Health Policy Solutions
May 5, 2012
Circumcision bill dies in Colorado House
By Katie Kerwin McCrimmon
A bill that would have restored Medicaid funding for circumcisions in Colorado died Friday.
The measure squeaked through a hearing in the House Health and
Environment Committee on Thursday, then died in Appropriations Friday
morning.
Opponents, who included health professionals, budget hawks and
anti-circumcision activists told health committee members on Thursday
that circumcision is cosmetic and potentially harmful, and taxpayers
should not fund it.
Proponents for the bill argued that funding for circumcision for
babies on Medicaid is a social justice issue. In general, insurance
companies pay for the procedure for insured Colorado babies even though
the American Academy of Pediatrics does not deem circumcisions to be
“medically necessary.” Meanwhile, low-income parents who want their
babies circumcised are being put on waiting lists for the procedure
until parents can prove they’ve paid in advance.
Sen. Irene Aguilar, D-Denver, an internal medicine doctor for Denver
Health, testified on behalf of restoring public funding for
circumcision. Last year, Colorado lawmakers decided to save money and
cut funding for Medicaid circumcisions. They were following the lead of
17 other states. Proponents wanted taxpayers to once again pay for the
procedures for parents who choose to have their infants circumcised.
Fiscal analysts estimated that covering the procedures again would
cost the state about $195,000 next year and $230,000 the year after
that.
“As a physician, I don’t try to influence parents one way or the
other,” Aguilar said. “People make this decision based on religious and
cultural reasons.”
[What business does a doctor have performing surgery based on religious or cultural reasons? (Answer: good business....)]
She said that there is some evidence that infant boys who don’t get
circumcised have higher rates of urinary tract infections and that adult
men who are uncircumcised and live in poverty tend to have increased
rates of HPV, which can lead to higher rates of cervical cancer in
female partners.
Only one other doctor testified on behalf of circumcision. The rest of the witnesses opposed public funding for the procedure for a variety of reasons.
They included Dr. Jennifer Johnson, a family physician who works with
Medicaid and uninsured patients at Clinica Family Health Services.
“
I’ve done at least 100 circumcisions and just recently decided to stop,” Johnson testified.
She said
she and her husband, who is Jewish, decided not to circumcise their own son,
who is now 4. She said she was concerned when she researched the issue
and found that removing the foreskin from a boy’s penis damages numerous
nerve endings. While circumcision is traditional in the Jewish
community, Johnson said her husband was open to new research about the
potential harms from circumcision.
If boys or men decide to remove the foreskin as adults, then they can
make that decision, Johnson said. But she decided that as a physician,
she should no longer do a procedure that is “potentially harmful.”
“This is not a necessary procedure,” Johnson said. “It’s a healthy,
normal body part.”“There are a lot of medical needs in our population.
We have no business using limited health care dollars on a medically
unnecessary cosmetic procedure.”
One lawmaker, Rep. Sue Schafer, D-Wheat Ridge, elicited laughter in the hearing room when she asked Dr. Johnson if
circumcision might help reduce teen pregnancy rates and teen sexual activity by reducing nerve sensation in boys’ penises.
“I’m wondering if there’s a risk of more sexual activity, more male irresponsibility” for uncircumcised boys, Schafer asked.
[Rep. Janak Joshi, R-Colorado Springs, looks incredulous at Rep. Schafer's question.] Joshi, a retired doctor, voted against restoring circumcision funding,
saying circumcision is uncommon in India and he's never seen infections
due to lack of circumcision.
Johnson answered that teen pregnancy is certainly a problem, but said circumcision won’t halt teen sexual activity.
“Circumcision is not a cure for behavior. That’s about education,” she said.
...
While circumcision is an ancient tradition in some religions,
circumcision opponents said it became popular in the U.S. as a method to
prevent masturbation among boys. Later, fathers wanted their sons to
look like them.
“Frankly that’s cosmetic surgery…and I strongly urge you to vote
against it,” said Dr. Matt Mason, a physician from Telluride. He was
skeptical about cost estimates and said circumcision is now rare in
Western Europe, Canada and New Zealand.
[Circumcision has always been rare in Western Europe.]
...
Earlier story
