Interesting thought

[bugmenot]

I was in a discussion regarding circ a few days ago. The point about the economy was brought up. Could a weaker economy lead to more intact babies? I wonder how many people won't circ if money is a deciding factor.

If someone WOULD circ if insurance/HMO/Medicaid/whatever would pay for it, but wouldn't if THEY had to pay for it, I'd welcome that hypocrisy any day. They may end up not doing it ever, once they get used to the natural state of the penis.

[NewSolarMomma]

I don't know, but I hope so! Gotta get something positive out of a poor economy.

[AnnaNova]

i always tell that to people that i know are planning on circing, and it doesnt seem  to bother them... surprisingly. i tell people "you might check with your ins provider, because a lot of them dont cover it anymore as it is not a medically necessary procedure", and the response is almost always "oh, ok" or "yeah, thats fine". not sure why, maybe people dont realize how much it costs out of pocket

[Pirogi]

How much does it cost?

[MamaJenese]

While it varies a bit in the NorthEast (of America)  Most Doc's bill out about $400 for a cric.

[vachi73]

The "cost" depends on how you look at "cost" (and I don't mean the cost to the boy later in life ... that's a whole different can of worms!) -- what the doctor CHARGES you or what the insurer actually PAYS the doctor -- and also the location/setting of the procedure.

For outpatient circ, e.g., done in the doctor's office, the CHARGES range from about $300-500 based on location and whether it's done by a pediatrician or a urologist/pediatric urologist. In terms of what insurers pay to the doctor, I would assume it's no more than 80% of the charges, and likely less in many places (even as low as 40-50% of charges ... so, as little as $120 per procedure).

For neonatal circ, done in the hospital, there are doctor's charges (usually to the OB or resident who performs the procedure), which are similar to the outpatient example above; plus there is a facility charge that is paid to the hospital. Yep, the hospital gets in on the action, too, which is why hospitals actively solicit for circ after births in most hospitals. I am not sure how much the facility fee is, but I think that someone (Ron?) once quoted a figure around $300 per procedure.

In some cases, the hospital will re-sell the foreskin to pharmaceutical/cosmetics companies, which puts more money in the hospital coffers beyond the facility fee. I have no idea how frequently this happens, but I understand that it does happen. It's not a "cost" in the sense that parents/insurers pay it, but it is a financial transaction that occurs related to RIC.

All of these "costs" assume there are no short-term or long-term complications (again, I don't mean to ignore the obvious complication of being without a foreskin ... but I can't quantify that cost). In the case of excess bleeding, re-circ, potentially ED, etc. -- there are many short- and long-term actual medical costs that should be considered as part of the cost of the initial circ, but are often ignored. Probably because we have no idea what the real stats are on most of the "side-effects" and "risks" (including death) associated with RIC.

Others with better info, please correct these numbers. I think that understanding the true financial implications of circ is very, very valuable.

Can you tell I am fired up about this today?!

Going to chill out now... HTH!

Edited by vachi73 - 1/5/11 at 11:01am

[Pirogi]

Originally Posted by vachi73 

I think that understanding the true financial implications of circ is very, very valuable.

I agree.  I think the business of circumcision is extremely influential to its persistence in our society.

[hlg1212]

Well, just an example, but my nephew required an extra overnight in the hospital following his birth due to excessive bleeding from his circ wound, which definitely generates extra revenue for the hospital and requires minimal effort on their part.  How often does this happen?  I agree that the true costs are impossible to quantify. 

[eepster]

There are the additional costs of caring for the wound.  Though these are relatively small, they are completely out of pocket.  There is the cost of vaseline, gauze, tape and ointment for dressing the wound.  There is the cost of baby tylenol for comfort.  There is the cost of extra diapers b/c the child will be in pain every time he pees a teeny tiny bit.

[Mom2Brendan]

I also think that pediatricians should stop offering them to have them done in their office as in it gives a chance for babies who go for their 7 day check up or 10 day check up or 2 wk checkup to be circ'ed.

Some parents don't want to pay Hospital fees and the pediatrician can save them money on their circs. Plus, sadly when a parent is determined to have their kid circ'ed I'm for sure they will be willingly to cough up 1,000 dollars which even to pay 600 dollars for one its ridicolous.

[Treece]

To have it done is ridiculous. IMO. However, when I was prego with ds1 the doc said that she would want $200 up front for it. We weren't even discussing it at that point, but when we got home, i asked xh if we would, and his response was why? I really couldn't answer. Researched it. Learned. Saw photos. Cried, and apologized to him for even considering. :( I am so happy that is how that story went. But long story short, I seriously doubt I would have paid anything for it. I just wouldn't have.

[Ron_Low]

The next time I have an UN-interesting thought, I'll post here with "UN-interesting thought" as the subject line.  Oh wait, I just broke my own rule. 

How about "Circumcison frequency vs economic downturn" so folks can know what they're reading/following up on? 

[PlainandTall]

Ouch Ron! In the future, just so you know... you can mouse over the thread title (as well as the most recent comment) and see the start of a post. Maybe you were on a phone. 

[PlainandTall]

I have seen numbers pushing a grand on some pregnancy boards, with $500- $800 not that uncommon.  Amazingly, in New York- Medicaid only pays $14 for a circumcision.  I'm surprised that a Dr. would "waste their time" for only $14... (certainly not their breath to give even the minimal run down required for "informed consent")  The only way I can figure is that the aftermarket for human tissue is strong enough to make it worth their effort to harvest the foreskins even if they aren't making money on the surgery. 

[Ron_Low]

Originally Posted by PlainandTall 

you can mouse over the thread title (as well as the most recent comment) and see the start of a post. Maybe you were on a phone. 

The daily email update doesn't have that mouse-over text.  That's the link I clicked. 

[jessjgh1]

It is more about 'loyalty' and the perceived threat of losing clients. if a pedi has to tell the patient s/he doesn't do circs, then s/he might lose them as a client- so $14.00 isn't much, but it increases their patient base. Infants will collect a bunch of copays that first year and then trickle down to once a year or so.  And I'm sure they hope the family comes back to them if they have more children.  All of that is significant income.  In addition, most docs take both medicaid and private insurances, so they cannot "fairly" perform circs for privately insured and refuse a medicaid one. The income will be mixed. 

Even (some) Ob's and hospitals don't want 'not'  to offer something in case it causes a family to go somewhere else.  And they want to keep the clients so they come back if they are pregnant again (and recommend them to friends, etc).  I've heard of some hospitals doing them for free for patients that don't have insurance coverage. 

So $14.00 may not seem like much, but they are looking (even if subconscious) at losing or gaining a patient for multiple transactions.  

Of course, if doctors STOPPED offering them, I think most parents would either not have it done, or simply arrange/see a doctor that does them, probably just for that procedure.  I don't think it is a significant factor for most parents.

And I don't know how to address the selling foreskins issue.  I've read on the boards that these foreskin samples cannot be tainted with pain relief, so the practice seems highly unethical even by circumcision sympathetic standards.  Nobody knows about it, though.

Jessica

Originally Posted by PlainandTall 

I have seen numbers pushing a grand on some pregnancy boards, with $500- $800 not that uncommon.  Amazingly, in New York- Medicaid only pays $14 for a circumcision.  I'm surprised that a Dr. would "waste their time" for only $14... (certainly not their breath to give even the minimal run down required for "informed consent")  The only way I can figure is that the aftermarket for human tissue is strong enough to make it worth their effort to harvest the foreskins even if they aren't making money on the surgery. 

[Treece]

Originally Posted by jessjgh1 

It is more about 'loyalty' and the perceived threat of losing clients. if a pedi has to tell the patient s/he doesn't do circs, then s/he might lose them as a client- so $14.00 isn't much, but it increases their patient base. Infants will collect a bunch of copays that first year and then trickle down to once a year or so.  And I'm sure they hope the family comes back to them if they have more children.  All of that is significant income.  In addition, most docs take both medicaid and private insurances, so they cannot "fairly" perform circs for privately insured and refuse a medicaid one. The income will be mixed. 

Even (some) Ob's and hospitals don't want 'not'  to offer something in case it causes a family to go somewhere else.  And they want to keep the clients so they come back if they are pregnant again (and recommend them to friends, etc).  I've heard of some hospitals doing them for free for patients that don't have insurance coverage. 

So $14.00 may not seem like much, but they are looking (even if subconscious) at losing or gaining a patient for multiple transactions.  

Of course, if doctors STOPPED offering them, I think most parents would either not have it done, or simply arrange/see a doctor that does them, probably just for that procedure.  I don't think it is a significant factor for most parents.

And I don't know how to address the selling foreskins issue.  I've read on the boards that these foreskin samples cannot be tainted with pain relief, so the practice seems highly unethical even by circumcision sympathetic standards.  Nobody knows about it, though.

Jessica

I've heard this too. I was searching through Pub Med and cannot find anything specific. But there is ALOT on foreskin fibroblast