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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

With a population density of six people per square mile, few places are quite as suited to ride out COVID-19 as Wyoming.But in the south-central part of the state, close to the Colorado border, sits a ranch that might offer the best accommodations of all.At ,000 per night, renting out Magee Homestead might not be for everyone, but for the clients it does attract, it offers an opportunity to quarantine with family while offering the ability to vacation with fly fishing, archery, and horseback riding.“The decision was either to open or not,” said ranch proprietor Jeremy Belnap. “Then, we slowly started to get inquiries for families wanting to get away.”Like so many businesses across the country, the ranch had to answer a difficult question during the months of March and April.“We had originally chosen to close the ranch for the season and open back up for the 2021 season,” said Belnap.With 7,500 acres of land to tend to and dozens of living spaces that require electricity, the prospect of closing was daunting and carried loads of overhead.“Financially, we suffer if we close the night with two or four guests on property,” Belnap said. “We have a staff of 45 dedicated people. We spend that much on labor in a day so it can cripple you.”As it was preparing to close, however, the ranch started getting calls from families, some of whom had stayed at Magee Homestead previously, that were interested in renting the entire ranch out.After some consideration, Belnap and the staff made the decision to switch their business model to accommodate the buyouts, allowing them to stay open while offering the families a chance to stay safe away from home.“It’s like we’re quarantining together,” said Belnap. “[It was] a light bulb moment. We took enough phone calls to say this could really make sense.”At capacity, the ranch can house up to 12 couples at a time. At approximately ,000 per guest per night, it requires a sold-out crowd on each night to reach its revenue ceiling, but Belnap says the buyouts offer more revenue with fewer question marks, and it is something they plan to continue once the worst of COVID-19 passes.“It’s very efficient,” said Belnap. “It’s a lot of fun having a family here for entire week, where you really get to know the family and the kids.” 2297

Will Power won the 102nd running of the Indianapolis 500 on Sunday afternoon, but another major story throughout the race was the number of crashes during the race.In all, there were seven different crashes involving eight different cars, after nearly 1/4 of the race had been run. Several fan favorites were also taken out of the race, including Danica Patrick and Tony Kanaan.It started when reigning Indy 500 champion Takuma Sato and the No. 33 of James Davison came into contact in Turn 3 on lap 48. Both men were checked and released from the infield hospital. 573

With increased expenditures and decreased tax revenues, the debt owed by the US federal government is expected to exceed the GDP of the US in 2021, according to a government analysis.On Wednesday, the Congressional Budget Office released the updated figures showing that the federal government’s debt is projected to be 104% of the size of the economy in fiscal year 2021. 2021 is expected to be the first time since 1946 that the amount of debt is larger than the size of the economy.The CBO’s projection shows that the debt is expected to remain larger than the size of the economy through the upcoming decade.For several decades following World War II, the amount of debt the US owed relative to the size of the economy decreased, bottoming out in 1974 at 23%. The US debt began increasing in the 70s and 80s as balanced budgets became more of an exception. The last time the US had a balanced budget was in 2001. While the US debt burden decreased for most of George W. Bush’s presidency, it began to skyrocket amid the last recession.The CBO says that while 2020 saw a slight decline in revenue, the year saw a massive increase in government spending amid the coronavirus pandemic.To see the full analysis, click here. 1231

While many Americans will sit down and enjoy a traditional turkey dinner on Thanksgiving, some will opt to skip the tradition. Although many, if not most, major chain restaurants will be closed on Thanksgiving, there will be plenty of options for those opting to skip a meal at home. While some restaurants will be offering their standard menu, others will feature a special Thanksgiving Day menu for those just not wanting to cook. Here is a list of major chain restaurants opting to open for Thanksgiving (hours and participation vary):Boston Market: Boston Market fans have two options for Thanksgiving: Participate in the restaurant's Thanksgiving Day menu, or have the restaurant cater a meal at home. To see the full Thanksgiving menu, click here. Buca di Beppo: Like Boston Market, Buca di Beppo is offering diners the option of enjoying a traditional Thanksgiving meal in the restaurant, or by catering. Click here to see the options. Cracker Barrel: Cracker Barrel calls Thanksgiving its "busiest day of the year" as the company said all of its 647 locations will be fully staffed for Thanksgiving. For .99 for adults, and .99 for children, the restaurant is offering its Homestyle Turkey n’ Dressing Meals for in-store guests. The meal comes with gravy, a sampling of sugar cured ham, sweet potato casserole, cranberry relish, choice of a country side, a refillable beverage, buttermilk biscuits or corn muffins and a slice of pumpkin pie for dessertCracker Barrel as is offering its Heat n’ Serve Holiday Family Meals and Homestyle Turkey n’ Dressing Family Meals as a to-go option.Denny's: Most of its locations will have its standard menu available. Among the menu items, Denny's offers a turkey and stuffing meal. Fleming's Prime Steakhouse: For , guests can enjoy a three-course turkey dinner that includes all the traditional fixings. Click here for reservations and details. Golden Corral: Golden Corral will be open with a special Thanksgiving buffet, among other entrees. Prices varies by location. Click here to see the buffet menu. Ruth's Chris Steak House: The steakhouse will have a special 3-course dinner starting at .95 with all of your holiday favorites, including: Oven-roasted turkey breast; sausage and herb stuffing; sweet potato casserole; and pumpkin cheesecake. Reservations are available by clicking here. Ted's Montana Grill: Most Ted's Montana Grill locations will be open, and offering a special Thanksgiving Day menu, featuring a roast turkey feast for . Ted's will also have a select menu of other items, including burgers and steaks. Its menu and a list of participating locations is available here. Waffle House: Almost every Waffle House locations offers hash browns and other classic items 24 hours a day, 365 days a year, including Thanksgiving.  2983