Medicaid no longer provides  
 funding for circumcision in   
  the following states:

     1. California

     2. Mississippi

     3. Nevada

     4. North Dakota

     5. Oregon

     6. Washington

     7. Arizona

     8. Missouri

     9. North Carolina

     10. Montana

     11. Utah

     12. Florida

     13. Maine

     14. Idaho

     15. Minnesota
      
     16. Louisiana

     17.
Who will be next?
Medicaid to drop practice
Missouri coverage will no longer include routine circumcisions.

By STEVIE ST. JOHN, Missourian staff
July 25, 2002

Beginning next month, Missouri Medicaid will no longer pay for
male infant circumcisions. The decision to no longer fund the
procedure will save state coffers about $260,000 a year.

Missouri Medicaid officials were looking for ways to reduce costs
and considered professional recommendations regarding routine
circumcision, said Greg Vadner, director of the Missouri Division of
Medical Services.

Beginning Thursday, Missouri Medicaid will no longer cover routine
male infant circumcisions, he said. Circumcisions that are medically
necessary, such as in case of infection, will still be covered.
By not covering routine circumcisions, in which the foreskin is
removed from the penis, Missouri Medicaid expects to save
$262,103 a year, he said.

“We think this is a change that is reasonable . . . that follows
established medical guidelines,”
Vadner said.

Missouri Medicaid listened to input from Doctors Opposing
Circumcision, the American Academy of
Pediatrics and individual doctors before making the decision, he
said.

Vickie Greenlaw, reimbursement assistant for the division of
urology at MU Health Care, said there
is a $210 doctor’s fee and a small instrument use fee for each
circumcision procedure.

Dr. Lynn Teague, a pediatric urologist with MU Health Care,
performs one or two circumcisions per
week. However, he said, the circumcisions he performs are mostly
procedures that are necessary
because of congenital problems. Teague said he does not believe
routine circumcisions are
medically necessary and counsels parents against it.

“I think (Missouri) Medicaid did the right thing,” he said.

Circumcision was thought to be a treatment for ailments including
epilepsy and alcoholism around
1900, he said, and became the norm. He said babies are
circumcised “to look like dad.”

“I think it’s a cultural thing rather than a medical thing,” he said.

Circumcision does decrease the risk of infections for the first few
months of life, he said, but does
not seem to make much difference later. He said that studies
suggest an uncircumcised man who
practiced proper hygiene would not be at an increased risk for
penile cancer.

Dr. George Denniston, president of the Seattle, Wash.-based
international organization Doctors
Opposing Circumcision, said circumcision is harmful. Foreskin
protects glands, covers the shaft of
the penis when it is erect and has nerve endings related to sexual
pleasure, he said in a phone
interview from the Seattle Doctors Opposing Circumcision office.

Dr. Jack Swanson, a pediatrician in Ames, Iowa, served on the
American Academy of Pediatrics
task force on circumcision in 1999, when the academy’s
statement on circumcision was last
revised. In a phone interview, he said uncircumcised men have a
slightly increased risk of infection
in the first year of life and a slightly increased lifetime risk for
penile cancer.

But he said these occurrences are not frequent enough to justify
every male being circumcised as
a preventative medical measure.

He said that he tells his patients it is OK to have their baby
circumcised but that they should
understand that they do not need to.

“It’s got to be a personal choice about what the parents think is
right,” he said.
Missouri Stops Funding Circumcision
Circumcision was thought to
be a treatment for ailments
including epilepsy and
alcoholism
Missouri Medicaid listened to
input from Doctors Opposing
Circumcision, the American
Academy of Pediatrics and
individual doctors before
making the decision

I think it's a cultural thing
rather than a medical thing,
said Dr. Lynn Teague.  I
think Missouri Medicaid did
the right thing.
A $1000 reward is offered to
any individual who can prove
that  male circumcision is a
legal and an ethical medical
procedure.

Medical Fraud
 take the challenge