Medicare: Defund Circumcision
While the provision of Medicare rebates in Australia is legislated to be for “clinically relevant” procedures only, it is common knowledge within the circumcision industry that rebates will be paid by Medicare for cultural and religious circumcisions.
What this means is that our taxpayer funds are being used unlawfully by Medicare to fund procedures on perfectly healthy individuals – often on non-consenting infants. Given that it is extremely rare for an infant to require a circumcision as a procedure of last resort for a genuine medical necessity, and based on the statistics published by Medicare, we can estimate that in the last 10 years over $20 million dollars has been unlawfully spent funding the circumcision of infant boys – including the initial consultations and follow-up appointments in addition to the unnecessary procedure itself. Curiously, and also alarmingly, a number of girls appear in the MBS statistics each year for circumcision which Medicare should also investigate.
We call on Medicare to act within the legislation which governs the provision of financial rebates, and fund only medically indicated circumcisions, with the appropriate audits, investigations and discipline for non-complying practitioners.
The Key Details So Far
- In 1973 the Health Insurance Commission Act 1973 is passed, which establishes that benefits (rebates) are payable for clinically relevant procedures on the Medical Benefits Schedule (MBS).
- In 1985 the Hawke government removed circumcision from the MBS, but was forced to re-instate it – not for medical reasons but under pressure from religious groups.
- In 2018 the Urology Clinical Committee, as part of the MBS Review Taskforce, confirm that circumcision of healthy children is funded by Medicare when they publish the recommendation that it should “continue to include circumcisions conducted for religious and cultural reasons…”
- In May 2019 the Paediatric Surgery Advisory Group affirms the above recommendation.
- In December 2019 Foreskin Revolution launches a social media campaign, calling out the above recommendation for the unlawful funding of circumcision.
- In July 2020 Foreskin Revolution provides to Medicare a list of 20 clinics, out of 22 approached in an investigative campaign, that confirm in writing that Medicare rebates will apply for circumcisions requested to be undertaken for “cosmetic” reasons only.
- In September 2020 (updated 9 October 2020) Medicare release a fact sheet reminding service providers that they “have a responsibility to ensure that any services they bill to Medicare are clinically relevant and meet the eligibility requirements outlined in the MBS item descriptor.”
Why do we alledge that there is widespread unlawful funding of circumcision?
The MBS Review Taskforce published it in a report
Medicare confirmed it as part of the MBS Review Taskforce when in multiple published reports it recommended that Medicare “continue to include circumcisions conducted for religious and cultural reasons”. These reports were written and reviewed by leading nurses, doctors, urologists and paediatric surgeons – some of whom perform circumcisions.
The statistcs show it
The true rate of medically indicated circumcision has been estimated at 1/1600. If we look at the MBS statistics within, the rate in Tasmania (where they have largely done away with forced cultural/religious circumcision) is about 1%. When we compare this to other states such as Qld, NSW and SA where the rates are greater than 10% it is clear that providers in those states are claiming rebates at the rate of at least 10x more than what would be expected for medically necessary circumcisions.
The doctors told us
Out of 22 circumcision clinics approached in an investigative operation, 20 clinics confirmed in writing that Medicare rebates will apply for circumcisions requested to be undertaken for “cosmetic” reasons only.
The web is littered with references to it
The internet is littered with references to how circumcision clinics will help parents claim for the non-medical, forced cultural/religious genital cutting of their children. These references can be found in parenting groups and also the pricing pages of the clinics themselves. See below for examples.
Clinics advertising that they offer Medicare rebates
The following shows examples of clinics that brazenly advertise Medicare rebates for non-medically indicated circumcision on their websites.
Gentle Procedures Brisbane
Gentle Procedures Brisbane quotes a $160 rebate from Medicare with no qualifying text around the need for medical necessity. The quoted amount is more than what Medicare provides for circumcision, with a possible explanation being that the clinic offers rebates for the pre and post consultations – costing even more for the Australian taxpayer. See the current website here, and the archived version of this page here.
Melbourne Circumcision Centre
Gentle Procedures Perth
Gentle Procedures Perth quotes a $210 rebate from Medicare with no qualifying text around the need for medical necessity. This includes the rebate for initial consultations and follow-ups – costing the taxpayer at every stage of this unnecessary procedure. See the current website here and the archived version here.
Melbourne Vasectomy & Circumcision
Dr Paul Cowie
At 11 August 2020 Dr Paul Cowie was offering Medicare rebates for circumcision as shown in the screenshot. By 24 October 2020 these prices and all information relating to circumcision had been removed from the website. See the archived version here.
The recommendation from the Urology Clinical Committee, as part of the Medicare Benefits Schedule Review Taskforce, that Medicare “continue to include circumcisions conducted for religious and cultural reasons“, confirmed that this is currently what is happening. For the Committee to admit this in a recommendation to Medicare (the very agency that is supposed to be enforcing that this does not happen), and then subsequently for the Paediatric Surgery Advisory Group to affirm the recommendation shows just how systemic this blind eye mentality is in unlawfully funding circumcisions with taxpayer money.
In 2019 we called out these groups on this unlawful recommendation in a social media campaign.
We followed up to ask if anyone on the Committee, the Advisory Group or in the medical industry in general could advise how this recommendation could be considered legal under the HIC Act to which we received no response.
Let us know!
Have you seen a circumcision clinic that advertises that Medicare rebates are available? Or were you offered a Medicare rebate to circumcise your son? Send us the details by clicking the button below.
Report to Medicare
If you would prefer to report a clinic directly to Medicare for unlawfully using you taxpayer funds to circumcise healthy children please email them using the button below or call them on 1800 314 808 or complete their online form.