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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

When it comes to voting, laws, deadlines and Election Day minutiae vary state-by-state, and there's some important things to know before you head to the polls.Here's a rundown of some important questions (and answers) for voters. 237

With Christmas right around the corner, many businesses around San Diego County are getting ready to open their doors to sell fresh Christmas trees. Many of the farms begin welcoming customers the day after Thanksgiving, when people typically start decorating for Christmas. Check out the list below to find out where you can grab a fresh Christmas tree:  378

Wisconsin voters are heading to the polls on Tuesday for primary elections, and Democrat voters will select from a crowded ballot of gubernatorial candidates.A total of 10 candidates are on the Democratic primary ballot — but one of them is telling voters to skip his name."I could never imagine that I would be asking people not to vote for me," candidate Andy Gronik said.Gronik withdrew from the race last month, but not before ballots were printed. "I've already received some emails from people who have voted for me, and they were disappointed to learn I wasn't in the race," Gronik said.Dana Wachs is also still on the ballot, in the last spot, but he's also withdrawn as well.There are eight other candidates that hope to go up against Gov. Scott Walker in November: Matt Flynn, Tony Evers, Josh Pade, Mike McCabe, Paul Soglin, Kathleen Vinehout, Mahlon Mitchell and Kelda Roys.Some Wisconsinites did not even know who was running."What I had in mind is to Google it tonight for a little bit of information before I go vote tomorrow," Walker's Point voter Simon Rodrigeuz said. Others said it was hard to narrow it down."There was definitely a lot to pick from. A lot of them are good too," Lisa Vulpas saidThat's why candidates are using every second before the election. Roys went to Milwaukee Public Market this Monday afternoon as a last push before the polls opened on Tuesday."We have been communicating with voters more and for longer periods. We have been on TV for almost a month," Roys said.Mitchell rallied his volunteer door knockers in Milwaukee Monday evening."What distinguishes us is, yes we are running a statewide campaign, but we are running it like we are running a local election. And that is to get out and talk to people," Mitchell said.  1822

White House press secretary Sarah Sanders privately berated the White House communications and press staff Friday after a leak the previous day of comments by aide Kelly Sadler about Sen. John McCain, according to several sources familiar with the meeting.In discussing McCain's opposition to CIA nominee Gina Haspel, Sadler,?a special assistant who handles surrogate communications for the White House, said in a private meeting Thursday that it doesn't matter "because he's dying anyway." It was a joke that fell flat, a White House official told CNN. 571