Circumcisions and cost cutting
Since we’re talking about cutting costs, let’s talk about procedures. Giving Americans more input and more stake in their health care, making them pay for some things directly will likely go a long way towards reducing costs and reducing needless or frivolous testing. North Carolina Medicaid, as well as some other private insurance companies, has stopped paying for circumcisions. It’s considered a cosmetic surgery and therefore if parents want one done, they have to pay out of pocket. The NHS adopted this policy some time ago.
How good of a deal is a circumcision to the doc performing one? I don’t know national averages, but I asked one of the OBs here who performs them. My residency didn’t train us in circs and I’ve never wanted to learn, so I can’t and won’t do them. The OB told me that for this 15 minute procedure he makes about $115, and that he does maybe five circs in any given day if he’s on the delivery service. So for about an hour’s worth of work, he makes nearly $600 of pocket money. Not bad, right?
I propose that if we are so interested in cost cutting we drop coverage for circumcisions. There’s no point to getting them done, and parents that want them should pay for them. On average, there are about 11,000 births per day in the U.S. Assuming that half of those births are males (not entirely accurate, but go with it), that makes 5,500 males born daily. At $115 per circumcision, this procedure costs us $632,500 per day or $230,862,500 per year (again, assuming that all males are circumcised, which they aren’t). That’s probably a generous estimate, but I still posit that we could save a good deal of money. We’d also save money on management and repair of botched circumcisions (and I’ve seen a few) that get sent to the urologist to fix.
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