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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 a young sperm whale washed up on a beach in southern Spain, scientists wanted to know what killed it. They now know: waste -- 64 pounds of it. Most of it plastic, but also ropes, pieces of net and other debris lodged in its stomach.The discovery has prompted authorities in Murcia, Spain, to launch a campaign to clean up its beaches."The presence of plastic in the ocean and oceans is one of the greatest threats to the conservation of wildlife throughout the world, as many animals are trapped in the trash or ingest large quantities of plastics that end up causing their death," Murcia's general director of environment, Consuelo Rosauro said in a statement.A sperm whale's diet is usually comprised of giant squid. But the 33-foot long mammal that washed up on the beach of Cabo de Palos on February 27 was unusually thin. 839

With millions of Americans set to lose a weekly 0 unemployment supplement this week, leaders in Washington are discussing another stimulus package that could extend the supplement for the unemployed. The 0 a week program from the federal government was added to state unemployment benefits.Leaders on Capitol Hill also are pushing for a second round of stimulus checks. While it appears Democrats and Republicans are in agreement that there should be another stimulus bill, compromising to the details remains an issue.On Tuesday, President Donald Trump said that he is looking at continuing an unemployment supplement, but at of 70%. Trump said that he and other GOP lawmakers believed that the supplement gave Americans an incentive to remain unemployed.“We want to have people go back and want to go back to work as opposed to be sort of forced into a position where they're making more money than they expected to make and the employers are having a hard time getting them back to work,” Trump said. “It still worked out well because it gave people a lifeline, a real lifeline. Now we're doing it again.”Senate Minority Leader Chuck Schumer agreed that an unemployment supplement is needed as unemployment levels remain in double figures. Democrats in the House passed a bill in the spring that would have extended the added unemployment through the end of the year. The GOP-held Senate has not considered the legislation.“It makes no sense to cut back at a time when we have over 20 million unemployed and we have the greatest unemployment crisis since the Great Depression,” Schumer said in an interview with CNN. “To cut back on unemployment insurance makes no sense whatsoever. That's what they're proposed. In the other proposal, we'll pay people to go back to work. Well, those who go back to work are getting the salary.”Senate Majority Leader Mitch McConnell suggested that an agreement is still a ways off. He also hasn’t signed off on an unemployment supplement, and says that his focus is to get workers back to work rather than provide supplemental unemployment. McConnell, however, said that his proposal would include a second round of stimulus checks. Details of that plan are not available, but McConnell previously said a second round of stimulus would include fewer Americans. With coronavirus cases remaining at high levels and large gathering spaces forced to operate at reduced capacities, it is hard to imagine employment levels reaching pre-coronavirus levels. McConnell told reporters earlier in July that the next round of stimulus funds should cover Americans making less than ,000 per year, which is far lower than the threshold for stimulus funds during the last round of aid, which many Americans received in April and May.McConnell said on Tuesday that the Senate is also looking at replenishing the Paycheck Protection Program, which gave companies funds to help them make payroll during the coronavirus pandemic.“With the majority of businesses expected to exhaust their initial paycheck protection funding this summer, we'll also be proposing a targeted second round of the PPP with a special eye toward hard hit businesses,” McConnell said. “And speaking of building on what worked in the Cares Act, we want another round of direct payments, direct payments to help American families keep driving our national comeback." 3375

WILLIAMSVILLE, NY — Rep. Chris Collins, who was charged with insider trading Wednesday, has announced in a statement that he will be suspending his campaign for re-election to Congress in New York's 27th District. Collin's Statement: 266

When it comes to things like the economy or the military, the United States is considered among the strongest countries in the world.But when it comes to education, the U.S. isn’t making the grade, says Dr. Tanji Reed-Marshall with the Education Trust, a Washington D.C.-based group that aims to pinpoint and fix problems and inequities in education.Through nationwide research, Dr. Reed-Marshall found fixing our schools’ funding could be the ticket to better curriculums, improving classroom leadership and creating quality education in America."It's really important for us to understand how we think through where dollars go," says Dr. Reed-Marshall.Dr. Reed-Marshall says the billion in federal funding is not enough and isn’t going to the right places."In this country, zip code still tells the story about what you're likely to receive and the quality of it," says Dr. Reed-Marshall.Teacher Chrystal Miller stresses the notion that all areas aren’t created equal when it comes to getting a piece of the education pie. If she had to give education funding an overall grade, she says it’d be a D or an F.Miller came from a rural public school in Arkansas to the Washington Leadership Academy, a public charter in D.C. She says the difference in zip code is night vs day, and it shouldn’t be that way."Schools and students should be funded based on their need and not necessarily because you're at this zip code or you have this kind of family background or this kind of economic status,” Miller says. According to research by the Education Trust, students who live in lower income areas get about ,800 fewer tax dollars per student.Dr. Reed-Marshall says tax dollars drive education dollars. She believes there needs to be equal distribution of the tax dollars to raise the U.S. to the top of the ranks and in order to create an even and quality playing field, regardless of where students live. 1919