Changes

Third-party payment for non-therapeutic unnecessary, harmful, or unnecessary injurious medical procedures encourages the performance of such services, simply so the attending physician can collect a fee.Kamanzi et al. (2023) reported:<blockquote>Private insurance plans reimburse significantly more than public plans for newborn circumcision. For non-newborn circumcision, private plans reimburse more than public but the coverage is more restricted, with a smaller differential between newborn and non-newborn circumcision. This coverage and reimbursement structure may indirectly encourage newborn circumcision for privately insured boys and non-newborn circumcision for publicly insured boys.<ref>{{REFjournal |last=Kamanzi |first= |init=SN |author-link= |last2=Walton |first2= |init2=RF |author2-link= |last3=Rosoklija |first3= |init3=I |author3-link= |last4=Corona |first4= |init4=LE |author4-link= |last5=Holt |first5= |init5=JL |author5-link= |last6= |first6= |init6= |author6-link= |last7=Johnson |first7= |init7=EK |author7-link= |etal=no |title=Differential Insurance Plan Coverage and Surgeon Reimbursement of Pediatric Circumcision at an Urban, Midwestern Hospital |trans-title= |language= |journal=Urology |date=2023-09 |volume=179 |issue= |article= |pages=143-50 |url=https://www.goldjournal.net/article/S0090-4295(23)00475-2/abstract |archived= |quote= |pubmedID=37343682 |pubmedCID= |DOI=10.1016/j.urology.2023.04.031 |accessdate=2025-01-31}}</ref></blockquote>

Third-party payment for injurious medically-unnecessary, non-therapeutic child [[circumcision]] in the [[United States ]] keeps the incidence of non-therapeutic circumcision of children far higher than any other industrial nation. The only party to benefit from such third-party payments is the receiving physician, or hospital.

The physicians Cessation of third-party payment is likely to reduce the incidence of harmful [[circumcision]] in the [[United States]]. Hill (2021) estimated that most commonly perform the overall incidence of circumcision in Mississppi, where Medicaid has not provided third-party payment for non-therapeutic infant circumcisions are obstetricianscircumcision since 1998, pediatriciansis only about 20 percent.<ref>{{REFweb |url=https://www.researchgate.net/publication/350799429_Circumcision_Incidence_in_Mississippi |archived= |title=Circumcision Incidence in Mississippi |trans-title= |language= |last=Hill |first=George |author-link=George Hill |publisher=Research Gate |website= |date=2021-04 |accessdate=2021-04-14 |format=PDF |quote=Depending on the accuracy of the assumptions, these figures may indicate that cessation of Medicaid payments and family doctors. They formed an agreement in 2007 other third-party payments is a highly effective way to produce a new statement with the AAP as reduce the lead. It was published in 2012 but was poorly received because incidence of its evident omissions [[trauma]] of facts. The AAP statement was not reharmful non-therapeutic circumcision and to improve male health and well-affirmed is accordance with AAP policy, so it expired on August 31, 2017being.

(1) (PDF) Circumcision Incidence in Mississippi. Available from: https://www.researchgate.net/publication/350799429_Circumcision_Incidence_in_Mississippi [accessed Apr 14 2021].}}</ref> The only party to benefit from such third-party payments is the receiving physician and/or hospital. The physicians that most commonly perform non-therapeutic infant circumcisions are obstetricians, pediatricians, and family doctors. They formed an agreement in 2007 to produce a new statement with the [[AAP]] as the lead. The intent of the statement was to spur the demand for [[circumcision]] to aid the [[circumcision industry]]. It was published in 2012 but received overwheming, unrelenting criticism from many critics because of its evident omissions of facts. The 2012 AAP statement was an acute embarrassment to the AAP so it was not re-affirmed and allowed to expire in accordance with long-standing AAP policy, so it expired on August 31, 2017. The AAP has not replaced the failed 2012 policy statement so it now has ''no'' official policy regarding male circumcision and does ''not'' recommend circumcision. ==The certain harm of circumcision==[[Circumcision]] is a cutting operation to amputate a functional part of the [[penis]]. Newborn boys cannot receive general anesthesia, so every circumcision of newbory boys causes great [[pain]]. Analgesia is offered to sell circumcision by making parents feel better, but does little for the infant boy. There is also extreme physical and psychic [[trauma]] caused by the loss of a body part. The [[foreskin]] normally has [[Foreskin#Physiological_functions| protective, immunological, sensory, and sexual functions]], which are destroyed with the [[amputation]]. All circumcisions excise the [[ridged band]], which is the source of much [[Sexual sensation of the foreskin| sexual sensation]], resulting in a permanent life-time loss of sensation. The loss of the immunological and protective functions makes penile health issues more likely. In comparison, due to the open wounds and raw [[bleeding]] flesh in a diaper, the [[circumcised]] [[penis]] needs much more care after [[circumcision]]. The surgically externalized [[glans]] is dirty rather then clean because of constant exposure to dirt, abrasion, pathogens, and contaminants.<ref name="vanhowe2003">{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |url=https://bjui-journals.onlinelibrary.wiley.com/doi/pdf/10.1046/j.1464-410X.1997.00467.x |title=Variability in penile appearance and penile findings: a prospective study |journal=Br J Urol |date=2003 |volume=80 |pages=776-782 |DOI=10.1046/j.1464-410X.1997.00467.x |accessdate=2019-10-20}}</ref> [[Circumcised]] boys are also found to be more likely to develop [[balanitis]], [[meatitis]], [[Skin bridge| coronal adhesions]], and [[meatal stenosis]].<ref name="vanhowe2006">{{REFjournal |last=Van Howe |init=RS |author-link= |title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting |journal=Clin Pediatr (Phila) |volume=45 |issue=1 |pages=49-54 |url=https://journals.sagepub.com/doi/10.1177/000992280604500108?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed |quote= |pubmedID=16429216 |pubmedCID= |DOI=10.1177/000992280604500108 |date=2006-01 |accessdate=2025-01-31 |note=Jan-Feb 2006}}</ref> The excision of skin by circumcision makes painful erections more likely. [[Circumcised]] males may experience tight and/or painful erections when there is insufficient residual shaft [[skin]] to permit full expansion and extension of the shaft of the [[penis]] during [[erection]]. Maguire & Parkes (1998) stress the need to grieve loss of body parts and functions,<ref>{{REFjournal |last=Maguire |first= |init=P |author-link= |last2=Parkes |first2= |init2=CM |author2-link= |etal= |title=Coping With Loss: Surgery and Loss of Body Parts |trans-title= |language= |journal=BMJ |date=1998-04-04 |volume=317 |issue=7137 |pages=1086-8 |url=https://www.cirp.org/library/psych/maguire/ |archived= |quote= |pubmedID=9552917 |pubmedCID=1112908 |DOI=10.1136/bmj.316.7137.1086 |accessdate=2025-01-31}}</ref> and there are many other [[Psychological issues of male circumcision| psychological issues]]. ==U.S. Government policy on circumcision== The government policy regarding male [[circumcision]] seems to have been formulated by the military services at the time of World War I. It appears to have been based on the 1914 article of [[Abraham L. Wolbarst]], M.D., an ardent Jewish promoter of [[Brit Milah| ritual circumcision]], who published an opinion-based paper in 1914 in the ''Journal of the American Medical Association'' to defend ritual cirumcision that falsely claimed health benefits of circumcision.<ref name="wolbarst1914">{{REFjournal |last=Wolbarst |first=Abraham L. |init=AL |author-link=Abraham L. Wolbarst |title=Universal Circumcision as a Sanitary Measure |journal=JAMA |date=1914-01-10 |volume=62 |issue=2 |pages=92-97 |url=https://jamanetwork.com/journals/jama/article-abstract/453164 |accessdate=2025-01-19}}</ref> The purpose of the paper was to defend [[Brit Milah| ritual circumcision]], which was under attack for transmitting tuberculosis to newborn infants.<ref name="holt1913">{{REFjournal |last=Holt |first=L. Emmett |init=LE |author-link=L. Emmett Holt |etal=no |title=Tuberculosis acquired through ritual circumcision |journal=JAMA |date=1913-7-12 |volume=61 |issue=2 |pages=99-102 |url=http://www.cirp.org/library/complications/holt1/ |accessdate=2025-01-19}}</ref> The article seems to have influenced the medical officers of the United States military service who were seeking to keep military personnel free of venereal disease.<ref>{{REFconference |last=Skeldon |first=Sean |author-link= |title=The Medicalization and Resultant Decline of Circumcision in Canada |trans-title= |language= |url=https://prism.ucalgary.ca/server/api/core/bitstreams/028cdb7b-3536-4b5b-921b-46ba3a2262ec/content |archived= |place=Calgary, AB |publisher=Health Sciences Centre |source= |date=2008-03 |datefrom=2008-03-07 |dateto=2008-03-08 |format=PDF |accessdate=2025-01-19}}</ref>The unspoken and unwritten official U.S. Government policy seems to be that it is clear every male needs a [[circumcision]], so support for free circumcision is provided without any questions being asked. This had been the policy of the military services since about 1917 when the [[United States]] intervened in the World War. When the Congress created the Medicare and Medicaid programs in 1965, the existing ''every male needs a circumcision'' policy was adopted. About 45 percent of births in the [[United States]] are covered by Medicaid and in most states free coverage of infant circumcision is provided.<ref name="craigG2005">{{REFjournal |last=Craig |init=A |author-link=Amber Craig |last2=Bollinger |init2=D |author2-link=Dan Bollinger |url=https://www.academia.edu/6394931/Of_Waste_and_Want_A_Nationwide_Survey_of_Medicaid_Funding_for_Medically_Unnecessary_Non_Therapeutic_Circumcision |title=Of Waste and Want: A Nationwide Survey of Medicaid Funding for Medically Unnecessary, Non-Therapeutic Circumcision |journal=Academia |date=2005 |volume= |issue= |pages=1-14 |format=PDF |accessdate=2025-02-01}}</ref> United States Medicaid is one of the largest third-party payers for medically-unnecessary, non-therapeutic circumcision.<ref name="adler2011>{{REFjournal

|title=It is Is it lawful to use Medicaid to pay for circumcision?

The advent of [[American Academy HIV]] provided an additional excuse to provide free circumcision.===Cost of Pediatricscomplications===Moreover, the [[foreskin]] created its 2012 policy statement has [[Immunological_and_protective_function_of_the_foreskin| immunological and protective functions]] that are ablated by circumcision, therefore [[foreskinned]] males enjoy better health.<ref>{{GairdnerDM 1949}}</ref> <ref name="vanhowe2006" /> <ref name="fendereski2024">{{REFjournal |last=Fendereski |first= |init=K |author-link= |last2=Horns |first2= |init2=JJ |author2-link= |last3=Driggs |first3= |init3=N |author3-link= |last4=Lau |first4= |init4=G |author4-link= |last5=Shaeffer |first5= |init5=AJ |author5-link= |etal=no |title=Comparing Penile Problems in Circumcised vs. Uncircumcised Boys: Insights From a Large Commercial Claims Database With a Focus on Provider Type Performing Circumcision |trans-title= |language= |journal=J Pediatr Surg |date=2024-11 |volume=59 |issue=11 |article=161614 |url=https://www.sciencedirect.com/science/article/abs/pii/S002234682400407X |archived= |quote= |pubmedID=39084960 |pubmedCID=11486584 |DOI=10.1016/j.jpedsurg.2024.06.022 |accessdate=2025-01-03}}</ref> Circumcisions have [[Complication#47_classes_of_complications| 47 cLasses of complications]], which must be treated at additional expense in addition to the expense of the original [[amputation]].  Many circumcisions are unsatisfactory and require revision by a pediatric urologist. It is said that pediatric urologists spend twenty percent of their time in repairing damages caused by circumcision. ===U. S. government providers of circumcision===The [[United States]] has numerous medical programs through which free harmful and unnecessary non-therapeutic circumcisions are provided. They include: * [https://www.medicare.gov/ Medicare] (For men 65 and over).* [https://www.medicaid.gov/ Medicaid] (For less prosperous Americans and now expiredillegal immigrants).* [https://www.medicaid.gov/chip/index.html Children's Health Insurance Program] (CHIP) (For children who do not qualify for Medicaid).* [https://www.ihs.gov/ Indian Health Service] (for indigenous people although circumcision is not part of their culture.) specifically to preserve * [https://www.airforcemedicine.af.mil/ Air Force Medical Service]* [https://medcoe.army.mil/amedd-medical-service-corp U.S. Army Medical Center of Excellence]* [https://www.med.navy.mil/Medical-Service-Corps/| Naval Medical Service Corps]* [https://www.tricare.mil/Plans/Eligibility/ADSMandFamilies Tricare] (for military dependents.)* [https://www.opm.gov/healthcare-insurance/healthcare The Federal Employees Health Benefits (FEHB) Program] (For federal employees and their dependents.)* [https://www.state.gov/pepfar/ President's Emergency Plan For AIDS Relief] ([[PEPFAR]]) (For every male who lives in Africa.)==Fraud, waste, and protect third abuse==Third-party paymentfor non-therapeutic [[circumcision]], by various U.S. government entities, enriches medical doctors, but causes [[pain]], [[trauma]], and lasting harm to patients. It is a glaring example of the <b>fraud, waste, and abuse</b> that is so endemic throughout the federal bureaucracy.

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