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When he was diagnosed with two autoimmune diseases, Joel Hechler knew he’d be in for a battle. He didn’t realize maybe his toughest one would be with his insurance company.“I think they put the dollars ahead of a patient’s health,” Hechler said. “I don’t think they fully understand the impact the medicine will have on my long-term health and well-being."Hechler suffers from Crohn’s disease and ulcerative colitis, diseases that attack the lining of his digestive tract. Autoimmune conditions like his can’t be cured but, with the right medication, the symptoms can be controlled.  Finding the right medicine can be hard for those suffering from autoimmune diseases. Even if there are scores of drugs on the market, some patients might only respond to one. In Joel’s case, his doctor thought he’d have a better chance trying a drug called Remicade.“I received a letter from my insurance company that denied the Remicade on the basis that I have to try a different drug before I can get to Remicade," Hechler said.Hechler's insurance company, Premera Blue Cross, wouldn’t approve the drug his doctor prescribed because they wanted him to try a cheaper one first.It’s part of a program that health insurers nationwide use called step therapy, requiring that patients try less-costly drugs before “stepping up” to more expensive ones — even if doctors believes the cheaper drug won’t work.Dr. Larry Adler is president of Huron Gastro in Ypsilanti, Michigan and says he spends virtually every day battling insurance companies over step therapy drugs.“They have to fail this medicine first before they get the new drug,” Adler said. “That doesn’t make any sense.”Adler says it's common for patients to get sicker while waiting for step therapy to run its course.In Hechler's case, it took six weeks of fighting with his insurer to convince them that the cheaper drug wouldn’t be effective. As he was waiting, he was getting worse.“It got to the point where I had to be admitted to the hospital,” Hechler said. "I was very, very sick.”Step therapies are used by insurers to try to control skyrocketing prescription medicine costs, says Glen Perry, Director of Pharmacy Contracting and Sales for Blue Cross Blue Shield of Michigan.“These drugs can cost up to 0,000 per year. These are not cheap medications,” Perry said.“It seems like you’re telling patients that, in many cases, your insurer knows what’s best for you, rather than your doctor,” Jones said.“We are trying to provide the most cost effective and safe medication use,” Perry said, adding that when a doctor and insurer disagree over a drug, they can usually resolve the case within a few days without putting a patient at serious risk.“A delay of one or two days I don’t think is really going to make that much of a difference for the medical outcome of the patient," he said.But for many patients, like Phyllis Toole, the delay is longer than a few days.Phyllis suffers from rheumatoid arthritis, a condition where her body attacks her joints. When her doctor wanted to put her on Orencia, her insurance company HAP said she needed to first try a less expensive drug, Humira.But Phyllis’ doctor was worried about possible side effects and thought Humira could be risky.After battling for months, Phyllis says the whole thing made her feel more like a number than a patient. With her doctor and insurer in a standoff, she was forced to rely on samples of the drug she got from her doctor. HAP never approved her prescription.“They’re playing doctor, is what it feels like,” Toole said. “They’re saying this is what you can have for the symptoms you have. It may make you sicker, but this is what you can have.”HAP issued the following statement to Scripps station WXYZ in Detroit: 3800

White House chief of staff John Kelly announced at a senior staff meeting Monday that President Donald Trump asked him to stay on as chief of staff until at least 2020 -- and that he agreed -- three White House officials confirmed to CNN.The news came after Kelly marked his first anniversary as chief of staff amid a swirl of rumors about his potentially imminent departure. The Wall Street Journal first reported news of Kelly's plans.Kelly has seen his status as chief of staff diminished in recent months, with the President circumventing many of the policies and protocols the retired Marine Corps general put in place when he entered the West Wing last year.In the two weeks leading up to Trump's disruptive swing through Europe, senior aides predicted that Kelly had days or hours left. Those same aides now think the ensuing chaos of the trip may have helped Kelly hang on a little longer.The-CNN-Wire 917

We've heard about telehealth for people, but now it's there for animals too. According to the American Veterinary Medical Association, there's been a significant increase in telemedicine, and some veterinarians are entirely virtual.The pandemic has proven we can do almost anything from our couches, computers and phones. We've grown accustomed to all things virtual and it seems our pets are used to it too.“It really highlights the value of something like this and it also really highlights where society is living. Even before the pandemic, turned to google, turned to the internet first. It's our first step in almost everything,” says Dr. Sarah Machell.Machell is the lead veterinarian for Vetster, which provides on-demand virtual care for your pet.“Consultations, meeting pet owners in their homes, where they are with their pets, and helping to address urgent and preventive care health conversations to them,” Machell said.She says the company, which launched in October 2019, wasn’t formed because of the pandemic, but they certainly evolved at the right time."The veterinary clinics themselves are feeling a really heavy surge with the pandemic. It’s a pretty crushing situation for them. We already as a profession had some staffing challenges, not enough veterinarians for how many pets and pet owners there are,” Machell said.Pet owners, she says, often have a hard time getting an appointment. Or they have to wait in their cars with their animal outside of their clinic. And, according to Vetster, 50% of pet owners don't even have an established home clinic.“There was a poll recently that showed 37% of American households welcomed a new pet into their home during the pandemic. Pandemic puppies are a real thing,” Machell said.“I think it offers a great addition to the tools I have at my disposal. Telehealth can be used very much the same way,” said Dr. Douglass Kratt, president of the American Veterinary Medical Association. The AVMA serves roughly 96,000 veterinarians across the country. They've been through a lot this year, adjusting to new norms, like all of us. As in human medicine, they've had to perfect, or initiate virtual options.“It doesn’t replace your veterinarian. What it does is help your vet better serve you and your family member,” Kratt said.Kratt admits there are some obvious challenges.“I can’t hear if your dog is coughing, I can’t listen to the heart and lungs via telemedicine so that wouldn’t be amenable,” Kratt said.He says, however, it's effective overall, and especially worthwhile if it's with your established vet. But if you don't have one, Vetster and other businesses like it aim to help.“There are so many pets and pet owners who sometimes sit on things and aren’t sure if they need to go into a clinic, really appreciate that piece of mind in the middle of the night that no, you don’t need to pack yourself up and get into a vet clinic. This is something you’re okay to wait until the morning,” Machell said.And she says they're prepared to help all animals from pocket pets to exotic and large animals. It’s yet another adjustment and another pivot in 2020. 3131

When Hurricane Michael made landfall Wednesday as a Category 4 storm, it brought 150 miles per hour winds, 14-foot storm surges, flash floods and heavy rains.But news of this coming disaster also brought charities and volunteers to the scene to help with immediate rescues and long-term recovery. You can assist these efforts by clicking the 'Take Action' button below or through?this link.If you are in the hurricane's path or had to evacuate, you can let friends and family know that you are safe through the American Red Cross Safe and Well page and Facebook's Safety Check on their Hurricane Michael Crisis Response page. Both of these tools can also be used to check on people you know in the area. 726

Widespread flash flooding along small streams, urban areas, and roadways is expected to begin this afternoon into Thursday from far eastern Texas, across Louisiana and Arkansas. This will also lead to minor to isolated moderate freshwater river flooding. #Laura pic.twitter.com/z71y3icU29— National Hurricane Center (@NHC_Atlantic) August 26, 2020 356