Medpundit offers a concise summary of the fallacy that U.S. universal health care/coverage will mimic other established universal systems. It also explains why I don’t believe that universal health care/insurance will lead to the end of routine infant circumcision in America. (I removed the links from this excerpt because they make it appear too busy, but they’re worth reviewing at the original entry. Emphasis here is in original text.)
The British are often held up as the standard to which we should aspire. But we don’t live under a British style of government. We live under a government that’s truly government of the people, by the people, for the people. And what the people want, the people get. Witness the influence of disease activism even now on disease specific government funding and treatment mandates. In England, the government only pays for colonoscopies to check for colon cancer if there are symptoms suggestive of cancer or a family history of colon cancer. In the United States, the Medicare pays for a colonoscopy every ten years for everyone over 50, regardless of symptoms or risk. So do many insurance companies., sometimes if not by choice, by mandate. In England, mammograms are only covered for women between the ages of 50 and 70, and then only every three years. In the United States, we pay for mammograms beginning at age 40, yearly, and with no upper age limit. We just don’t have the heart for rationing that they have in other countries.
It’s possible, probable even, that universal coverage would reduce the number of unnecessary circumcisions performed as compared to our quasi-private system now. However, I suspect the decrease will be neither significant nor long-lasting. The fundamental flaw in populism is that it can’t say “no” if a majority demand a “yes”. Principles and rules do not matter. The rights of the minority do not matter.
In this particular procedure, the opinion of the patient will continue to not matter. He is treated as a statistic, at best. If the procedure has the potential to prevent a problem later on, regardless of the actual risk faced, the foreskin’s contribution to that risk, or the consequences of that risk, the illogical defense allowing parents to continue cutting the healthy genitals of their sons will continue.
Remember that populism doesn’t care about proper context in cost-benefit, or even the existence of such analysis. As long as the case could be made, every parent is assumed to be making it. And every infant is assumed to be pleased at that assumption, depsite the undeniable evidence that intact adult males almost never choose or need circumcision.
The out-of-context nonsense we use today is illogical to anyone seriously considering all the evidence. The risks are small. There are less-invasive treatments and preventions available. Comparable countries that do not circumcise manage to achieve the same low levels of disease. These facts are ignored because they contradict our mental conditioning. We believe of circumcision what we want to believe, not what is true. That is why we hear that male circumcision reduces the risk of HIV infection by 60% rather than the more honest explanation of how much it reduces the absolute risk. Sixty percent is far more persuasive than two percent.
For the United States we must be honest and ask if a central planner wannabe who is immune to the rights of individuals enough to issue mandates wouldn’t also be immune to fiscal rationing for non-medically-indicated circumcision, as long as it pleases “the people”.
Via Kevin, MD