Study: Drop in circumcisions leads to billions in health care costs
Each circumcision not performed on newborn U.S. males adds an average of $313 a year in health care costs tied to diseases that could have been prevented if the procedure had been performed, according to a study by Johns Hopkins University researchers.
Dr. Aaron Tobian, a health epidemiologist who was the senior investigator for the study, says roughly 55 percent of the 2 million males born each year in the U.S. are circumcised, down from 79 percent in the 1970s and ’80s. Rates in Europe average 10 percent.
The study, published in the Archives of Pediatrics & Adolescent Medicine, says the added expenses stem from new cases and higher rates of sexually transmitted diseases (STDs) and related cancers among uncircumcised men and their female partners. The STDs include HIV, herpes and genital warts; the cancers include cervical and penile.
Circumcision removes foreskin at the tip of the penis, obstructing the buildup of bacteria and viruses in the penis’ skin folds.
“Our economic evidence is backing up what our medical evidence has already shown to be perfectly clear,” Tobian, an assistant professor at Johns Hopkins’ medical school, says in a news release. “There are health benefits to infant male circumcision in guarding against illness and disease, and declining male circumcision rates come at a severe price, not just in human suffering, but in billions of health care dollars as well.”
The 20-year decline in the number of U.S. males circumcised at birth already has cost the country more than $2 billion, Tobian and his colleagues estimate. If the U.S. circumcision rate dropped to 10 percent — the same rate as in Europe — the country would be hit with $4.4 billion in avoidable health care costs over a 10-year span, the study says.
Tobian says state funding cuts in Medicaid, the government health insurance program for the poor, have reduced the number of U.S. infant male circumcisions. He points out that 18 states prohibit Medicaid coverage for the procedure.
“The financial and health consequences of these decisions are becoming worse over time, especially if more states continue on this ill-fated path,” he says. “State governments need to start recognizing the medical benefits as well as the cost savings from providing insurance coverage for infant male circumcision.”
The 18 states that have banned Medicaid funding for circumcisions are Arizona, California, Colorado, Florida, Idaho, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nevada, North Carolina, North Dakota, Oregon, South Carolina, Utah and Washington.
Some observers take issue with the Johns Hopkins study.
“To totally ignore all the harm circumcision does and say we’re going to save money is a limited and distorted view of what this is all about,” Ronald Goldman, executive director of the Circumcision Research Center in Boston, tells The Baltimore Sun.
Ryan McAllister, a biophysicist at Georgetown University and coordinator of NotJustSkin.org, argues that medical costs rise when babies are circumcised, the Baltimore newspaper reported. Many boys need surgery to correct botched circumcisions and may suffer emotional strain, he says.
Circumcision is no more than cosmetic surgery, McAllister says.
“People forget it is a child’s penis you are operating on,” he says. “They said it’s just a snip when it is much more.”