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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 many have people lost their jobs over the past few months, for some people, the COVID-19 pandemic caused a scenario that made it easier for them to find work. Lashaunda Garner is one of those people.“In my situation I was out of work for 16 years,” said Garner.After nearly two decades, Garner found a work-from-home job at the start of the pandemic.“As soon as I got the job, I was like ‘oh my gosh, I can do something past my disability,’” she added.Garner suffers from severe PTSD and anxiety, which makes it difficult to work in a traditional work environment.“In my case, there are certain sounds, certain smells and things that trigger your depression and when I am at home, I can limit those things,” said Garner.While work-from-home options were previously limited. During forced business closures and stay at home orders, the U.S. saw a surge in work-from-home jobs, especially call center positions.“The pandemic struck, and all of the call centers had to send their agents home. This was worldwide. This was something that never happened before,” said Alan Hubbard. “Some of the agents that were sent home in India, the Philippines and China didn’t have the physical infrastructure in order to do those jobs.”Hubbard is with the National Telecommuting Institute (NTI), which helps people with disabilities work from home. In Garner’s case, it had already helped her setup a home office and everything needed to work from home when the surge happened.“You hear people say, ‘you aren’t your job’ right, but for a lot of people, that is how they identify themselves,” said Hubbard. “That they are working, that they are productive. That is the opportunity that we try to provide.”Garner is just one example out of many people with disabilities who have been able to find work-from-home jobs and thrive in that environment over the past few months.Since the beginning of the pandemic, NTI has had a significant increase in companies come to them for help finding workers. They have four times as many available jobs to fill and have actually been able to place nearly 200 people in work-from-home jobs in the last six weeks. When, typically, it places about 50 people a month.“That is what the pandemic has done. It has opened up this opportunity for these folks,” said Hubbard.Hubbard is currently working with a dozen companies looking to hire another 240 people.Lashaunda is thriving in her current role and hoping her story inspires not just other people with disabilities, but the millions looking for work right now.“Do the best you can and fight for what you want,” said Garner. “It may take you, hopefully not 16 years, but you will end up getting it.” 2681

When Hurricane Michael barreled through Florida's Mexico Beach, it reduced the beachside town to pile of rubble, mangled structures and splintered houses.These aerial images from NOAA offer a stark look at how there's nothing left in some parts where houses once stood.Most houses in the northern section of Mexico Beach, where the canal and marina start, aren't there anymore.The pier toward the bottom of the image, isn't either.Zooming in closer on the marina, the debris from houses is piled up on the northern shore of the canal.The boat moorings, gone. And the debris field extends into the trees beyond the canal. 628

With businesses around the country reopening, customers may notice an additional expense on their bill: a COVID-19 surcharge. This new surcharge is popping up around the country and is an extra fee that businesses can add to a bill to help alleviate the financial burden placed upon them during the virus outbreak. It is meant to help offset losses due to businesses having to temporarily close, or help businesses keep up with the new requirements to reopen under health guidelines.The practice of adding an additional surcharge is legal for businesses although it may feel sneaky to customers without prior notification."Businesses would have to make decisions on their own," Kern County Administrative Officer Ryan Alsop told KERO-TV. "Simply having something on the bill at the end of the night that addresses something like a COVID-19 surcharge, possibly in addition to having signage in the restaurant, maybe something on the menu upfront."Adding a surcharge to the bill isn't the only option to help businesses during this time of reopening. Businesses could choose to raise prices overall. This has already been seen in some restaurants where expenses such as food supplies and third-party delivery fees, like DoorDash and GrubHub, have gone up considerably.Alsop points out that as a business, communicating with your customers might be the best way to maintain trust and keep your customers coming back during this difficult time."If I'm a business owner, customers are my livelihood," he said. "Those I think are points where you can engage your customers and talk to them about your business decisions."This story originally reported by Veronica Morley on turnto23.com. 1689

While not as many Americans are expected to travel for Thanksgiving as usual, 56% of Americans are intending on traveling according to data from Tripadvisor. Tripadvisor says that this year's figures are down from an estimated 70% of Americans travelling in 2019.Tripadvisor surveyed Americans from October 16 to 20, so it is possible increased travel restrictions associated with a rise in cases could scare off some from traveling by Thanksgiving. Many states are telling travelers to quarantine for two weeks before coming into contact with others. The vast majority of those traveling, 76%, say they will drive to their Thanksgiving destination, compared to just 11% who say they will fly.The survey found that 22% are staying in a hotel or vacation rental to practice social distancing from friends and family."Despite COVID-19 concerns, the majority of Americans are still traveling this Thanksgiving. The way in which consumers travel, however, will look very different from past years," said Christopher Hsi, Consumer Market Research Lead Analyst for Tripadvisor. "This year, we can expect shorter trips with smaller groups of people for more intimate, close knit gatherings. Many are taking day trips (24%) or spending one night at their destination. Americans are also continuing to avoid big cities, instead opting for warm weather and beach destinations in southern states. We do see, however, that Boomers are less likely to travel this year compared to last (29% vs. 51%)."Whether Americans can safely travel for the holidays remains up for debate, as many public health experts warn that informal gatherings have contributed to the spread of the virus, which has been killing roughly 1,000 Americans per day in recent days.“Unfortunately, the COVID-19 epidemic is worsening, and small household gatherings are an important contributor to the rise in COVID-19 cases,” the CDC said.The CDC issued guidance for holiday gatherings. Part of the recommendations say masks should be worn at holiday gatherings involving people who are not from the same household, and that guests stay 6 feet apart. The CDC also advises against handshakes and hugs.One public health expert says following these guidelines is dependent on your risk tolerance.“I am very risk tolerant,” Dr. Amesh A. Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said in August. “I am an infectious disease physician. I have taken care of people with the coronavirus. Both of my parents are physicians. I don’t take any special precautious with my parents. I don’t think they take any special precautious with me.“I think physicians might be risk tolerant, but I have not changed my behaviors with people I see regularly, other than if they’re telling me they have a fever, and then I might say ‘stay away’ because I don’t want to be quarantined and not be able to work.”Adalja agrees, however, that there is a risk in attending family gatherings, and while face coverings are effective, they're not a panacea.If you ask Dr. Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, he is opting not to see extended relatives amid the pandemic.“Personally, in our family, we will not have our family get together,” Murrays said about Thanksgiving. “I am particularly cautious. That would be our strategy. Certainly, we have avoided, on a personal level, we have avoided any indoor exposure to friends or family and have restricted any exposure at all to outdoor interaction where we can maintain 6 feet or more.” 3579