Medical center policy affects circumcisions

New payment policy cuts circumcisions

JACKSON, Miss.—The number of circumcisions has dropped drastically at the  University of Mississippi Medical Center since a new policy of charging for the procedure was implemented.

Since July 1, when the policy began, just about a fifth of patients are still interested in having their children circumcised, said Dr. Bryan Cowan, chairman of UMC's obstetric and gynecology department.

For at least the past 20 years, that department has picked up the tab for circumcisions by including the optional procedure in the general cost associated with delivering baby boys.

But circumcisions have now been made separate, and parents have to pay about $220 at the time of delivery in order to have it done, Cowan said.

Over the years the pediatric groups have come together and have made this a completely elective procedure, Cowan said.

So with no agency willing to pay for this, we simply structured a fee system for this and have now applied it to the patients, he said.

The fee for circumcisions has to be paid in full before doctors will perform the procedure, Cowan said.

Since circumcision has not yet been proved to be a necessary medical procedure with definite benefits, most insurance companies don't pay for it.

The American Academy of Pediatrics said there is some scientific evidence showing potential benefits, but not enough for the academy to recommend it as a routine procedure.

In its most recent policy statement, the academy said an estimated 1.2 million newborn males are circumcised in the United States at a cost of between $150 and $270 million.

The 1999 policy states that circumcised males have a smaller chance of developing urinary tract infection during their first year of life, a three times lower chance of developing penile cancer and could have a reduced risk for developing syphilis and HIV infections.

But the policy also says that babies who are circumcised without pain relief may respond more strongly to pain of future immunizations than those who are uncircumcised.

Though rare, minor complications of mild bleeding and local infections also have been associated with the surgery.

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