Diane Carman at Denver Post reports breaking news:
Colorado will end coverage for routine circumcisions under Medicaid next month, saving thousands of dollars and nudging the state closer to a debate that has been growing in intensity across the country.
Can a painful surgery which is not needed but alters the genitals be performed on a child? Should medical insurance pay for it?
Halting Medicaid coverage for circumcision is increasingly common across the country and is a relatively easy choice because there is virtually no medical justification for the procedure.
It defies reason that medical insurance, in any form, would cover surgery on a patient who has no medical condition prompting treatment.
But some states are going further and proposing bans on the procedure, arguing it is comparable to laws outlawing female genital mutilation.
When the patient is a child it goes beyond the notion that purely elective procedures are outside the scope of medical insurance. Are normal, healthy body parts the right of individuals to keep, or parents to dispose?
For some families, however, the procedure is a cherished tradition. ... "This is really about the free exercise of religion, something that is guaranteed to everyone in the United States under the First Amendment," Levin said.
Complicating matters, some parents are motivated by religious belief to modify the form of their child's genitals. Can the child's rights be abridged so that parents may practice what they consider a religious rite?
The answer has little to do with doctors, hospitals, and insurance plans. That some people have strong religious views is beyond question, but their power to influence the practice of medicine is not.
The No. 1 risk is pain. "We try to minimize it," said Dr. Sarah Pilarowski, pediatrician at Cherry Creek Pediatrics, but penile nerve blocks don't always work and numbing creams "are not 100 percent."
The risk of pain, however, does rest at 100 percent. Not only during the surgery when local anesthesia is sometimes applied to somewhat reduce pain (at significantly increased cost), but also during a healing period without it.
Pilarowski speculates that the changes in Medicaid policies will spark changes in private insurance coverage.
Insurance plan provisions, private or public, cannot answer the question: Whose body, whose rights? But they do influence the rate at which genital integrity rights are preserved. Cost makes an unnecessary surgery even less attractive.
"This is a normal body part," said Gillian Longley, a registered nurse in Louisville and member of the National Organization of Circumcision Information Resource Centers. "We are doing our sons a favor to support them to stay whole."
That favor, when done, preserves this choice for the rightful arbiter. Circumcision should be freely available to anyone who wants it, and everyone should be free to keep their whole sex organ.
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