The Medical Necessity of Treatment Abusive control is 
the root problem of our health system 
By Yee-Wing Tong, MD 


U.S. consumers are given the 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 a tool used to monopolize healthcare. 

The battle of Alexander Horwin’s parents against the authorities over treatment of his brain tumor is described on . 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 drew national attention for a similar conflict with the FDA and his oncologist over his cancer therapy. Such inequity is common in view of the popularity of fringe medicine. There is no proof that the alternative therapies in these cases would be more effective, but they are safer. Safety is one reason I have explored beyond the allopathic paradigm and innovated a therapy called Neuro-Bio-Energetics (NBE), which combines anesthetic techniques with Chinese medicine to achieve dramatic results. 

Sadly, I found that vested interests, rather than efficacy and safety, are the real concerns of physicians. Normally, insurance companies pay for anesthetic injections. Yet when reviewers learn of my unorthodox approach, many disapprove this western therapy on the ground of no “medical necessity” despite its remarkable results. 

For example, Diane 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 had extensive orthodox therapies, including hyperbaric oxygen, ICU admissions 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 healed her pain, ulcers and infection in four months. Yet insurance reviewers disallowed my injections. Her symptoms recurred two years later. She was treated with another chemotherapy, which caused kidney damage and her eventual death at age 40. 

Blue Shield recently denied my anesthetic therapy for Gad, a youth with grandmal seizures for 6 years, suffering 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 medications and epilepsy to a few episodes per month. Yet Blue Shield refused to pay us. Gad later received neurosurgery and suffered severe complications. His care for that year cost nearly $300,000! Blue Shield paid for it, but not our $4000 bill! 

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

More cases are described in my appeal letter to Carroll Cederburg  of Blue Shield. Dr. Cederburg ignored my argument: the irrefutable results, safety and cost saving of my therapy, and the disturbing data on drug mortality. Instead, he felt I should adhere to the orthodoxy. 

This selfish attitude is widespread in the profession and further reflected in the case of Billie who has been in pain and confined to a wheelchair for 14 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 unassisted without pain for 2-1/2 months! Yet her insurance and a committee of the Orange County Medical Association both agreed to deny her claim! 

Dr. Jeffrey Kaufman wrote for the OCMA, “…The committee is happy to hear the patient is feeling better. However, the services rendered are not generally accepted professionally as appropriate and essential treatment of the disease. The data available fails to support the medical justification for this treatment or fees charged.” 

A conflict of interest is glaringly apparent. The dramatic success of an alternative therapy comparing to the dismal failure of orthodox medicine has caused alarm in these physicians, and they have ensured the insurance would not compensate their competitor. Their verdict has sentenced Billie back to her prison of pain. I can provide countless similar atrocities committed by the OCMA and medical reviewers. How doctors can be so cruel is beyond comprehension! 

The necessity of a treatment is the sole discretion of the patient, and should be based on clinical improvement. To interfere for self-interest and deprive the patient the only therapy that has proven effective is unethical. This blatant disregard for individual rights is at the root of our rotten system. L. Dossey, MD attributed our health enigma to dogma, the ego, and unkindness of physicians. L. Rockwell, Jr. 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 symptoms. The solution is a free market, giving the patients their absolute choice of treatments. This will happen only through public awareness, as economic survival is the main factor that governs medicine. 

References and case histories are posted on  under “Newsletter.” For more information or subscription to newsletter, call (714) 556-8664. 

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

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