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Activist wants MassHealth to cut it out with state-funded circumcisions; sues

A Boston anti-circumcision activist will be allowed to try to make his case before a jury that state-funded circumcisions are a waste of taxpayer money.

In a ruling last week, a Suffolk Superior Court judge rejected a request by the Executive Office of Health and Human Services to completely dismiss a suit by anti-circumcision activist Ronald Goldman over the way the state MassHealth program now pays for what he considers medically unnecessary circumcisions.

Judge Robert Gordon did agree with state attorneys that Goldman could not sue under federal Medicaid regulations, but added that Goldman's suit - which he brought with 27 other Massachusetts residents - could continue under a Massachusetts law that lets its citizens sue over what they consider wastes of state taxpayer money.

In addition to stopping payments for circumcisions done for religious or cosmetic reasons, Goldman wants the state to set up an "institutional review board" to ensure only medically necessary circumcisions are performed and to initiate disciplinary action against any doctors or health-care facilities that try to get MassHealth funding for procedures that aren't medically necessary.

Goldman, founder of the Circumcision Resource Center, which is against the practice, raised money through a GoFundMe page to sue MassHealth last year, several years after MassHealth rejected his request and told him the procedure does have health benefits.

In his ruling, Gordon noted that rulings by federal courts - including the Supreme Court - have held that federal Medicaid regulations preclude private lawsuits over the way governmental agencies spend their Medicaid money.

No such similar bans, however, exist for the state law on wasteful government spending when it comes to regulations specifically written by Massachusetts agencies, such as MassHealth, Gordon continued.

And because of that, Goldman can make his case to a jury that the way Masshealth approves payment for all neo-natal circumcisions without a review currently should be stopped, Gordon ruled.

Gordon took no action on Goldman's request, at least for now, for an injunction to stop MassHealth-funded circumcisions while the case is pending.

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Comments

... mutilation is to the bank accounts of the doctors who perform it.

Let grown men decide what they want their penis to look like.

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Voting closed 53

Yeah I’m sure any grown man will willingly sign up to have their jawn sliced up . And then have to deal with the post surgery care. They’ll just deal with a life time of dick cheese

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Voting closed 21

Nope.

There is this stuff called soap and this other stuff called water for that.

Not an issue so long as you bathe regularly.

Grown men have a right to do what they want with their junk. Unnecessary cosmetic surgery on newborns is both risky and, well, unnecessary.

Would you support newborn rhinoplasty to prevent fictitious nose cheese? Probably not.

Genital mutilation is genital mutilation.

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Voting closed 66

At least grown men have a choice and can avail themselves of anesthesia.

Babies do not and cannot.

I only know one who did make this choice and chopping off his foreskin didn’t solve the psychological issues he hoped it would. Other men left intact that I know couldn’t be bothered and they do bathe.

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Voting closed 44

about people who pierce babies' ears. In fact, there are better arguments for circumcision than earrings.

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... and less painful too.

I agree parents should never pierce their kids ears. But at least the holes often close up, if left alone. I never heard of a regenerating foreskin.

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Voting closed 35

Less of a health risk to pierce ears ...

I'd say any injury to the head area is more of a risk. Ask a dentist.

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Voting closed 12

Funny head pun. Lol!

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Voting closed 16

...Magoo's younger brother?

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Voting closed 11

I'm confused. What happens at a bris?

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Voting closed 12

Are rabbi circumcisions paid for by healthcare coverage?

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Voting closed 19

Here's a very brief and humorous video that explains the whole process.

https://vimeo.com/312218800

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Voting closed 8

Magoo wonders...never mind. Magoo.

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Voting closed 30

The intactivists make a few points I can agree with, then they make it weird.

While I don’t think Medicaid should pay for elective, routine circumcision (let’s be real, it’s mostly a cosmetic procedure), an “institutional review board”? Made up of who, Ron and his cohorts with the red-stained pants? Being paid by whom? Whose new career is going to involve sitting in a boardroom, talking about infants’ genitals? This is why people think the anti-circumcision crowd is nutty.

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Voting closed 24

"Docking" makes a comeback and I'll be too old to participate. Thanks, Ron.

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Voting closed 16

Goldman wants the state to set up an "institutional review board" to ensure only medically necessary circumcisions are performed...

I'm not clear on his intent with that. Does he want this board to prohibit any medically-unnecessary circumcisions from being performed, or just prevent MassHealth from paying for them?

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Voting closed 12

At last, a UHub comment thread I know something about. Institutional Review Boards are set up by hospitals and other institutions to serve as an important checkpoint on ethical and medical protections. The most common use of a review board, or IRB, is in relation to medical and psychological research and experimentation. An IRB board will be made up of other professionals (usually doctors) and have written procedures and guidelines by which they review cases or proposed interventions. The goal of an IRB is to protect the wellbeing, privacy, and human rights of patients and participants. In research, the IRB reviews proposed research projects to make sure the doctor-researcher is accurately describing the risks to participants, that the experiment's potential benefits outweigh any potential risks, that there's a plan to keep HIPAA data safe, etc etc. It's SUPER important in research but can be applied as a framework to non-research issues of want-vs-need institutional procedures.

In this case, because they want: ""institutional review board" to ensure only medically necessary circumcisions are performed "

What it would likely be is a small board, probably made up of pediatricians, surgeons, urologists? Who create and then implement the criteria by which "medically necessary circumcisions" is defined. Then, any parents who want their baby circumfixed would need to come before the board and make a case as to why their case is 'medically necessary' and get an exemption from the rule. I would imagine this to be a 3-5 person board made up of existing medical staff at the institution who want board activity on their resume and meets on an ad-hoc basis.

It makes sense to do it this way if your goal is to really get rid of cosmetic circumcisions. Otherwise, a hospital can have a "only medically necessary" rule, but it becomes up to individual doctors to implement what they think is necessary, and THAT becomes up to the particular opinions and biases of that doctor. There's reasons "doctor shopping" is a thing - good and bad - and in this day and age if you let it known you'll sign off on the medical necessity of any baby boy brought to you, that info gets passed around on facebook and then the rule has no teeth at all. An IRB would be beholden to their own rules and has to report decisions in an auditable way, etc.

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Voting closed 7

So at the risk of deactivating the ammonium thioglycolate...

The Civil Rights Act defines disparate impact as adversely affecting a particular group of people, in this case, MassHealth subscribers. Therefore, wouldn't denial of a reasonable and widely available elective medical procedure, for such a targeted group of people, set the stage for a future disparate "intact" class action?

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Voting closed 14

The Civil Rights Act defines disparate impact as adversely affecting a particular group of people, in this case, MassHealth subscribers.

If you're talking about the 1964 Civil Rights act, that is not the case. It specifically addresses certain categories, not any "particular group of people", and MassHealth subscribers are definitely not on that list.

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Voting closed 20

The Civil Rights Act defines disparate impact as adversely affecting a particular group of people, in this case, MassHealth subscribers.

You don't actually believe Masshealth subscribers are a legally protected class, do you??

LMAO

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Voting closed 19

Low-income people should just be happy to get whatever handout you deem appropriate? Stay classy, Shamu

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Voting closed 15

Low-income people should just be happy to get whatever handout you deem appropriate?

It's not a "should" thing. You cited "civil rights" legislation, and there is no civil rights legislation I'm aware of that considers MassHealth subscribers to be a protected category.

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Voting closed 18

You literally tried to say that “masshealth subscribers” were part of a legally protected class because of the “civil rights act”. That’s factually false.

Sorry you can’t handle being wrong and need to claim that I am saying something about people with lower incomes.

I guess you’re wrong twice now!

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Voting closed 12

Snarky, little bugger, aren’t you.

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I guess I shouldn't be surprised that you're repurposing "snarky", given that you apparently don't know what "bugger" means.

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I mean - they only take tips.

https://www.youtube.com/watch?v=9CdVTCDdEwI

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Voting closed 12

It was a Tuesday. I remember it being a bright, sunny day in Maternity Ward 3 at the Boston Lying Inn. The windows of Ward 3 were large, rectangular shaped monsters, designed so that mothers had a place to sit with their children if they had jaundice. Several of my Ward 3 roommates (Eugene and Stanley) would sit in that chair with their mothers, basking in the thick columns of sun where flecks of dust could be seen floating in the fog of these golden rays. Although I had never been outside in my life, the air looked cold and crisp, as I would imagine the air would be on a early morning in January.

I had milk for breakfast that day, as I had for all my other meals during by stay so far. That was fine, no one had lactose issues back in the 1970's and food allergies wouldn't be detected for another few months for most kids. After breakfast I took a nap, and remember waking up to the sounds of nurses stacking paper cups and closing drawers to cabinets. It was peaceful lying there that day, not knowing the horrors that would come that afternoon. After my nap I had milk again for lunch and spent some quality time with my Aunt and Uncle who had travelled up from Cumberland, RI to see me. It was then where things would change in my life forever.

The doctor briefed me on what was going to happen during the procedure. He didn't have to, as people my age weren't required to be informed of medical procedures like this, but he did out of courtesy anyway. After the debriefing I sat there staring at that jaundice window, wondering if the babies of other wards across the city were also awating the removal of part of one of their organs. But this was no ordinary organ. This was an organ that would give myself and others so much pleasure over the next 40 years, I couldn't imagine doing something so horrible to it. But then the moment came.....

SNIP!!!!

It was gone. My foreskin was gone forever, carried out like the trash from some Combat Zone cafeteria. The pain lasted a few hours, but some warm milk helped take my mind off the pain and I soon learned to adapt and live with the reality of not having this extra fatty skin at the edge of my penis. There were some upsides. My penis no longer looked like a five day old corn dog. It was bright and vibrant, cooler in the summer and the girls didn't laugh at it. My life would be ok after all.

It would all be ok.

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Voting closed 35

I enjoyed this autobiographical snippet!

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And girls still laugh at mine....

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is no guarantee of future results.

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Trying to make law through the courts.

If Mr. Goldman feels that MassHealth shouldn't be funding circumcision, he should contact a member of the General Court and draft a bill to ban the funding. Then he can build support for the bill and guide it through the legislative process to make it the law of the land.

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Voting closed 14

I made my elected representative submit a bill in this manner in Massachusetts in the mid-2000's. It made it to a joint review board, in which the chairperson was a jewish woman who would rotate her chair 180' and ignore and shun testimony from the dozens of people who were harmed by circumcision. She refused to listen and the bill was not adopted due to religious discrimination on the part of the chairwoman.

See: Massachusetts MGM Bill (2006) - https://nebula.wsimg.com/c153e37330d742b3b2537cf60764a741?AccessKeyId=38...

and: Massachusetts MGM Bill (2014) - https://nebula.wsimg.com/6f02120b0f10695e9466d5db81eee159?AccessKeyId=38...

As this point, raising awareness and stopping tax-payer moneys from funding the practice when not required in any manner possible is acceptable.

New law isn't being proposed, new policies are -- based on existing laws that state tax-payers money is not to be frivolously wasted on unnecessary, harmful, cosmetic procedures.

If you want a circumcision for yourself, I have a list of doctors that will do a GREAT job for you (as a consenting adult who desires one!) Leave babies alone.

We are an army fighting for the rights of baby boys to have a complete, unharmed, intact body and we're NOT going away.

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Voting closed 12

Well yes, case law is in fact made through courts. Statutory law is made through the legislature.

How else do you propose we set precedent for how the law is to be applied in various contexts? Psychic legislators who write 5000-page laws about everything they imagine it might ever be applied to?

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Voting closed 17

And if that is not the case, we no longer live in a democracy.

At the end of the day, this guy is using an obscure section of state law to force state a change to the regulations. Nothing in state law says the state can or can't use the funds for circumcisions. If the will of the people is that it shouldn't, a law can be passed that says as much.

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Voting closed 9

Nothing in state law says the state can or can't use the funds for circumcisions.

At the end of the day, a judge ruled that this guy's argument about the law was good enough that he gets to make the case to a jury. That seems to argue that there's at least a non-zero chance that this is covered by the existing laws, in which case, it would be more appropriate to enforce the existing law here rather than pass a new one saying the same thing.

Or if he's wrong, and the law doesn't say that, then he can try your method. But the current legal system says he's free to try this line of arguing, at least for now.

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if you believe that there's a law that already applies to this and just needs to be enforced?

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Voting closed 16

Let’s hope for a bris(k) trial!

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All the rich kids get clipped, honey, I was poor and on Mass Health so could never afford it.

Hospitals will still routinely do the procedure but end up not being compensated for it.

It is a parent’s choice but this guy and his agenda doesn’t sit well with the poor people crowd. I’d like to snip him for pursuing it.

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Voting closed 14

My kids qualified for CHIP when my sons were born and I refused to have them circumcized despite institutional pressure based on extremely poor studies. It is nothing but a cosmetic procedure performed on non-consenting newborns for the sake of profit. No healthy child needs to be mutilated like that.

They are teens now. They have both thanked me for making it their decision.

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Somehow, it is illegal for females and legal for males.

And it doesn't matter that "they do much worse to the girls!!!!!" because legal male mutilation will someday be a talking point in courts of law to break the FGM bans. Just watch.

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How is it a parent's choice? It's not their body, and there's no other part of the body where they can have healthy normal living tissue removed from a child's body. Even a pinprick on a girl's genitals is illegal, so why don't boys get the same protection?

I'd pay a year's salary rather than be circumcised or have my son circumcised. Why would I want the most sensitive and pleasurable parts cut off? That little bit of skin makes a big difference (it's not just there to protect the glans).

Why don't we just let everyone decide for themselves whether or not they want irreversible genital surgery? It's their body after all.

It's not like it can't wait. I think it's only the USA (at around 60% and dropping) and Israel where more than half of baby boys are circumcised. Other countries circumcise, but not till anywhere from the age of seven to adolescence. Only about 12% of the world's circumcised men were circumcised as babies. Around two thirds of the world's men (including 88% of the world's non-Muslim men) never get circumcised.

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Voting closed 10

I asked my son when he was born if he wanted to be circumcised. He hemmed and hawed for a while on that one, and eventually wouldn't say either way what he wanted or didn't want. It was frustrating for sure so we just decided not to do it but made that decision for him. Fuck him right? Why should he get to decide at a young age what to do with his body? He isn't old enough to make a decision like that right? Then the doctors asked about the vaccines and we went through the same process. He kind of made a goo goo ga ga sound when we asked him about those. We took those sounds as a yes and had him vaccinated as well.

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Voting closed 9

That's a terrible analogy, and there's a chasm of difference between vaccination and circumcision.

Vaccination saves lives – lots of lives, it doesn't remove erogenous tissue and is recommended by all national medical organizations, whereas several such organizations are against routine infant male circumcision.

Vaccines are the most effective way to reduce the risk of a disease that you're vaccinating for; diseases which are highly virulent, usually through inconsequential social contact. For example, one can get measles just by entering into the same room that an infected individual left hours ago. There are no other reasonable alternatives to protect yourself against measles and you're at immediate risk for it.

Circumcision can wait. I think it's only the USA (at around 60% and dropping) and Israel where more than half of baby boys are circumcised. Other countries circumcise, but not till anywhere from the age of seven to adolescence. Only about 12% of the world's circumcised men were circumcised as babies. Around two thirds of the world's men (88% of the world's non-Muslim men) never get circumcised.

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How is it a parent's choice to drag a child to church and indoctrinate them in a belief system?

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Voting closed 10

You're comparing permanent removal of parts of a child's genitals to a religious upbringing. If you get dragged to church as a child, you can stop going (or be part of a different religion) when you grow up. You still have your whole body though.

Your argument would also apply to female gen1tal cutting btw.

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Voting closed 2

I'd pay a year's salary rather than be circumcised or have my son circumcised. Why would I want the most sensitive and pleasurable parts cut off? That little bit of skin makes a big difference (it's not just there to protect the glans).

Why don't we just let everyone decide for themselves whether or not they want irreversible gen1tal surgery? It's their body after all.

It's not like it can't wait. I think it's only the USA (at around 60% and dropping) and Israel where more than half of baby boys are circumcised. Other countries circumcise, but not till anywhere from the age of seven to adolescence. Only about 12% of the world's circumcised men were circumcised as babies. Around two thirds of the world's men (including 88% of the world's non-Muslim men) never get circumcised.

If I'd been circumcised at birth though, I can easily see how I might be on the opposite side of this argument. I'd be the one who didn't know what he was missing...

Three national medical organizations (Iceland, Sweden and Germany) have called for elective infant male circumcision to be banned btw, and two others (Denmark and the Netherlands) have said they'd support a ban if they didn't think it would drive the practice underground.

"Routine" circumcision *is* banned in public hospitals in Australia (almost all the men responsible for this policy will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%).

If it weren't a religious thing, elective circumcision of boys would have been banned in lots of countries decades ago, same as it was for girls.

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Voting closed 6