The circumcision decision

As powerful an institution as the AAP is, it was not the first to make this determination about a procedure that is performed on more than one million male newborns annually. In the last few years, the American Medical Association, the American Cancer Society, the Centers for Disease Control and Prevention and the National Institutes of Health have deemed circumcision an unnecessary medical procedure.

There is no doubt these official proclamations have influenced the multibillion dollar health insurance industry. A 1990 article in the New England Journal of Medicine claims that routine infant circumcision earns the health insurance system an estimated $140 to $160 million annually. The cutting procedure has become an automatic response after birth the article said, and is routinely practiced in thousands of hospitals around the country.

Dr. Mark Fleiss, a pediatrician at the University of Southern California Medical Center, says the AAP's announcement fortified a fairly new trend among insurance companies not to cover the procedure. He points to Blue Shield of Pennsylvania and Prudential Insurance Company, along with some welfare programs, that now refuse to pay for the operation.

Despite modern medicine's rejection of what in America is a century-old tradition, millions of parents continue to circumcise their newborn sons. For many, this decision stems from tradition, particularly among Jewish parents whose faith guides the father to circumcise his eight day-old son as a way of forming a covenant with God. For others, the decision is based on the desire for cosmetic conformity, and belief that a cut penis is a cleaner and healthier penis.

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