By Michelle Andrews
Kaiser Health News

WASHINGTON, D.C. — They know less than they think they know. That’s the finding of a recent study that evaluated people’s confidence about choosing and using health insurance compared with their actual knowledge and skills.
As people shop for health coverage this fall, the gap between perception and reality could lead them to choose plans that don’t meet their needs, the researchers suggest.

“There’s a concern that people who don’t have much experience with health insurance don’t protect themselves financially, and then something happens,” says Kathryn Paez, a principal researcher at the American Institutes for Research who co-authored the study. “So they’re learning through hard knocks.”

The nationally representative survey of 828 people aged 22 to 64 is part of a project to develop a standardized questionnaire that researchers, health plans and providers can use to assess people’s health insurance literacy.

The study found, for example, that while three-quarters of Americans say they’re confident they know how to use health insurance, only 20 percent could correctly calculate how much they would owe for a routine physician visit. Many people don’t understand commonly used terms such as “out-of-pocket costs,” “HMO” and “PPO,” according to the study.

The study also found that certain groups of people tended to have a tougher time using health insurance, including young people, minorities, those with lower income or educational levels and those who used health care services infrequently.

People who visit the doctor occasionally but have never been hospitalized or visited the emergency room may be overconfident they understand how health insurance works, says Paez. Likewise, people who belong to integrated health care systems where providers are generally on staff may not realize the potential complications of in-network and out-of-network coverage, among other things, she says.

More comprehensive education could help close the gap between what people think they know about health insurance and what they actually know. In the meantime, the issue brief about the study includes a consumer checklist to aid consumers in choosing a plan.

Michelle Andrews is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.

FERGUSON, Mo. (AP) — The parents of Ferguson police shooting victim Michael Brown are headed to Switzerland next week to speak at a United Nations human rights conference.

Michael Brown Sr. and Lesley McSpadden are scheduled to address the 53rd Session of the United Nations Committee Against Torture in Geneva on Nov. 12 and 13. A Saint Louis University law professor is helping to organize the trip and to solicit online
donations for the couple’s travel expenses.

The trip comes as a St. Louis County grand jury prepares to conclude its inquiry into the Aug. 9 shooting death of Brown by Ferguson officer Darren Wilson.
Family attorney Anthony Gray told the St. Louis Post-Dispatch that Brown’s parents plan to leave on Nov. 10.

PROVIDENCE, R.I. (AP) — Federal workplace safety regulators have proposed fining Ringling Bros. and Barnum & Bailey Circus $7,000 for an accident during a hair-hanging stunt that seriously injured eight acrobats in Rhode Island.

The proposed fine announced Tuesday by the Occupational Safety and Health Administration is the maximum allowed by law.

The acrobats were injured May 4 when a carabiner clip snapped, sending them plummeting 15 feet to the floor. A ninth worker, on the ground, was also hurt.

OSHA says the carabiner was overloaded in violation of industry practice and manufacturer instructions.

The circus’ parent company has 15 days to either pay the fine or contest it.

A spokesman says the circus disagrees with some of OSHA’s findings and has not yet decided whether to appeal.

United States Attorney

KANSAS CITY, Mo. – Tammy Dickinson, United States Attorney for the Western District of Missouri, announced  that Assistant U.S. Attorney Dan Nelson will lead the efforts of the office in connection with the Justice Department’s nationwide Election Day Program for the Nov. 4, 2014, general elections.

Nelson has been appointed to serve as the District Election Officer for the Western District of Missouri, and in that capacity is responsible for overseeing the district’s handling of complaints of election fraud and voting rights abuses in consultation with Justice Department headquarters in Washington, D.C.

The Department of Justice has an important role in deterring election fraud and discrimination at the polls, and combating these violations whenever and wherever they occur. The department’s long-standing Election Day Program furthers these goals, and also seeks to ensure public confidence in the integrity of the election process by providing local points of contact within the department for the public to report possible election fraud and voting rights violations while the polls are open on election day.

Federal law protects against such crimes as intimidating or bribing voters, buying and selling votes, impersonating voters, altering vote tallies, stuffing ballot boxes, and marking ballots for voters against their wishes or without their input. It also contains special protections for the rights of voters and provides that they can vote free from acts that intimidate or harass them. For example, actions of persons designed to interrupt or intimidate voters at polling places by questioning or challenging them, or by photographing or videotaping them, under the pretext that these are actions to uncover illegal voting may violate federal voting rights law. Further, federal law protects the right of voters to mark their own ballot or to be assisted by a person of their choice.

Nelson, in his capacity as District Election Officer, represents the U.S. Attorney’s Office, Western District of Missouri on the Missouri Elections Integrity Task Force. The task force, which includes local, state and federal law enforcement and election authorities, will coordinate efforts to ensure Missouri elections remain fair, secure and accessible.

In order to respond to complaints of election fraud or voting rights abuses on Nov. 4, 2014, and to ensure that such complaints are directed to the appropriate authorities, Nelson will be on duty in this district while the polls are open. He can be reached by the public at 816-426-3000.

In addition, the FBI will have special agents available in each field office and resident agency throughout the country to receive allegations of election fraud and other election abuses on election day. The local FBI field office can be reached by the public at 855-527-2847.

Complaints about possible violations of the federal voting rights laws can be made directly to the Civil Rights Division’s Voting Section in Washington, D.C., by phone at 1-800-253-3931 or (202) 307-2767, by fax at (202) 307-3961, by email to voting.section@usdoj.gov or by complaint form at http://www.justice.gov/crt/complaint/votintake/index.php.

KANSAS CITY, Mo. (AP) — A letter obtained by The Kansas City Star shows a developer withdrew plans to renovate Kemper Arena after the American Royal Association threatened a lawsuit.

The newspaper  reports an attorney for American Royal, which hosts livestock exhibitions and professional rodeos, told Foutch Brothers in a letter to quit its efforts to have Kemper Arena declared a historic structure.

The designation would have helped with financing for Foutch’s proposal to turn the arena into a youth sports facility.

Foutch and American Royal have spent months pitching plans for the future of the arena. While Foutch’s proposal would preserve the arena, plans by American Royal call for tearing it down and replacing it with a multipurpose building.

The letter claims a historic designation would negatively affect American Royal’s lease with the city for the American Royal Complex that includes the arena.

JEFFERSON CITY, Mo. (AP) — Missourians have been weighing in on an unusually large number of proposed changes to the state constitution this year.

Tuesday’s ballot features four proposals, including an amendment to base teacher evaluations largely on student performance data. Proposed Constitutional Amendment 3 is opposed by public education groups, and the sponsors have quit campaigning for it.

Proposed constitutional amendment 6 would create a six-day, no-excuses-needed early voting period for general elections, but only if the state provides funding.

Proposed constitutional amendment 2 would allow allegations of past criminal acts to be used against those facing sex-related charges involving victims under 18 years old.

Proposed constitutional amendment 10 would allow lawmakers to override a governor’s decision to freeze or slow spending on items in the state budget.

VATICAN CITY (AP) — The Vatican’s top bioethics official calls “reprehensible” the suicide of an American woman suffering terminal brain cancer who stated she wanted to die with dignity.

Monsignor Ignacio Carrasco de Paula, the head of the Pontifical Academy for Life, told the ANSA news agency on Tuesday that “dignity is something other than putting an end to one’s own life.”

Brittany Maynard’s suicide in Oregon on Saturday, following a public declaration of her motives aimed at sparking political action on the issue, has stirred debate over assisted suicide for the terminally ill.

Carrasco de Paula said “Brittany Maynard’s act is in itself reprehensible, but what happened in the consciousness we do not know.”

He cautioned that he was not judging individuals “but the gesture in and of itself should be condemned.”

DAVID KOENIG, AP Airlines Writer

DALLAS (AP) — The federal government is suing Southwest Airlines Co. after failing to reach a settlement with the carrier over charges that repairs to dozens of planes didn’t meet safety standards.

The Justice Department sued Southwest on Monday in federal district court in Washington state. The lawsuit seeks to enforce $12 million in civil penalties that the Federal Aviation Administration announced in July.

The government says that starting in 2006 Southwest hired a contractor to make extensive repairs on 44 planes to prevent the aluminum skin from cracking. The FAA says the contractor failed to follow proper procedures.

Southwest says it disputes the FAA’s charges.