HCFA, Circumcision, and Medical Fraud

Clinical Pediatrics, Volume 39, Issue 1: Page 65, January 2000.

Letters to the Editor

Focus on the foreskin, Not its destruction

To the Editor:

As a surgeon, it is no surprise that you are interested in circumcision surgery.1 As a human being, it is surprising that you have no interest in the mechanical gliding function and the erogenous sexual benefits of the foreskin. Dr. Taylor2 beautifully describes the anatomy, sex nerves, and physiology of the foreskin.

The Health Care Financing Administration provides no room for debate about circumcision. According to HCFA, circumcision requires a patient-voiced complaint, physical abnormality, and a pathologist's report documenting the pathology. Failing HCFA necessity criteria, circumcision is fraud and abuse.

The treatment for infection is antibiotics, not amputation. Circumcision fails the Severity of Illness Intensity of Service criteria. The foreskin is not an "infection-facilitative factor." Van Howe3 clearly elucidates the immunologic functions of the foreskin. Additionally, the neonatal foreskin is firmly adherent to the glans like a fingernail to its nail bed. It protects both mechanically and immunologically against infection.

For scientific evidence, compare statistics with non-circumcising countries. Intact neonates, with a virgin foreskin never subjected to ripping retraction from the glans during their medical exams, fare better than either circumcised infants or uncircumcised infants subjected to ripping retraction. Parents need to know that the infant is born with the foreskin fused to the glans and must view ripping of the immature foreskin from the immature glans as a painful type of sexual abuse, an invitation to infection, and damage to the undeveloped erogenous sex nerves.

Heuristics mandates that the child keep his foreskin and learn its mechanical and erogenous sexual benefits. The child is the owner of his foreskin. The child is the patient. Circumcision a not a matter of family choice. The circumciser needs the signed legal informed consent of the patient himself. Once he has enjoyed his god-given foreskin, he will not consent to man taking it by circumcision.

Eileen Marie Wayne, MD
1302 Seventh Street
Moline, IL


  1. Bloom DA. Editorial: The Circumcision Issue. Clin Pediatr. 1999;38:243-244.
  2. Taylor JR, Lockwood AP, Taylor AJ. The Prepuce: Specialized Mucosa of the Penis & Its Loss to Circumcision. BJU. 1996;77:291-295.
  3. Fleiss PM, Hodges FM, Van Howe RS. Immunological Functions of the Human Prepuce. Sexually Transmitted Infections 1998;74:364-367.


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