Scottish parents who wish to have their male infants circumcised should have the procedure paid for by the NHS to prevent the transmission of AIDS, a World Health Organisation (WHO) expert said yesterday.
First, allow me to repeat the obvious counter-argument to this. Male infants are not sexually active and parents have more ability to teach their children safe sex practices and responsibility than ability to predict their child’s personal behavior 15 or more years into the future. So, unless their sons intend to have unprotected sex with HIV-positive women, something parents can’t know, circumcising male infants to protect them from HIV is unconscionable folly.
Second, the World Health Organization is strongly pro-male infant circumcision and strongly anti-female infant circumcision. I understand the reasoning depends on centuries of what’s socially acceptable, but I’ve already pointed out the hypocrisy in applying different rules to boys and girls when they apply equally. Specifically, human rights are subject to more than just a clean operating room and good intentions. The World Health Organization should read through its own literature with a keener eye.
Third, for those in the United States longing for socialized healthcare, this is the sort of quandary you’ll be in. Fanatics will seek to allow parents to chop off parts of their sons on the national dime. That’s absurd enough, since there is no medical need for the surgery, but it should be clear that national resources are not unlimited. Every penny unnecessarily removing a foreskin is a penny not spent curing disease. I suspect socialists don’t think this way. There’s always another rich person who can be forced to pay her fair share, right? That’s unjust, but also false. People will die now so that little boys might not die six or seven decades from now of diseases with causes not specific to their foreskins. It’s stupidity.
“Fanatics will seek to allow parents to chop off parts of their sons on the national dime.”
They can seek all they want but, in the end, they’ll lose because their arguments are fallacious and the cost savings from defunding circumcision are substantial.
The single-payer system was the best thing that ever happened to baby boys in Britain and Canada. It accomplished what circumcision opponents were unable to: eradicating the practice among the gentile majority and putting circumcision advocates on the defensive.
I’d love to see a single-payer system here in the US, but I’m not holding my breath. There are too many special-interest groups fighting against it.
I just think circumcision is too ingrained in the U.S. system. Aside from the other issues I have with a single-payer system (government involvement, really) the system would be designed/managed by politicians. They do not have the ability to say no, even if the money isn’t there. Circumcision wouldn’t go anywhere.
Circumcision proponents fear the single-payer system and well they should. As I said, it’s already responsible for eradicating the practice among gentiles in two different countries.
The best thing about this kind of system is that the administrators are under constant scrutiny and the pressure to axe unjustifiable expenditures is considerable. The pro-circumcision people know this and that’s why they’re so opposed to it.
I’m not really concerned about politicians meddling with things because it’s unlikely they’d be able to overrule an administrative ban on funding for circumcision.
I think the problem lies with support for circumcision still being in the majority. We’ve descended from being a republic to being ruled by the mob mentality. I think the implementation will be bad, or at least the possibility that circumcision will come back exists. I’d much rather have the Congress (ha!) or courts criminalize it.
In a single-payer system, I just don’t think Congress can keep its hands off. Too many votes to be purchased, and the pro-circumcision folks will buy what they can. Congress would rather raise taxes than take something away.
That said, I’m willing to concede for the argument that budget concerns will rule out coverage for circumcision. There are still at least two problems. The rich parents will still have their kids circumcised. They’ll pay a doctor, of if that’s too difficult, a mohel, to do the deed for them. It’s not going away.
But even if that didn’t happen, there are other consequences to a single-payer system. With cost controls comes rationing. “Unjustifiable expenditures” becomes an administrative rather than medical decision. Circumcision should be clearly cosmetic and unnecessary, but what about other procedures?
If my knee gives out, how long will I have to wait to get it fixed if I can still walk on it, albeit in pain? I’m willing to pay for it, but there are no doctors with free time. (Doctors have left practice because it’s not economically feasible any more.) I’m worse off. The list goes on. Every country that has a single-payer system is stressed, with long wait times and limited procedures. These are not outcomes I want, in the interest of general health.
If it worked out that circumcision would cease, that’d be wonderful. But what if it doesn’t? And what about those parents who want to circumcise for religious reasons? That wouldn’t stop, even thought it’s just as wrong as non-ritual circumcision.
You’d rather have Congress criminalize circumcision? You’re kidding, right?
Unless you’re referring to the Congress on some other planet, there’s no chance of that ever happening. As far as the courts are concerned, I already commented on what the probable outcome of a legal battle would be in one of your earlier posts so I’ll let that suffice.
I don’t want to get into the broader issue of how a single-payer system should be implemented. The “rationing” argument is an old one that’s been answered many times by those who advocate this type of system and I don’t feel like getting into it here so I won’t.
I agree that Congress would most likely botch the job if they were charged with designing such a system and that’s why I’d prefer that the states come up with their own proposals and enact them at the state level without involving the federal government (that’s how the single-payer system began in Canada).
It’s true that religious circumcisers and some rich folks would continue to lop off their sons foreskins, but there’s nothing that can be done about these reprobates except to wait them out. The hope is that they’ll be forced to rethink their position once it becomes clear that circumcision is no longer a culturally accepted practice and they’ve been relegated to the status of a tiny minority within the larger society.
I’d rather have Congress criminalize circumcision. I don’t expect it to happen, of course, but it’s what should happen. But I’m under no illusion. I’ve read former Rep. Pat Schroeder’s speech on the floor of the House in defense of the FGM Act where she states that female and male circumcision are not the same.
That leaves the courts, which we’ve discussed as you said. I think the recent string of minor victories will help in the long run, but I have faith in the wisdom of the law and Constitution.
As for a single-payer system, you’re right that debating it is off the path of the main issue here. I’ll just say that I’d like to believe it will work out, but central planning always leads to price increases and rationing. Less for more. The problem is that government needs to get less involved, not more. Let capitalism take hold.
In that scenario, it then becomes critical to educate insurance companies. From what I’ve heard, one of the biggest obstacles to convincing insurance companies from paying for routine circumcision is that the government still pays for it. If the government stops, the insurance companies can stop. Spineless, yes, but I think it’s true. Given that it hasn’t stopped yet, even though we’re all paying for those circumcisions funded by the government indicates that the politicians in charge would rather remain popular than save money.
Ultimately, I think arguments like this are good. More ideas will lead to better solutions. As I said elsewhere, we’re on the same side, and that’s the issue we should be focused on. Disagreement in how to get there is fine as long as we don’t let our egos get in the way and fracture the unified goal. But, in this arena, the only goal is to end circumcision of children.
Unlike yourself, I have no faith whatsoever in the federal constitution or the federal government. My belief is that there should never have been a federal government.
The single-payer system doesn’t guarantee victory in the fight against circumcision, but it does tilt the odds in our favor. You already conceded this when you said that “budget concerns will rule out coverage for circumcision”.
Private insurance companies will never stop paying for circumcision as long as there’s a demand for it. Attempts to “educate” them have gotten us nowhere.
Your opposition to the single-payer system appears to be purely ideological. I try to focus on what works and what doesn’t work without regard to ideology.
The fact is that we already have price increases (the price increases for prescription drugs alone are outrageous) and rationing (an extremely cruel form of rationing based on one’s income). The single-payer system helped bring these problems under control in Canada and I’m sure it could do the same for us if it was properly designed and managed.
I definitely have faith in the Constitution, as it’s the greatest document ever written. I don’t have faith in the federal government, because it ignores the Constitution.
When I conceded the point on budget concerns and circumcision, I should’ve stated that I conceded only to explain the other reasons why I don’t favor a single-payer system. Circumcision in America isn’t a cost-based decision, as I’ve seen more than enough blog entries of people complaining that circumcision isn’t covered by their insurance. They’re unhappy that they “have” to pay the fee out-of-pocket. American circumcision is based on ego, not economics. Parents think their children should look like them, and no amount of cost is going to change that. It’ll just create a further rich/poor divide on the issue.
My opposition is based on an ideological point, based on my understanding of the Constitution. However, it’s also based on a practical, experiential understanding of what the government does when interfering with markets. The result isn’t good.
Price increases in prescription drugs have more to do with existing government regulation than market failure. And the end to rationing in Canada you mention seems to be based more on rationing as defined by who has access than what services are offered. I just don’t consider it an improvement if everyone has access to limited services. I agree that uninsured need coverage, but the biggest focus is on getting them typical coverage. That’s not reasonable, I think, since what we should be pushing is catastrophic coverage. That protects people but leaves preventive care and the such to individuals to take care of themselves.
What it comes down to, though, is that we’re not going to agree on this point. We still obviously agree on the initial point that circumcision must end. That’s at least a start that too many aren’t at.
The reason I don’t have faith in the federal constitution is because it necessitates the existence of a federal government. And federal governments always ignore federal constitutions except in those instances where it happens to serve their crooked agenda.
It makes no sense to put one’s faith in a federal constitution when the federal government it created will simply wipe its butt on said constitution.
The whole point of defunding circumcision is to take the “automaticness” out of the process. Once the “automaticness” is removed from the equation, people will be forced to think more seriously about what it is they’re agreeing to (Marilyn Milos of NOCIRC has said this many times).
There won’t be any overnight end to the circumcision quagmire no matter what. Infant circumcision would suffer a very slow gradual demise even with a single-payer system.
I’m not persuaded by ideology-based arguments (capitalism is always good, socialism is always bad, etc). What I am persuaded by is real-world models that can be pointed to as examples.
You say the result isn’t good when governments interfere with what you call “markets” (despite the obvious example to the contrary: Canada) but the truth is there’s no way to avoid government involvement in this “market”. I don’t know of any country anywhere that has a 100% privately run unregulated heath-care system.
Sorry for the delay in responding. I have a couple responses.
As to the Constitution, the problem lies with those implementing the system, not the system itself. The Constitution is designed to constrain them. Where they ignore it, the system must be used to stop them. It’s difficult, but a fight worth pursuing. Specifically because parts of the Constitution guarantee protection against violations. Even when we ignore them. Not perfect, but the best we have. (Essentially, you’re not going to get any arguments from me about politicians wiping their butts with the Constitution, but that is the fault of the politicians and the voters who enable them.)
I agree on taking the “automaticness” out of the decision. A single-payer system would likely impact this. I don’t like the method, but the result would be better. But better isn’t good enough for me.
I do have faith in markets and a distrust of government interference. Specifically with the Canadian health care argument, I offer this and this. The first is a good example, while the second is more of a commentary on the general idea of private vs. public provision. (I remember more recent discussion about Canada, but I can’t find the links right now.)
Eventually we’ll have to agree to disagree, which is fine with me. The only topic people I expect people agree with me on, however long it takes to get there, is that circumcision of non-consenting individuals for non-medical reasons must stop. Everything else is a matter of ideology – I prefer principle, which seems semantic, but I could explain my difference with more time – that is open to debate and real world proof.
It’s good to have you back. Your blog is the only one I read (or try to read) on a daily basis.
And now, without further ado, my response:
We, the citizenry, have a hard enough time holding local and state governments accountable for their actions. Adding a power-hungry federal government to the mix makes it next to impossible to hold anyone accountable for anything which is why politicians love federal governments.
Many people rightfully attack the idea of a “one-world government” as being inherently despotic, but what they don’t seem to realize is that federal governments operate in a nearly identical manner. Big centralized governments are always bad news for humans and human rights.
We don’t need a federal constitution for the same reason we don’t need a federal government….the states already have their own constitutions and many of them provide legal protections that are much stronger than those in the federal one.
I strenuously disagree with just about everything you’ve said about the single-payer system (“the death of the canadian model” my ass ) but there’s no point in continuing this debate since neither of us are going to change our minds about this issue. Like you said, we’ll just have to agree not to agree.