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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 heavy hearts, we can confirm that Prayer Warrior was humanely euthanized following an injury in today’s sixth race on the main track.Our deepest sympathies to the Metz family and their team.— Del Mar Racetrack (@DelMarRacing) November 11, 2019 262

What's happening in the political world:Delta, United joins list of companies cutting ties with NRA-- Delta and United airlines have joined several large companies that pulled benefits offered to National Rifle Association members, following calls to boycott the organization following their response to the Parkland, Fla., school shooting.Delta tweeted that they have requested to be removed from the NRA's website: "Delta is reaching out to the NRA to let them know we will be ending their contract for discounted rates through our group travel program. We will be requesting that the NRA remove our information from their website.""United is notifying the NRA that we will no longer offer a discounted rate to their annual meeting and we are asking that the NRA remove our information from their website," United similarly tweeted Saturday.  Metlife, Symantec, and Enterprise are just some of the companies who announced they will cut ties with the NRA this week. None of the companies have given details about why or when they decided to cut ties, but the news comes as the hashtag #BoycottNRA has circulated widely on social media.Manafort indictment alleges secret payments to European politicians 1246

When Nolan Davis called his community to march for Black Lives Matter, hundreds turned up for the cause. On Saturday, he led demonstrators from a park in his hometown of Kirkwood, Missouri to the town's city center, leading chants along the way.But Nolan's protest looked a bit different than others that have taken place across the country in recent weeks — because almost all the participants were children.Nolan, 8, helped organize the protest along with his mother, Kristin Davis. According to CNN, he was inspired to lead his own protest after the two attended a few other rallies in the St. Louis area.Nolan and his mother designed a flyer to get the word out about the protest and shared it on Facebook. Nolan told CNN that he believed that about 50 people would show up to his event. But when he arrived at the park on Saturday morning, there were about 700 people ready to support his movement.According to CNN, Kristin Davis, who is white, adopted Nolan and his 5-year-old sister, Caroline, who are both Black. Their mother says that while she could never understand what her children go through, she's tried to have regular conversations about racism with them to keep them safe."We're preparing them for when they're older and taller and bigger. When they're not going to be perceived as cute little kids anymore," Kristin Davis told CNN.During the protest, Nolan held a sign that read "Kids Can Make a Change," according to photos from St. Louis-Post Dispatch. 1481

While all hands are on deck to combat the novel coronavirus, there is another virus that experts are keeping their eyes on – the EEE virus, commonly known as the "Triple E."It stands for eastern equine encephalitis.You may have heard of the virus last year when we started seeing more cases outside of Gulf Coast states, where the virus is normally seen."Triple E" can cause inflammation in the brain, which can be deadly.In 2018, the United States only had six cases of "Triple E." In 2019, that number rose to 38, an alarming number considering about a third of people who become infected are expected to die.With coronavirus at top of mind this summer, experts are concerned people may not take the right precautions for "Triple E."“You hear all about coronavirus, having to wear a mask,” said Dr. Brittany Campbell, an entomologist with the National Pest Management Association. “We've been doing social distancing for months now, with a little bit of movement. So, I can understand that everyone is a little bit exhausted from being concerned about their health all of the time. But at this time, I really encourage people to remain diligent.”This can be done by making a habit of dumping out any standing water in your yard and also protecting yourself by wearing repellent.And when it comes to how rampant "Triple E" will be this mosquito season, experts aren't exactly sure. It really depends on the temperature, climate and rain specific to each region.Massachusetts saw a large outbreak last year. The state is now looking at a bill that would have the public health department reduce the mosquito population, as a precaution. 1644

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