Circumcision: Exactly How Does it Affect Healthcare?

Circumcision. Historically, it is the world’s oldest planned surgical procedure, pre-dating recorded history at over thousands of years. It has been performed worldwide for centuries in both religious and healthcare practices, and is renowned for the benefits that it has to male health.

Regarded as a trusted and proven method of healthcare and disease prevention, of course it would be covered by healthcare as a preventative measure, right? Wrong. Uncircumcised males are more exposed to a wide variety of health issues throughout their lifetime. HIV has been a topic of conversation among health professionals since it emerged in the early 1980’s with the first diagnoses of AIDS among young men.

Though this disease has been predominately attributed to homosexual males, there is also an observable correlation between the numbers of diagnosed causes of HIV/AIDS amongst uncircumcised, heterosexual males. A study performed in 1989 showed that uncircumcised males in South Africa, Kenya, and Uganda were 8.2% more likely to contract HIV than their circumcised counterparts.

Males who remain uncircumcised are further predisposed to developing penile cancer; though rare (1 in 100,000 cases reported annually), it does surface –predominantly in males who have contracted HIV/HPV. Therefore, forgoing circumcision not only exposes one to HIV, HPV, and AIDS, but increases the risk of developing cancer. There are lesser effects on health (though just as concerning), such as an increased risk of contracting syphilis, cancroid (genital sores), herpes, and chlamydia, as well as increased UTI, bladder, and kidney infections.

So where do these procedures fall in terms of health care coverage and costs? Today, circumcision is not currently covered by MOST health insurers, and – in combination with the nationwide decrease in the rate of male circumcision – is becoming an increasing concern. Not including this preventative procedure in their offered policies allows insurers to immediately cut costs in their coverage, thus saving the companies money and allowing them to offer lower, more competitive rates.

Aaron A. R. Tobian MD, PhD., a professor of pathology, medicine, and epidemiology at Johns Hopkins, has stated the following regarding his team’s study on circumcision and healthcare costs: “If our male circumcision rate was to go down to 10%, the additional health care costs over a 10-year period would be $4.4 billion…the most conservative estimate. This analysis focuses on direct medical costs alone, so there is nothing about other factors such as patient transportation costs and productivity loss”. This is a steep price to pay in for both patients and insurers – especially when the ultimate goal initially was saving money.

So, what role does insurance play the procedural decision? Tobian claims in his findings that: “During the same time circumcision rates have fallen, state governments have been increasingly decreasing Medicaid coverage for male circumcision…there’s a correlation between lack of Medicaid coverage and reduced numbers of infant circumcision”. This means that with the reduced coverage, there comes a steady drop in circumcision rates.

When new parents are made to choose whether or not to have their infants circumcised – an “optional” procedure, as defined by federal Medicaid – they’re more likely to waive the procedure entirely, without realizing the health effects it will have later on down the road. Another factor they may not consider is the cost of adult circumcision without healthcare assistance.

As of 2013, adult circumcision was estimated at $2,500, and that’s only if the foreskin is not considered “non-retractable”, in which case, another $500 is added to the procedure. Whether cosmetic or for health, circumcision is a proven method of maintaining male health and wellbeing. It has been proven time and time again, yet healthcare providers still hold out providing coverage for this preventative procedure.

The bottom line: Circumcision is a necessary step to ensure male health, and being a preventative procedure, as opposed to being an optional procedure, should require coverage by all healthcare providers. Without circumcision, healthcare providers are going to pay more to treat these individuals later, when the reality is they could be solving the problem now – saving all parties valuable time and money.

References:

http://www.cbsnews.com/news/declining-circumcision-rates-may-add-4-billion-in-us-health-care-costs-researchers-say/

http://www.hopkinsmedicine.org/news/media/releases/declining_rates_of_us_infant_male_circumcision_could_add_billions_to_health_care_costs_experts_warn