Coming up: circumcision campaigns

The advocates of ObamaCare insist that medical decisions will remain between doctors and patients and not involve mandates from government.  However, the same people also cheer the idea of government “coaching” doctors to adopt practices, and to back up those choices with pressure from payment schedules, which will result in de facto diktats, especially when it evolves into a single-payer system.  If they succeed, expect to see a campaign to push new parents into circumcising their male children in the name of AIDS prevention — even though the risks are manageable and the effect less than certain:

Public health officials are considering promoting routine circumcision for all baby boys born in the United States to reduce the spread of H.I.V., the virus that causes AIDS.

The topic is a delicate one that has already generated controversy, even though a formal draft of the proposed recommendations, due out from the Centers for Disease Control and Prevention by the end of the year, has yet to be released.

Experts are also considering whether the surgery should be offered to adult heterosexual men whose sexual practices put them at high risk of infection. But they acknowledge that a circumcision drive in the United States would be unlikely to have a drastic impact: the procedure does not seem to protect those at greatest risk here, men who have sex with men. …

But Dr. Peter Kilmarx, chief of epidemiology for the division of H.I.V./AIDS prevention at the C.D.C., said that any step that could thwart the spread of H.I.V. must be given serious consideration.

“We have a significant H.I.V. epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic,” Dr. Kilmarx said. “What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks.”

Barack Obama has warned us of Tonsil Vultures and Foot Rustlers.  So far, he hasn’t issued a warning on Foreskin Fiends.  In 1999, approximately 65% of all males born in the US were circumcised, which represents around 1.3 million each year.  In contrast, surgeons perform only 600,000 tonsillectomies a year.

I’m neutral on the issue of circumcision, which has become a controversial practice, but find this idea of interventions very, very odd.  In the first place, circumcision does not provide an immunity to STDs, not AIDS or anything else.  Studies indicate that circumcised males may have less danger of acquiring an infection, but as the NYT points out, that’s from heterosexual relations — a very minor channel of AIDS communication in the US.  Men have much better choices than circumcision for avoiding HIV infection, including the use of condoms (still not a perfect defense, but better than circumcision), refraining from intravenous drug use with shared needles, avoiding high-risk sexual practices altogether, and so on.

Why should the CDC push circumcision at all?  The government has no business being in the middle of that decision.  Under ObamaCare, however, when the government starts paying more and more of the health-care tab, they will point to ambiguous cost savings down the road — in this and other cases, decades down the road — to pressure Americans into surrendering their choices now.

Update: Let me try to explain this in small words for people who like to give “awards” for hysteria but still demand to see Sarah Palin’s gynecological records.  If Obama says he’ll stop doctors from enriching themselves through unnecessary tonsillectomies and amputations, that is an explicit call for government control of health-care delivery and the interference of government between patients and doctors.  If the CDC — which is part of the same government that will control health care — decides that circumcision is beneficial and cost-efficient in the long term, that same mechanism would create pressure on doctors and patients to perform them.

You can’t have it both ways.  The government that has the power to stop Tonsil Vultures and Foot Rustlers also has the power to pressure for greater numbers of circumcisions.  The apparatus for that will be put in place, as Obama not only admits but brags.

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