outcomes and lower our overall medical spending if we gave parents $500 per newborn boy not to circumcise. The actual figure is around $612 to break-even, but offering $250 or $300 or $500 is still a win for the insurance companies, policyholders, and taxpayers.
I just got off the phone with him and he said his thinking is this: many parents choose circumcision because they think they're getting something "for free". To pass up on this insured benefit would be to leave value on the table -- but that is only because most parents don't fully understand that circumcision does not improve health outcomes in the aggregate and that the rate of complications is ridiculously high, and the cost of fixes is also high, compared with other routine procedures. Almost all parents who choose circumcision look only at what they perceive as a net benefit for free, instead of what it really is... a net health and cost loss. Other developed nations have figured this out and would never go back to offering free or mostly subsidized infant circumcisions.
So, my question is whether dangling a few hundred bucks in cold hard cash would substantially alter the decision-making process for parents. My personal view is that merely de-insuring circumcision would do the trick under either private insurance, HMOs or Medicaid, since the data points we have from every other English-speaking country is that parents miraculously lose their enthusiasm for newborn circumcision when it has a perceived cost with it. But would a carrot work as well as a stick?
Anecdotally, I have some friends who have in fact offered their siblings and cousins money not to circumcise, and in every single case it was accepted.
I'd be interested in your thoughts. Would your relatives/friends/neighbors jump at the chance to collect cash not to circ, or are they too personally invested in the procedure?
