The Huge Cost Of Male Genital Mutilation, Ctd

A reader counters my analysis of these numbers:

On the issue of circumcision, you are biased and unbalanced. You call circumcision “male genital mutilation”. OK, that’s a bias you are entitled to. Attack circumcision as a moral abomination if you must, but eliminating circumcision will do little for healthcare costs. You cite its $1.8 billion cost and italicize it for emphasis. That is unbalanced. The data report you cite says that of the top 20 operating-room procedures, circumcision is the cheapest per procedure by far and is 20th on the list of 20. And the total cost of circumcisions is just 0.069% of total spending of $2.6 trillion on healthcare in 2010 in the US, and less than 1% of total OR procedures.

The biggest source of healthcare costs are in people over 65, of course, and the biggest source of healthcare costs in people over 65 are in the 25% or so of people with chronic diseases such as CHF, COPD or diabetes. The biggest driver of healthcare cost increases is medical technology driving new treatments to market. Circumcision has very little to do with medical costs.

Of course, mutilating infant boys’ genitals is a small factor in the context of the costs my reader cites. And yes, circumcision is itself not that expensive. But its ubiquity means a remarkable use of medical and operating room resources for an elective procedure. And by “elective”, I do not mean, of course, that the boys choose it. Their parents choose it without the patient’s consent. Another reader on the issue in general:

Okay, you win.

For years I’ve been a loyal reader despite the fact that you occasionally hammer on crusades that I can’t get behind – most notably, your war against “male genital mutilation”.  As a parent of two boys, I reflexively had them circumcised at birth; because I was, and because I’d never seen an uncircumcised one in real life, and because I didn’t want my boys to grow up wondering why they looked different than me “down there”.  In that context, I’ve always been annoyed by your relentless stance on this issue.

Until today.  You see, I’m a healthcare actuary by profession, so today you finally hit on an argument that resonates with me – that male circumcision is symptomatic of our society’s over-utilization of healthcare.  Way to keep attacking from different angles until your target finally yields …

Another really took the blogging to heart:

Just thought I’d share that your ongoing coverage reinforced the decision my wife and I made not to circumcise our son. We both come from Southern, conservative, Protestant families where circumcision has been the norm for who-knows-how-long, but our families haven’t made any complaints, and we feel we made the right choice.

Update from another:

I have always rolled my eyes at the term “male genital mutilation.” Same goes for some of the other hysterics of anti-circumcisionists. None of those arguments ever did much for me. (Less sensitivity? Things feel just fine for me down there, thank you. Psychological damage? Please. There are plenty of sources of adult neuroses other than the penis. The anesthetized trimming of a little skin is hardly the worst thing that happened to me in childhood.) And until a month ago I always would have thought that I would have my sons circumcised, like me. I am American, after all, and circumcision is just what we do, right? Why should I make my sons “different”?

But last month, with a newly-pregnant wife, my view changed for a very simple reason: I realized that I don’t have any reason to circumcise. I attended the bris of a friend’s son and saw it all happen. None of it grossed me out. Not the blood, not the scalpel. And the baby didn’t seem to be in any pain. But it struck me quite suddenly that while my Jewish friends have a very good, compelling reason to circumcise – a covenant with their God – I just don’t have one. And as a rational person, it is simply not in my nature to make a permanent and unalterable decision without a good reason.

A rebuttal from a reader:

When discussing what you call male genital mutilation, you keep saying that this is surgery that is done without the patient’s consent. Obviously, a new born can’t consent to anything but circumcision is a very different operation for a newborn than it is for an adult. Ignoring the issue of whether it is necessary surgery, it is a very minor procedure for a baby and a huge deal for an adult. A close friend of mine, born in China, was uncut. He had to be circumcised as an adult (I believe he had the same condition as Louis XVI) and it was as Joe Biden would say, “a big fucking deal.” He was in a lot of pain for a long time and the surgery came with risks of complications and scarring.

You argue that the parent makes the decision to circumcise an infant son without his consent but the parent is also essentially making the decision not to circumcise too. An adult may think/want/believe he is better off circumcised but if his parents did not make that decision for him as a baby, it may not be a realistic choice for him to make as an adult.