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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

While Tuesday's election wasn't quite the "Blue Wave" that Democrats had hoped for, the Democratic Party won a majority of seats in the U.S. House once the new Congress is seated in January. Democrats needed to turn over at least 23 Republican seats for a total of 218 and the party claimed 222 on Tuesday night, according to numbers from CNN.Although Democrats will lose seats in the Senate, taking the House gives Democrats the ability to conduct investigations, which could pose issues for President Donald Trump pending the result of Special Counsel Robert Mueller's investigation. Ushering in a crop of new Democrats into the House, Alexandria Ocasio-Cortez, 29, will become the youngest woman in history to be elected to Congress. She upset New York Democratic Rep. Joe Crowley in the primary election earlier this year. Michigan Democrat Rashida Tlaib and Ilhan Omar, the Minnesota Democratic-Farmer-Labor Party's nominee, were elected on Tuesday as the first Muslim women in the House. Former Tennessee Titans linebacker Colin Allred, a Democrat in Dallas, defeated incumbent Pete Sessions to win his first time as a candidate.  1184

When Dr. Harold Bornstein described in hyperbolic prose then-candidate Donald Trump's health in 2015, the language he used was eerily similar to the style preferred by his patient.It turns out the patient himself wrote it, according to Bornstein."He dictated that whole letter. I didn't write that letter," Bornstein told CNN on Tuesday. "I just made it up as I went along."The admission is an about face from his answer more than two years when the letter was released and answers one of the lingering questions about the last presidential election. The letter thrust the eccentric Bornstein, with his shoulder-length hair and round eyeglasses, into public view."His physical strength and stamina are extraordinary," he crowed in the letter, which was released by Trump's campaign in December 2015. "If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency."The missive didn't offer much medical evidence for those claims beyond citing a blood pressure of 110/65, described by Bornstein as "astonishingly excellent." It claimed Trump had lost 15 pounds over the preceding year. And it described his cardiovascular health as "excellent."The White House didn't respond to a request for comment about Bornstein's claim.Later, as questions mounted over the health both of Trump and his rival Hillary Clinton, Bornstein offered a more businesslike assessment, listing things such as Trump's height, weight and prescription medications.He later told CNN's Drew Griffin he'd dashed off the first letter as he was seeing patients."I was just rushed for time," he said in September 2016. "I had people to see."He insisted then that the words were his own."Did I really write that letter? Yeah," he said.Now, as Bornstein re-enters the spotlight claiming Trump's ex-bodyguard Keith Schiller robbed his office when Schiller retrieved Trump's medical records, the story behind the letter is becoming clearer."That's black humor, that letter. That's my sense of humor," he said. "It's like the movie 'Fargo': It takes the truth and moves it in a different direction."He said Trump read out the language as Bornstein and his wife were driving across Central Park."(Trump) dictated the letter and I would tell him what he couldn't put in there," he said. "They came to pick up their letter at 4 o'clock or something." 2369

While travel advice abounds for the best times to buy the most affordable holiday plane tickets, flying during some of the year's busiest travel periods generally isn't cheap.In this era of packed airplanes, smaller seats and fees for extra leg room, what airline is going to offer inexpensive fares around Thanksgiving, Hanukkah, Christmas and New Year's? Common business sense dictates that high prices will follow high demand.What are procrastinating travelers to do besides drive or take the train to get to their destinations? CNN checked with airfare experts for some general advice and ways to dull the price pain: 644

WHITESTOWN, Ind. -- Family and friends gathered Saturday to salute and lay to rest a Whitestown, Indiana veteran who was buried in the wrong grave for nearly 12 years. Family members discovered the casket of Charles Bovenschen missing when they went to bury his wife in the same burial plot earlier this year at the Lincoln Memorial Gardens. Bovenschen passed away in 2006. His wife, Mary, died on February 18. A few days later, the cemetery found Bovenschen's casket buried in the wrong plot. The cemetery covered the costs of Saturday's ceremony, even providing a new casket for Bovenschen for him to be laid to rest next to his wife. Charles and Mary are now together forever.The troubling discovery could be the result of the business practices of the previous cemetery operator which oversaw several sites including Lincoln Memory Gardens. 892