The medical necessity of a treatment
Abusive control is the root problem of our health system

By Yee-Wing Tong, MD, 9/1/2000

US consumers are given the absolute right to choose a commodity or service, except in medicine. The medical profession has invented the term “medical necessity” on the pretense that it knows what’s best for the patient.  In reality, such is merely the tool used to monopolize healthcare.

Visit www.ouralexander.org on little Alexander Horwin, who died from a brain tumor. The web site describes the heart-breaking battle of his parents against the authorities over the treatment of their child. While the pediatrician had no clue as to the cause of the tumor, the parents’ diligent research pinpointed vaccines as the culprit. To avoid toxic chemotherapy, they opted for a safer alternative, but were forced to choose chemotherapy by the FDA and their oncologist, who would have invoked the law to take the child from them if they did not! The drugs caused grave side effects. While the parents were agonizing over their dying son, they overheard the oncologist laughing outside the room! 

Four-year-old Thomas Navarro recently drew national attention because of a similar conflict with the FDA and his oncologist over the therapy for his cancer. This prompted Congressman Dan Burton to sponsor legislation HR 3677 to allow him to use safer remedies preferred by his parents. Such inequity is common in view of the enormous interest in fringe medicine.

There is no proof that the alternative therapies in these cases would be more effective, but they are unquestionably safer. Safety is one reason I have explored beyond the allopathic paradigm and innovated a therapy called Neuro-BioEnergetics (NBE), which combines western anesthetic techniques with Chinese medicine to achieve dramatic results. Sadly, I found that vested interests, rather than efficacy and safety, are the primary concerns of physicians. Normally, insurance companies will pay for anesthetic injections. Yet when reviewers learn of my unorthodox approach, many deny payment for this western therapy, despite its remarkable results, on the ground of the lack of “medical necessity.”

For example, Diane 38-year-old came to me with persisting foot ulcers and osteomyelitis (bone infection) caused by Methotrexate, a chemotherapy used to treat her rheumatoid arthritis. For two years, she was in-and-out of ICU, had extensive orthodox therapies and five toes amputated, all to no avail. She refused to have her leg amputated, and was told twice that she would die.

In contrast, we cured her pain, ulcers and infection in four months. Yet insurance reviewers disallowed my anesthetic injections. Her symptoms recurred two years later. She was treated with a different chemotherapy, which caused kidney damage, requiring dialysis. Subsequently, she had five fingers removed, and died after refusing further dialysis.

Blue Shield recently denied my anesthetic injections after paying for them for 10 years. Gad was a 16-year-old Blue Shield patient with grandmal seizures for six years, with 5-6 attacks a day. His family had traveled around the world but found no solution. Our first treatment stopped his seizures for three days. Further therapy reduced his epilepsy to few episodes per month and at the same time decreased his need for medication. Nevertheless, Blue Shield refused to pay for our therapy. Gad later received neurosurgery and suffered severe complications. His medical expenses for that year reached nearly $300,000! Blue Shield paid for it, but not our $4000 bill!

Larry (Interview), another patient, is a former Wimbledon contender who had stopped exercising for two years due to arthritis of the knees. He did not respond to numerous drugs, cortisone shots and joint aspirations. A knee replacement was recommended. Fortunately, we cured his problem. He has since competed in three tennis tournaments against former professionals, and placed third in one of them!

More cases are described in my letter of appeal to Dr. C. Cederburg , Medical director of Blue Shield (posted on www.drtong.com ). Dr. Cederburg ignored my argument: the irrefutable results, the safety and cost saving of my therapy, the references on drug mortalities, and the fact that I don’t need MRI’s and expensive tests. Instead, he felt that I should conform to the orthodoxy.

The selfish attitude of this profession is further reflected in the case of Billie (Interview), who has been in pain for 14 years and confined to a wheelchair for over two years due to a spinal injury. Orthodox medicine had nothing to offer. On the other hand, four NBE treatments enabled her to walk and climb stairs without pain or assistance for one month! Yet her insurance, and a committee of the Orange County Medical Association both agreed to deny her claim!

The necessity of a treatment is the sole discretion of the patient. To interfere solely for the preservation of self-interest, depriving the patient of the only treatment that has proven effective is cruel and unethical. This blatant disregard for individual rights is at the root of our rotten system. L. Dossey, MD attributed the problem to dogma, the ego, and unkindness of physicians (Alt Ther, 7/2000)*. L. Rockwell, Jr. of Ludwig von Mises Institute concurred in his article “Medical Control, medical corruption” which chronicles how ruthless activists have transformed medicine into a monopoly.

In conclusion, abusive control is the underlying disease of our health system. The high cost, legislative intrusions and HMOs are merely the resulting symptoms. The solution is a free market, giving the patients their choice of treatments. This will happen only through public awareness. Orthodox medicine once denounced nutritional therapies, but has changed its view due to the massive demand for them. It is economic survival that governs medicine.

Dossey L. The science blues. Alternative Therapies in Health and Med. 2000;6(4)12-17,94-97.