Bloomberg's Next Project: Circumcision?
Peter Lawler is Dana Professor of Government and former chair of the department of Government and International Studies at Berry College. He serves as executive editor of the journal Perspectives on Political Science, and has been chair of the politics and literature section of the American Political Science Association. He also served on the editorial board of the new bilingual critical edition of Alexis de Tocqueville’s Democracy in America, and serves on the editorial boards of several journals. He has written or edited fifteen books and over 200 articles and chapters in a wide variety of venues. He was the 2007 winner of the Weaver Prize in Scholarly Letters.\r\n\r\nLawler served on President Bush's Council on Bioethics from 2004 – 09. His most recent book, Modern and American Dignity, is available from ISI Books.\r\n\r\nFollow him on Twitter @peteralawler.
There's been talk in California, Germany, and elsewhere of outlawing circumcision. The only justification, the thinking goes, is religious dogma. And that's not a good enough reason in a secular and health-conscious society for mutilating babies. There's also the issue, of course, of the mutilated men being deprived of a certain amount of sexual pleasure.
But the most recent study—from Johns Hopkins!—shows that the declining American rate of circumcision is a significant cause of an increase in the rate of various nasty diseases. So it's also, Mayor Bloomberg will doubtless notice, the source of a big increase in health care costs:
The Johns Hopkins team’s analysis showed that, on average, each male circumcision passed over and not performed leads to $313 more in illness-related expenses, costs which Tobian says would not have been incurred if these men had undergone the procedure.
According to the team’s analysis, if U.S. male circumcision rates among men born in the same year dropped to European rates, there would be an expected 12 percent increase in men infected with HIV (or 4,843); 29 percent more men infected with human papillomavirus (57,124); a 19 percent increase in men infected with herpes simplex virus (124,767); and a 211 percent jump in the number of infant male urinary tract infections (26,876). Among their female sex partners, there would be 50 percent more cases each of bacterial vaginosis (538,865) and trichomoniasis (64,585). The number of new infections with the high-risk form of human papillomavirus, which is closely linked to cervical cancer in women, would increase by 18 percent (33,148 more infections).
Tobian says state funding cuts in Medicaid, the government medical assistance program for the poor, have substantially reduced numbers of U.S. infant male circumcisions, noting that 18 states have stopped paying for the procedure. “The financial and health consequences of these decisions are becoming worse over time, especially if more states continue on this ill-fated path,” he says. “State governments need to start recognizing the medical benefits as well as the cost savings from providing insurance coverage for infant male circumcision.”
The problem in the United States is compounded, Tobian says, by the failure of the American Academy of Pediatrics to recognize the medical evidence in support of male circumcision.
The evidence here, it seems to me, at least as striking as that supporting the Mayor's recent initiative on nudging NYC women in the direction of breast feeding. So it's difficult to see why the power of the city shouldn't be mobilized to require or at least strongly encourage or incentivize circumcision. And certainly free circumcision, the evidence shows, should be part of any health care mandate.
I won't call attention to the obvious public relations issues that would flow from a Jewish mayor undertaking this initiative.
Actually, the evidence of the relationship between circumcision (or the lack thereof) and sexual pleasure is not unambiguous. But assuming it becomes stronger, then there's the problem of choosing between what's, to tell the truth, a slightly less healthy and safe life and slightly more pleasure.
And somebody has an opinion about it.
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