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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 she married George H. W. Bush in 1945, Barbara Bush became a vocal defender of her husband, and later his children. After her passing on Tuesday, former Bush rivals joined forces to honor the former first lady. President Donald Trump was among those who had kind words for Barbara Bush on Tuesday, even though she didn't always have nice things to say about him. Bush expressed her displeasure for Trump's comments during the 2016 presidential campaign, when he called Bush's son Jeb, a Republican presidential hopeful, "low energy." 551

While there are still questions about whether trick-or-treating will happen in 2020 and how neighborhoods will make it possible, there is no question Americans like their Halloween candy.Sales of Halloween candy and chocolate at grocery stores are up 17 percent over 2019 so far this season, according to the National Confectioners Association. Total sales, including online purchases, is up 13 percent year-over-year.The National Confectioners Association, NCA, represents manufacturers and suppliers of sweet treats, gum, mints and chocolates.Their research showed chocolate is driving the increase. Halloween chocolate sales are up 25 percent over 2019 so far. The NCA released data over the summer showing chocolate was the treat of choice of Americans during the pandemic, with sales increasing five percent March through August over the same time period in 2019. Sales of premium chocolate during that time was up 12 percent year-over-year. Ferrara Candy, which makes Sweetarts, Nerds, Brach’s Candy Corn, Gobstoppers and more, said Halloween sales bring in about .5 billion in sales. In an interview with Axios, CEO Todd Siwak said their company learned a lot from the drop in sales for Easter. This was also the time many stores were closing because of lockdowns to stop the spread of the coronavirus. Even as shopping has picked up a little, they have made some changes.“As the frequency in-store is reduced by the shopper, so fewer trips but bigger baskets, we wanted to make sure we were there presenting the opportunity to consumers,” Siwak said. He added Ferrara Candy created more individually-wrapped confections and got product to stores earlier to extend the selling season.There are still about three weeks until Halloween, and the industry expects sales to increase. Siwak says about 60 percent of the sales for Halloween candy happen in the last few weeks before the holiday.The NCA data also suggested Americans are getting more excited for Halloween in 2020. They found 80 percent believe they will find creative and safe ways to celebrate this year. The response was just 63 percent in July. 2125

When Kyle and Jessica Frankenstein found out they were pregnant, they were given Sunday, October 29 as their due date — so there was always the possibility of Jessica going a few days past her due date and delivering a Frankenstein baby on Halloween. Well, it happened! Jessica gave birth to Oskar Gray Frankenstein on Tuesday, October 31, 2017 after 14 hours of labor at Winter Park Memorial Hospital. "Honestly, I didn't think he would hold out till Halloween," Jessica Frankenstein said. "My husband and I discussed what it would be like having him on Halloween and how neat it would be when he gets older."Baby Frankenstein weighed in at 6 pounds (3 kilograms), 9 ounces (255 grams) and is 20 inches (50 centimeters) long."I am utterly in love with this little man and I couldn't have imagined a more perfect baby," Jessica said.Congratulations to the happy parents. FOLLOW Kelly Bazzle on Twitter 929

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

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