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The '''Financial Incentive''' to perform medically-unnecessary, non-therapeutic circumcision is very large. Circumcision, in the United States, is a multi-million dollar industry. Profit is reaped not only from the practice of circumcision itself, and associated hospital charges, but also from the sale of harvested foreskins, the sale of products derived from harvested foreskins, and the sale of circumcision specific tools and utensils.
'''Financial incentive''' in the [[United States]] to perform medically-unnecessary, harmful, non-therapeutic [[circumcision]] is very large. Non-therapeutic [[circumcision]] is a multi-billion dollar industry. Morgan (1967) termed it "<i>chronic remunerative surgery</i>", since physicians are paid over and over again for performing harmful unnecessary circumcision.<ref name="morgan1967">{{REFjournal
|last=Morgan
|first=
|init=WKC
|author-link=William Keith Campbell Morgan
|etal=NO
|title=Penile plunder
|trans-title=
|language=
|journal=Med J Aust
|location=
|date=1967-05-27
|volume=1
|issue=21
|article=
|page=
|pages=1102-3
|url=https://www.cirp.org/library/general/morgan2/
|archived=
|quote=
|pubmedID=4226264
|pubmedCID=
|DOI=10.5694/j.1326-5377.1967.tb20892.x
|doi=
|accessdate=2024-05-22
}}</ref> Profit is reaped not only from the practice of [[circumcision]] itself, and associated hospital charges, but also from the sale of harvested [[Foreskin| foreskins]], the sale of products derived from harvested foreskins, the sale of circumcision specific tools and utensils, and the treatment of [[Complication| complications]] and botched circumcisions.


== The procedure itself ==
== The procedure itself ==
1.2 million baby boys are circumcised a year in the United States alone. At a dollar per procedure, that is already $1,200,000 a year. The going rate for a circumcision procedure is approximately $1,700 when hospital charges are included. American; multiplied by 1.2 million, that is approximately $2,040,000,000 a year that circumcision brings in based on the procedure alone.
Mansfield et al. (1995) reported there are no [[medical indication]]s for non-therapeutic infant circumcision.<ref name="mansfield1995">{{REFjournal
|last=Mansfield
|first=Christopher J
|init=CJ
|author-link=
|last2=Hueston
|first2=William J
|init2=WJ
|author2-link=
|last3=Rudy
|first3=Mary
|init3=M
|author3-link=
|etal=no
|title=Neonatal circumcision: associated factors and length of hospital stay
|trans-title=
|language=English
|journal=J Fam Pract
|location=
|date=1995-10
|volume=41
|issue=4
|pages=370-6
|url=http://www.cirp.org/library/procedure/mansfield/
|pubmedID=7561711
|pubmedCID=
|DOI=
|accessdate=2020-08-04
}}</ref>


Bollinger (2012) estimates that the total cost of non-therapeutic male circumcision, including hospital costs, repair of botched circumcisions, treatment of complications, and so on is more than $3 billion per year.<ref>{{REFweb
1.2 million baby boys are [[circumcised]] a year in the [[United States]] alone. At a dollar per procedure, that is already $1,200,000 a year. The going rate for a circumcision procedure is approximately $1,700 when hospital charges are included, multiplied by 1.2 million, that is approximately $2,040,000,000 a year that circumcision brings in based on the procedure alone.
 
When a baby boy is to be [[circumcised]], mother and baby remain in hospital for about one-fourth of a day longer,<ref name="mansfield1995" /> so that increases the profit to the hospital. Early in hospital [[circumcision]] permits obstetricians to make more money.
 
Bollinger (2012) estimates that the total cost of non-therapeutic male circumcision, including hospital costs, repair of botched circumcisions, treatment of complications, and so on is more than $3 billion per year.<ref name="bollinger2012">{{REFweb
  |url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually
  |url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually
  |title=High Cost of Circumcision: $3.6 Billion Annually
  |title=High Cost of Circumcision: $3.6 Billion Annually
  |last=Bollinger
  |last=Bollinger
  |first=Dan
  |first=Dan
  |author-link=
  |author-link=Dan Bollinger
  |publisher=
  |publisher=Academia
  |website=https://www.academia.edu
  |website=https://www.academia.edu
  |date=2012
  |date=2012
  |accessdate=2019-10-23
  |accessdate=2020-11-25
  |format=
  |format=
  |quote=
  |quote=As the saying goes, follow the money. Now you know why neither the [[American Academy of Pediatrics]], American Medical Association, [[American Academy of Family Physicians]], or the [[American College of Obstetricians and Gynecologists]] haven’t condemned this unnecessary surgery, and why their physician members are quick to recommend the procedure to expectant parents.
}}</ref>
}}</ref> [[Third-party payment]] is a major support to the performance of this medically-unnecessary surgery.


== Medicaid pays for it ==
<!--The now expired and  discredited AAP 2012 ''Circumcision Policy Statement'' stated that "Although health benefits are not great enough to recommend routine (i.e. non-therapeutic) circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to '''warrant [[third-party payment]]''' for [[circumcision]] of male newborns. It is important that clinicians routinely inform parents of the health benefits and risks of male newborn [[circumcision]] in an unbiased and accurate manner." and "The American College of Obstetricians and Gynecologists has endorsed this statement."<ref>{{REFweb
While 18 states have stopped paying for it, 32 states pay for circumcision. Doctors may be driven to promote circumcision if they get a free stipend from the state.
 
The now expired AAP 2012 Policy Statement on Circumcision states that "Although health benefits are not great enough to recommend routine (i.e. non-therapeutic) circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to '''warrant third-party payment''' for circumcision of male newborns. It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner." and "The American College of Obstetricians and Gynecologists has endorsed this statement."<ref>{{REFweb
  |last=
  |last=
  |first=
  |first=
Line 35: Line 89:
  |title=Circumcision Policy Statement
  |title=Circumcision Policy Statement
  |url=http://pediatrics.aappublications.org/content/130/3/585
  |url=http://pediatrics.aappublications.org/content/130/3/585
  |publisher=Pediatrics
  |publisher=''Pediatrics''
  |accessdate=2012-11-24
  |accessdate=2012-11-24
}}</ref> Many new born circumcisions are performed by Obstetricians.
}}</ref> Many new born circumcisions are performed by obstetricians.
-->
 
==Solicitation for circumcision surgery==
 
[[Intact America]] commissioned a survey by [https://www.qualtrics.com/ Qualtrics] of the number of times that parents are solicited for a consent for non-therapeutic infant circumcision. The average was 8 times, which resulted in a 143 percent increase in the number of non-therapeutic, medically-unnecessary circumcisions carried out.<ref name="intactamerica2020">{{REFweb
|url=https://www.prweb.com/releases/having_a_baby_boy_intact_america_warns_get_ready_for_the_circumcision_sellers/prweb17552844.htm
|title=Having a Baby Boy? Intact America Warns, ‘Get Ready for the Circumcision Sellers!'
|last=Chapin
|first=Georganne
|author-link=Georganne Chapin
|publisher=Intact America
|website=prweb
|date=2019-11-18
|accessdate=2020-12-15
|format=
|quote=Each year, an estimated 1.5 million baby boys are circumcised in American medical settings. Intact America estimates that if circumcision solicitations were to cease, 600,000 boys—and the men they will become—would be spared every year from the trauma and lifelong consequences of the procedure.
}} </ref> Giving in to the constant solicitation means that two charges will be incurred:
 
# A hospital service charge or facility fee.
# A physician's fee.
 
Parents are reminded that neonatal [[circumcision]] has no [[medical indication]], does not provide treatment for disease, is non-therapeutic, unnecessary, and causes life-long irreversible harm because of the physical and psychic [[trauma]] and loss of the [[https://en.intactiwiki.org/index.php/Foreskin#Physiological_functions multi-functional foreskin]].
 
==Government support ==
 
Although the [[foreskin]] has [[Immunological and protective function of the foreskin| immunological and protective functions]], Government medical insurance in the [[United States]] still holds the antique notion, which originated in the late 19th century, that the [[foreskin]] is a cesspool of disease, and [[circumcision]] improves hygiene and prevents sexually transmitted diseases (STDs), therefore it is best cut off and insurance should pay for it without any proof of [[medical indication]] or necessity, so there are no effective controls in force to see that only medically necessary services are covered.<ref name="hodges1997">{{REFbook
|last=Hodges
|first=Frederick M.
|init=FM
|author-link=Frederick M. Hodges
|year=1997
|title=A Short History of the Institutionalization of Involuntary Sexual Mutilation in the United States
|url=https://link.springer.com/chapter/10.1007/978-1-4757-2679-4_2
|work=Sexual Mutilations: A Human Tragedy
|editor=George C. Denniston, Marilyn Fayre Milos, Frederick Mansfield Hodges
|edition=
|volume=
|chapter=
|pages=17-40
|location=
|publisher=Plenum Press
|isbn=
|quote=
|accessdate=2020-08-04
|note=
}}</ref> This view is not supported by current medical evidence. In reality, the opposite is true. The [[Immunological and protective function of the foreskin| immunological functions of the foreskin]] help to prevent disease, so [[intact]] boys are healthier.
 
===Medicaid===
[https://www.medicaid.gov/ Medicaid] is a medical insurance program for people whose income is below the federal poverty level (FPL}. However, in most states, pregnant women are covered to a variable amount above the FPL.
 
The medical expenses of many births are borne by Medicaid.<ref name="jones2022">{{REFdocument
|title=FOIA Request sheds new light on AAP's motivations
|url=https://www.circumcisionharm.org/images-circharm.org/2022%20FOIA%20Report%20on%20Circumcision%20Ryan%20Jones%20CIAF.pdf
|contribution=
|last=Jones
|first=Ryan
|publisher=Circumcision is a Fraud
|format=PDF
|date=2022-02
|accessdate=2025-05-24
}}</ref> The percentage of births covered by Medicaid varies by state. It ranges from a low of 20 percent in Vermont to 71 percent in New Mexico.<ref>{{REFweb
|url=https://www.kff.org/medicaid/state-indicator/births-financed-by-medicaid/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
|title=Births financed by Medicaid
|last=
|first=
|accessdate=2020-08-05
}}</ref> Medicaid financed 45 percent of all births in 2010.<ref>{{REFweb
|url=https://publichealth.gwu.edu/content/medicaid-pays-nearly-half-all-births-united-states
|title=Medicaid Pays For Nearly Half of All Births in the United States
|last=
|first=
|date=2013-09-05
|accessdate=2020-08-05
}}</ref> Circumcision is frequently included as part of the birth package of covered expenses, so [[third-party payment]] is provided. Ryan Jones filed a freedom of information act request and learned that Medicaid paid for 6,260,830 circumcisions at a cost of $537,176,694.<ref name="jones2022" />
 
While 18 states have stopped paying for non-therapeutic [[circumcision]], 32 states still pay for it. Doctors may be driven to promote non-therapeutic circumcision if they get a free stipend from the state. Adler (2011) has argued that such payments are contrary to law.<ref>{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|title=It is lawful to use Medicaid to pay for circumcision?
|journal=Journal of Law and Medicine
|date=2011
|volume=19
|issue=
|pages=335-353
|url=https://www.arclaw.org/wp-content/uploads/2019/04/is-it-lawful-to-use-medicaid-to-pay-for-circumcision.pdf
|quote=
|pubmedID=
|pubmedCID=
|DOI=
|accessdate=2020-08-05
}}</ref>
 
===Indian Health Service===
 
The [https://www.ihs.gov/ Indian Health Service] provides non-therapeutic circumcision to native Americans, even though [[circumcision]] is not part of the culture of native Americans.
 
===Tricare===
 
[https://www.tricare.mil/ Tricare] is the government medical insurance for military dependents. Tricare covers non-therapeutic circumcision of the newborn male infant.<ref>[https://www.tricare.mil/SearchResults?search=circumcision Circumcision (Newborn)]</ref>
 
===Civil servants===
 
There are about 2 million United States government employees in the [[United States]] whose health insurance covers non-therapeutic circumcision.
 
===Medicare===
 
The [https://www.medicare.gov/ United States Medicare Program] provides health insurance for persons who have reached the age of 65 years. It assumes that any man with a [[foreskin]] needs a [[circumcision]]. It does not require proof of medical necessity to provide [[third-party payment]].
 
===State and local government===
 
There are approximately 7,000,000 employees of state and local government. The great majority of these have health insurance that provides [[third-party payment]] for non-therapeutic circumcision.
 
Money provided from the above described sources to support the practice of non-therapeutic circumcision nourishes the [[circumcision industry]].
 
==Private insurance==
 
The United States has an unusual system, which originated during World War II, of having employers provide a non-taxable benefit of medical insurance to employees. The system is not universal so many employers do not provide insurance. Of those who do, many provide [[third-party payment]] to support non-therapeutic circumcision.


== Auxiliary tools ==
== Auxiliary tools ==
Industries that depend on the practice of circumcision, particularly infant circumcision include makers of the [[circumstraint]] (the board to which a baby is strapped down to for the procedure), makers of circumcision clamps, manufacturers of circumcision kits, and other utensils used for circumcision.
Industries that depend on the practice of circumcision, particularly infant [[circumcision]] include makers of the [[circumstraint]] (the board to which a baby is strapped down to for the procedure), makers of circumcision clamps, manufacturers of circumcision kits, and other utensils used for circumcision.


Clamp manufacturers:
Clamp manufacturers:
Line 62: Line 235:


== Profit from harvested foreskins ==
== Profit from harvested foreskins ==
Foreskins are sold to pharmaceutical companies for stem-cell research, the creation of synthetic skin, and the creation of consumer products. Since the 1980s, private hospitals have been involved in the business of supplying discarded foreskins to private bio-research laboratories and pharmaceutical companies who require human flesh as raw research material.<ref>A short history of the institutionalization of involuntary sexual mutilation in the United States. Hodges F. in: Denniston GC, Milos MF (eds). Sexual Mutilations: A Human Tragedy. New York: Plenum Press. 1997:17-40.</ref> They also supply foreskins to transnational corporations. Dr. Tania Phillips, professor of dermatology at Boston University of Medicine, insisting foreskin gathering and cultivating is scientifically and technologically "very promising." <ref>Ronald Rosenberg. 19 October 1992: 22-23.</ref>
Foreskins are sold to pharmaceutical companies for stem-cell research, the creation of synthetic [[skin]], and the creation of consumer products. Since the 1980s, private hospitals have been involved in the business of supplying discarded foreskins to private bio-research laboratories and pharmaceutical companies who require human flesh as raw research material.<ref name="hodges1997" /> They also supply foreskins to transnational corporations. Dr. Tania Phillips, professor of dermatology at {{UNI|Boston University|BU}} [http://www.bumc.bu.edu/ School of Medicine], insisting [[foreskin]] gathering and cultivating is scientifically and technologically "very promising".<ref>Ronald Rosenberg. 19 October 1992: 22-23.</ref>


=== Corporate benefactors ===
=== Corporate benefactors ===
The following transnational corporations reap corporate profits from the sale of marketable products made from harvested human foreskins:
The following transnational corporations reap corporate profits from the sale of marketable products made from harvested human foreskins:


* [[Advanced Tissue Sciences]] (ATS) <ref>Forget pork bellies, now it's foreskins. Manson B. San Diego Reader (May 4, 1995): 12, 14 passim.</ref>
* [[Advanced Tissue Sciences]] (ATS) <ref>Forget pork bellies, now it's foreskins. Manson B. ''San Diego Reader'' (May 4, 1995): 12, 14 passim.</ref>
* [[Organogenesis]]<ref>New skin twin life- and look-save. Brewer S. Longevity (September 1992): 18.</ref>
* [[Organogenesis]]<ref>New skin twin life- and look-save. Brewer S. ''Longevity'' (September 1992): 18.</ref>
* BioSurface Technology<ref>Companies see $1.5b market in replacement skin products. Rosenberg R. Boston Globe (October 19, 1992): 22-23.</ref>
* BioSurface Technology<ref>Companies see $1.5b market in replacement [[skin]] products. Rosenberg R. ''Boston Globe'' (October 19, 1992): 22-23.</ref>
* Genzyme
* Genzyme
* Ortec International
* Ortec International
* [[LifeCell Corporation]] (Nasdaq:LIFC)
* [[LifeCell Corporation]] (Nasdaq:LIFC)
* [[SkinMedica]]
* [[SkinMedica]]
* [[Vavelta]]


=== FDA approved products ===
=== FDA approved products ===
Line 84: Line 258:


== Grants from pro-circumcision interest groups ==
== Grants from pro-circumcision interest groups ==
There are pro-circumcision interest groups that give grants to doctors and researchers to "study" and promote circumcision. Organizations that do this include the [[Bill & Melinda Gates Foundation]]. In 2009, [[Schusterman Family Foundation]] gave a grant to mohel and professional infant circumcisor [[Neil Pollock]] to promote infant circumcision in Rwanda,<ref name='marketwire 2009-02-24'>{{REFnews
There are pro-circumcision interest groups that give grants to doctors and researchers to "study" and promote circumcision. Organizations that do this include the [[Bill & Melinda Gates Foundation]]. In 2009, [[Schusterman Family Foundation]] gave a grant to [[mohel]] and professional infant circumcisor [[Neil Pollock]] to promote infant [[circumcision]] in Rwanda,<ref name='marketwire 2009-02-24'>{{REFnews
  |last=Millman
  |last=Millman
  |first=N. Michael
  |first=N. Michael
Line 93: Line 267:
  |quote=...much of the trip's cost was covered by grant money from Canadian Institutes of Health Research and funding from the Shusterman Foundation...
  |quote=...much of the trip's cost was covered by grant money from Canadian Institutes of Health Research and funding from the Shusterman Foundation...
  |accessdate=2011-04-10
  |accessdate=2011-04-10
}}</ref> particularly the [[Mogen]] technique, in the name of HIV prevention.
}}</ref> particularly the [[Mogen]] technique, in the name of [[HIV]] prevention.


==Total annual costs of American circumcision==
Bollinger (2012) estimated that the total annual cost of non-therapeutic [[circumcision]] to Americans is $3,647,000,000.<ref name="bollinger2012"/> He has since updated his estimate of total annual cost in 2020 to be $5,685,000,000 or nearly six billion dollars per year.
==Video==
===This should be a crime.===
<youtube>v=ob4OADNIidc</youtube>
===Part Four: The Effects on the Male Soul and Spirit===
<youtube>?v=Fo9zBKUNVH0</youtube>
{{SEEALSO}}
{{SEEALSO}}
* [[Circumcision industry]]
* [[Third-party payment]]
* [[PEPFAR]]
* [[United States of America]]


* [[Third-party payment]]
{{LINKS}}
* {{REFweb
|url=http://acroposthion.com/the-foreskin-industry/
|title=The Foreskin Industry
|website=Acroposthion
|accessdate=2020-03-02
}}
* {{REFweb
|url=https://thehappyhospitalist.blogspot.com/2008/01/get-yer-snips-at-12-price.html
|title=How Much Does a Circumcision Cost? Detailed Analysis!
|publisher=Happy Hospitalist
|accessdate=2023-11-12
}}
* {{REFweb
|url=https://intactamerica.org/economics-of-circumcision/
|title=The Economics of Circumcision: A Full Breakdown of This Penis Business
|last=Garrett
|first=Connor
|publisher=Intact America
|date=2023-12-21
|accessdate=2023-12-31
}}
* {{REFweb
|url=https://intactamerica.org/adult-circumcision-cost/
|title=Adult Circumcision Cost: The Profit Motives and Hidden Toll
|last=Garrett
|first=Connor
|init=
|publisher=Intact America
|date=2024-03-07
|accessdate=2024-05-09
}}


{{REF}}
{{REF}}


[[Category:Motives]]
[[Category:Motive]]
[[Category:Financial gain]]
[[Category:Financial gain]]
[[Category:USA]]
[[Category:From CircLeaks]]
[[Category:From CircLeaks]]
[[Category:From IntactWiki]]
[[Category:From IntactWiki]]


[[de:Finanzieller Anreiz]]
[[de:Finanzieller Anreiz]]
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