Month: April 2010

Murray Waas takes a look at health insurance companies’ practice of recission.

INSURERS’ ANATHEMA: BREAST CANCER AND PREGNANCY

The cancellation of her health insurance in June 2008 forced Robin Beaton to delay cancer surgery by five months. In that time, the tumor in her breast grew from 2 centimeters to 7 centimeters.

Two months before Beaton’s policy was dropped, Patricia Relling also was diagnosed with breast cancer. Anthem Blue Cross of Kentucky, a WellPoint subsidiary, paid the bills for a double mastectomy and reconstructive surgery.

But the following January, after Relling suffered a life-threatening staph infection requiring two emergency surgeries in three days, Anthem balked and refused to pay more. They soon canceled her insurance entirely.

Unable to afford additional necessary surgeries for nearly 16 months, Relling ended up severely disabled and largely confined to her home. As a result of her crushing medical bills, the once well-to-do businesswoman is now dependent on food stamps.

“It’s not like these companies don’t like women because they are women,” says Jeff Isaacs, the chief assistant Los Angeles City Attorney who runs the office’s 300-lawyer criminal division. “But there are two things that really scare them and they are breast cancer and pregnancy. Breast cancer can really be a costly thing for them. Pregnancy is right up there too. Their worst-case scenario is that a child will be born with some disability and they will have to pay for that child’s treatment over the course of a lifetime.”

There is supposed to be an art to setting rates for insurance. It’s called ‘underwriting.’

Underwriting may also refer to insurance; insurance underwriters evaluate the risk and exposures of potential clients. They decide how much coverage the client should receive, how much they should pay for it, or whether even to accept the risk and insure them. Underwriting involves measuring risk exposure and determining the premium that needs to be charged to insure that risk. The function of the underwriter is to acquire—or to “write”—business that will make the insurance company money, and to protect the company’s book of business from risks that they feel will make a loss. In simple terms, it is the process of issuing insurance policies.

Once an individual receives a proposal, agrees to it, and signs a contract, the insurance company bears the risk of a policy holder becoming pregnant or getting breast cancer. It’s true that the underwriter proposes a premium based in part on information obtained by the prospective policyholder, and that fraud is possible. The individual could hide the fact that they are already pregnant, for example. Or, they could fail to disclose that they’ve previously been diagnosed with cancer and that it is in remission. However, the insurance companies haven’t limited themselves to looking for such obvious fraud. Once they discover that a policyholder has been diagnosed with breast cancer they automatically look to cancel the policy on any pretext that can be found. It’s even computerized (and, thus, automated):

As part of his investigation, [Jeff] Isaacs, [the chief assistant Los Angeles City Attorney], has sought information from WellPoint about its use of algorithms to single out women with breast cancer or who are pregnant. The company has fought him vigorously and so far largely kept information from him, Isaacs said.

But in response to an inquiry last year from the House Energy and Commerce Committee, which was investigating rescission, WellPoint said that it initiates a claims review every time policyholders receive medical treatment for certain conditions. The company listed diagnostic codes that could trigger investigations. One was for breast tumors.

During an audit of Anthem Blue Cross by the California Department of Managed Health Care, company employees showed regulators internal records revealing that pregnant women also automatically had their medical histories examined.

Let’s think about this. If a policyholder failed to disclose some preexisting condition (like treatment for acne) that would have led the underwriter to offer a slightly higher premium, I can see making some adjustment in the premium. The insurance company would agree to honor their commitment to cover the cost of breast cancer treatment or pregnancy, but they’d ask for a little more money to more accurately reflect the risk they faced when they issued the policy. I think that’s fair. But that’s not what they do. They look for any minor flaw in the paperwork as an excuse to drop coverage. And they do it to women who are in the greatest need. They do it to unborn babies, for chrissakes. What does the anti-choice crowd think about that?

The company [WellPoint] prides itself on being one of the United States’ largest corporations with women at the helm. Besides Braly, two high-powered, politically connected women sit on WellPoint’s board: Susan Bayh, the wife of retiring Democratic Sen. Evan Bayh of Indiana, and Sheila Burke, who was chief of staff to former Senate Republican leader Bob Dole.

Is anyone going to miss Evan Bayh?

And, if you’re thinking there is too much big government regulation in the health care reforms, think again.

In his push for the health care bill, President Barack Obama said the legislation would end such industry practices. Making the case for reform in a September address to Congress, Obama specifically cited the cancellation of Robin Beaton’s health insurance. Aides to the president, who requested they not be identified, told Reuters that no one in the White House knew WellPoint was systematically singling out breast cancer patients like her.

Many critics worry the new law will not lead to an end of these practices. Some state and federal regulators — as well as investigators, congressional staffers and academic experts — say the health care legislation lacks teeth, at least in terms of enforcement or regulatory powers to either stop or even substantially reduce rescission.

“People have this idea that someone is going to flip a switch and rescission and other bad insurance practices are going to end,” says Peter Harbage, a former health care adviser to the Clinton administration. “Insurers will find ways to undermine the protections in the new law, just as they did with the old law. Enforcement is the key.”

Recissions are against the law now, but as we’ve seen many times since Bush v. Gore, it’s not a crime if no one will enforce the law.

I’m shocked*, shocked I tell you that the banks who received the most TARP money actually cut lending while raising executive salaries and bonuses! Who could have predicted that?

Banks that received federal assistance during the financial crisis reduced lending more aggressively and gave bigger pay raises to employees than institutions that didn’t get aid, a USA TODAY/American University review found. […]

USA TODAY and the American University Investigative Reporting Project used federal bank data to conduct the first comprehensive analysis comparing the behavior of 940 banks in the Troubled Asset Relief Program (TARP) and 7,400 banks outside it. Key findings about TARP’s first year:

• Lending fell. The amount of loans outstanding to businesses and individuals fell 9.1% for the 12 months ending Sept. 30, 2009, at banks that participated in TARP compared with a 6.2% drop at banks that didn’t.

• Employee pay rose. Average pay at banks getting aid rose 9.4% in the program’s first year. By contrast, non-TARP banks increased salaries 1.8%.

• Cost-cutting limited. Banks in TARP cut costs less than those outside the program. Government-aided banks increased branches by 2.7% while non-TARP banks cut branches by 1.2%.

Hey, they held a party at taxpayer’s expense. Did this happen because former Bush Treasury Secretary Hank Paulson did not employ adequate oversight of the manner in which TARP funds were used? More likely than not, I’d say. Whenever you have a lack of transparency and accountability the risk of fraud and abuse increases dramatically. Like the unregulated financial derivatives sector. Isn’t that right Goldman Sachs?

So viva le bank bailout funds! If your financial institution received them, that is. If you are a US citizen you have to wonder why Paulson was allowed to give away the farm just to prop up a bunch of white collar criminals?**

* I lied. Nothing the banksters do shocks me anymore.

** Actually considering Paulson’s deep connections to Wall Street, you don’t really have to wonder about that at all.

In the category of: This Should Surprise No One:

“Barely 6 1/2 months before the midterm elections, an internal investigation by the Republican National Committee has revealed that the organization is beset with questionable financial management and oversight and is spending more money courting top-dollar donors than it raises,” the Washington Times reports.

This is a perfect metaphor for the Republican Party as a whole. Think about it. It’s a perfect fit.

It seems like a foregone conclusion that Obama will soon sign a financial regulatory reforms bill. He may even pass it with significant Republican support. Will success breed success? Is the Party of Hell No strategy breaking down?

Watch this:

You can’t parody these people.

Just after I have committed myself to living in my home for the rest of my life and started to renovate and insulate it comes the joyous news by post that the road planning authorities want to drive a 50M wide dual carriageway though my home. The map above shows a number of proposed routes around the town of Blessington on the edge of Blessington lake. At this stage in the planning process the map only shows a number of 300M wide corridors within which the new road could be situated.  The Blue Corridor runs right through my house. The cyan, red, blue and (barely visible) grey corridors run right through my brother-in-law’s farm rendering it likely to be inoperable or uneconomic as a working farm.

One of the routes also runs through the largely worked out quarries of Cement Roadstone Holdings Limited (CRH), one of the largest building materials companies in the world which employs 80,000 people and has not been behind the door in supporting politicians and parties it favours. CRH have been responsible for the illegal quarrying of much of Glen Ding and claims to have known nothing about the dumping of hundreds of thousands of rubbish there. Guess which route is unlikely to be chosen?
Obviously there are a lot of NIMBY reasons why no one would like to have a dual carriageway (basically a motorway but with some direct access for local roads) running through their property – especially in what has up to now been an idyllic rural area frequented by tourists and day trippers from Dublin.  However the planning process which has led to these proposals almost defies belief and one can only surmise that the planning department is desperately trying to make work for itself and justify its continued existence now that most of the major national road re-development schemes have been completed.

The official Feasibility Report (PDF) for the road replacement scheme acknowledges that Blessington (population 4,000) is the only town on the route from the Embankment, Tallaght, (outside Dublin) and which is planned to terminate at Hollywood, a village with two pubs, no shop and a surrounding population of 700. So it is not as if the planned road is linking major population centres.  

Moreover, Blessington, an historic tourist and recreation centre, is cradled in a valley between Blessington Lake (aka Poulaphouca reservoir) and Glen Ding and Deer Park – a range of glacial moraine hills which also contains the remains of Viking era ring forts and which is an important habitat for wild deer and goats.  There is very little room for any major road to bypass Blessington without impinging on these outstanding recreational resources and visual amenities. While there are difficulties with the existing road, there are no problems which cannot be resolved by enhancing it at particular bottlenecks along its route.

I had a conversation with the N81 road re-development scheme engineer at an exhibition to publicise the proposals a few days ago, and what follows are the main points I put to him:

1. The future traffic projections make no allowance for rapidly diminishing world oil supplies, the rapid increase in fuel costs and the impact of increasing the potential for road traffic on our carbon footprint and on climate change.  It is thus contrary to public policy and the common good.  The focus should be on improving public transport – either through an improved bus service or an extension of the Luas – a road based light rail scheme which is currently being extended to Saggart – the nearest town to Blessington on the way from Dublin.  It should be noted, in this regard, that much of the existing N81 road route follows the old Dublin Blessington Steam Tram route which was closed in 1932. We are therefore going backwards, not forwards, in creating an ever greater dependency on private as opposed to public transport
2. Kildare County Council should not be the lead local authority planning the route as most of the route is through Wicklow and this militates against the democratic accountability of the planning process. Wicklow County Council has previously attempted road realignment schemes in the area and have discontinued them in the face of widespread public opposition.  The introduction of Kildare County Council as the lead authority could be interpreted as an attempt to bypass such popular opposition in the area.
3. The traffic estimates appear to assume further population and commercial traffic growth.  In fact the population of Blessington is static and the local sand and gravel quarries are closing or downsizing resulting in much reduced commercial traffic.  (The engineer in charge of the project agreed that traffic surveys showed a significant decline in traffic on the route in recent years).
4. The hinterland beyond Blessington is sparsely populated poor agricultural land and with no further commuter towns of note.  Baltinglass and Tullow – the next towns beyond Hollywood – are small, 25-40 KM away and are not included on the National Spatial Strategy as population growth centres – and neither, for that matter, is Blessington.  On what basis therefore could the development of a 50M wide dual carriageway be deemed to be necessitated by the National road planning process?
5. In general, there is no significant congestion at the moment – even at rush hour. The current Tallaght bypass dual carriageway (which the new road is to connect to) is itself the biggest congestion point. If there is no plan to upgrade it to Motorway standard, any upgrade of the N81 simply exacerbates existing congestion at this point.
6. What little congestion there can be is mainly at Jobstown (where the current road reduces from from 4 to 2 lanes), City West, Crooksling, and Brittas.   This is caused by a winding, twisty road with few separate lanes for turning right – which means that any car turning right can block all traffic behind it until such time as gap appears in oncoming traffic.. This area is also prone to water run-off from the surrounding hills and icing in winter making it a safety hazard. The major public benefit from an enhancement/realignment of the road is in this section.
7. The road between Brittas and Blessington is wide and straight for the most part and better utilisation of the existing space would enable the provision of a third lane for overtaking, climbing, and turning right at selected locations.  This section should at most be widened, not replaced, and much of it could be widened to 4 lanes without difficulty.  It is questionable whether 4 lanes are required for its entire length in any case, and consideration should be given to providing 3 lanes with an alternating overtaking lane where widening to four lanes is difficult.
8. What little rush hour congestion there can be in Blessington village itself can best be alleviated by the extension of the inner relief road to the Hollywood road as initially planned. The junction of the inner relief road with the N81 north of Blessington should also be upgraded to a roundabout thus avoiding congestion created by there being no separate right turning lane there. This route would also avoid encroaching on Glen Ding and the scenic areas around it which are a vital scenic and historic amenity for the Blessington community and the many tourists and day trippers to the area.
9. The red, blue and grey routes through Cross cool harbour (on the map above) are particularly objectionable and egregiously damaging to the environment and will hugely degrade a high amenity and Special Protection Area near Blessington Lake and destroy several farms and houses as well as passing close to two schools.  In addition the routes also cut directly through the winter nesting and grazing sites of colonies of Hooper Swans and Brent geese which migrate from Iceland and Greenland respectively.
10. The official Feasibility Report (PDF) claims that an average speed of 80 KPH is desirable for national roads and that the current N81 route only achieves 62KPH. However the average road speed tests conducted in conjunction with the Feasibility Study show that if the Blessington town section from the Red Lane junction to the roundabout south of Blessington is excluded, the average speed rises from 62 to c. 70 KPH. Indeed, based on the same data, the average speed from Crooksling to the Red Lane junction is 83KPH – which more than meets that notional national target, and indicates that the primary areas in need of improvement are the section around Blessington town and the route from Brittas to Tallaght. In addition the National Road Needs Study level of service guideline of 80 KPH applies to inter-Urban routes when neither Blessington nor Hollywood can be considered urban areas.
11. All the potential routes chosen for the new road are very winding and add considerably to the total distance thus offsetting any time gains through increased speed.
12. The Cyan route (Brittas-Blessington) is least deleterious to the environment as much of the route is through quarries which are closed or nearing the end of their working lives.  Many of the worked out quarries are very environmentally degraded and a well designed road here could actually improve the environment in some respects.  Indeed the sand/gravel geological composition of the area would facilitate the sinking of the road below the surrounding hills and reduce the environmental, noise and visual impact of the road – whilst the sand/gravel extraction facilitated by the road building could offset some of the development cost and carbon footprint.

As a former Chairman of Blessington and District Community Council (a voluntary body as there is no statutory Town Council for Blessington) I spent many years fighting against Cement Roadstone Holdings Limited (CRH) and often against the direct opposition of the Wicklow County Council which, in our view, had an altogether too cosy relationship with said company. CRH is one of the largest building materials companies in the world and employs 80,000 people and has not been behind the door in supporting local politicians and parties it favours.

CRH deserves a story all of its own, but suffice to say here that it’s former chairman was closely involved in the dodgy finances of disgraced former Taoiseach, Charles Haughey, managed to buy the historic Glen Ding from the state for a song without public competition, proceeded to simply remove most of it in the form of open cast mining of sand and gravel in breach of its planning permission and devastating an area of c. 1 square mile, and then mysteriously didn’t realise that its lorry drivers where bringing back hundreds of thousands of tons of waste which was then illegally dumped in their quarries.

The relevance of all this to this story, is that the CYAN route – which would least impact the local environment around Blessington lake – also happens to impinge on the CRH quarries which are now largely mined out and resemble something of a moonscape. From an environmental point of view a route through those largely worked out quarries, but avoiding what is left of Glen Ding would be the least environmentally damaging. However given the past close relationships between CRH and the local authorities, I wonder which route is also least likely to be chosen?

The conventional wisdom is that President Obama’s nominee to replace retiring Justice John Paul Stevens won’t change the Supreme Court much, since Justice Stevens is part of the Court’s progressive wing and President Obama’s choice is likely to be of a similar stripe.  That thinking is dead wrong.  The next nominee could profoundly change the Court’s jurisprudence in ways that defy conservative-liberal labels and have a lasting impact.

The next nominee must, of course, be well qualified and committed to the Constitutional values of liberty, fairness, and equal justice for all.  She or he must be someone who approaches each case with an open mind and an unbiased eye.  But within those bedrock parameters, there is room for watershed change.  President Obama has the opportunity to nominate a constitutional visionary—a justice who charts new pathways, crafted for America in the 21st century.

A constitutional visionary is someone who sees the ways in which our society is evolving and articulates a jurisprudence—sometimes over the course of years or decades—that applies the Constitution’s text and principles to engage that new reality.  The term is ideologically neutral, with past examples coming from both parties’ nominees.

Consider, for example, Justice Hugo Black, a former Alabama Senator (and, remarkably, a former Ku Klux Klan member) appointed by President Roosevelt in 1937.  Serving on the Court through the Great Depression, World War II, and the Civil Rights Movement, Black saw that many of the threats to liberty and freedom that so troubled the Framers of the Constitution—suppression of free speech, government violence and oppression, taxation without representation, denial of due process and equal justice—were playing out most fiercely within states and localities.

Justice Black saw, too, that the Civil War Amendments to the Constitution, and particularly the 14th, were intended by their authors to transform the relationship between state and federal governments, forging a more cohesive and more equal nation, with the same basic rights and responsibilities for all.  Applying that history to the contemporary context, Black articulated the “incorporation doctrine,” under which almost all of the Bill of Rights restrain not only the Federal government—as was largely the case when Black first joined the Court—but also state and local governments, via the 14th Amendment.

Though Black was not significantly more liberal or conservative than his colleagues on the Vinson and Warren Courts, his constitutional vision transformed how the Constitution is lived by everyday Americans, in ways that transcend ideology.  The incorporation doctrine is accepted in all but the most extremist legal and political circles.  It protects the free speech rights of Americans—be they left, right, or center—against censorship by cities, towns, counties and states, for example.  And it is used by conservatives to assert property and gun rights, as well as by progressives to assert privacy rights and the rights of people accused of crimes.

Other constitutional visionaries have influenced the court and nation more subtly, yet in important and lasting ways.  Justice Sandra Day O’Connor, for example, a former state legislator and judge, advanced a theory of “new federalism” popular with conservatives that has hindered the federal government’s efforts to enforce civil rights and other laws against state and local governments—reigniting a trend that cuts against Justice Black’s jurisprudence.

Justice Harry Blackmun, for whom I worked as a law clerk, articulated a privacy jurisprudence that (however haggard) continues to protect most women’s intimate reproductive choices, and was vindicated in the Court’s Lawrence decision protecting the privacy of consensual sexual relations.  Lawrence overturned Bowers v. Hardwick, in which Justice Blackmun wrote one of his most eloquent dissents.

As a former constitutional law professor and President of the Harvard Law Review, Mr. Obama is as qualified as any President in our history to select and nominate a constitutional visionary for the coming era.  Yet the rancorous policies of today’s Senate, looming mid-term elections, and an ambitious legislative agenda will militate toward a politically “safe” choice, with incrementalist and largely unarticulated views.

That would be a mistake—first, Republican leaders have already made clear that they will attack, and may filibuster, whoever the President nominates.  More importantly, though, the challenges of today and tomorrow—preserving privacy in the age of Facebook, YouTube, and ubiquitous outdoor surveillance cameras; protecting equality in an era of genetic coding and engineering; ensuring freedom and security at a time of growing corporate power and transborder terrorism—demand fresh ideas and perspectives.

Even a transformative nominee won’t change the nine-member Supreme Court’s jurisprudence overnight, and it shouldn’t.  But the vetting of a broad range of ideas and approaches, each committed to fairness, equal justice, and our Constitution, is what our Court and the country need.

Israel has been expanding illegal settlements on occupied Palestinian land for decades, but it is only now emerging just how far-reaching this policy is. Israeli building in East Jerusalem as shown above has not skipped a beat.
It is really difficult in these times of political change, principally the election of Barak Obama as president of the US, to summarize the status of the Israeli-Palestinian conflict one year later, except to assert that the status quo, Israeli colonialism, persists. Obama’s backtracking from his optimistic Cairo speech is pulling a black curtain over Palestinian aspirations for freedom and self-determination in a  country of their own, Palestine.

A recent survey of Palestinian opinion makes clear that the Obama hope is practically dead.

Palestinian hopes that US President Barack Obama will bring an end to the Israeli occupation of Palestinian territory have significantly declined in recent months, a public opinion poll published Wednesday found.

Only 9.9 per cent of Palestinians now believe that Obama’s policies will increase chances of achieving a “just peace,” down from 23.7 per cent in October last year and 35.4 per cent in June. The poll also found that over 78 per cent of Palestinians interviewed believe the US-Israel dispute over the issue of West Bank settlements is “not serious.”

One crack in Likud government intransigence appeared when Labor ministers recently threatened to leave the government.

Labor party ministers threatened Defense Minister Ehud Barak on Sunday that if significant steps won’t be taken soon to advance the peace process, they will consider quitting the government.

Senior Labor party officials have said that this was the first time Labor ministers discussed the diplomatic freeze since the formation of the Netanyahu government “The main message from the discussion was that the status quo cannot continue,” said a senior official. “We emphasized to Barak that in the coming weeks we will reach a political decision.”

Minister Benjamin Ben-Eliezer had the harshest criticism of the government and warned of Israel’s growing international isolation, and pointed at the crisis of relations with the United States, saying it will only strengthen Israel’s de-legitimization in the world. “We must make important decisions very soon.”

Last week, the leader of the Labor party, Ehud Barak also spoke at a Memorial Day ceremony

JERUSALEM — Israel must recognize that the world will not put up with decades more of Israeli rule over the Palestinian people, the country’s defense minister said in unusually frank remarks Monday. Ehud Barak’s comments came against the backdrop of severe friction between the U.S. and Israel’s hawkish government over an impasse in peacemaking. (snip)

Barak told Israel Radio that Prime Minister Benjamin Netanyahu’s government has “done things that didn’t come naturally to it,” such as adopting the vision of two states for two peoples and curtailing settlement construction. “But we also shouldn’t delude ourselves,” he added. “The growing alienation between us and the United States is not good for the state of Israel.”

The way to narrow that gap is to embark on an Israeli diplomatic initiative “that doesn’t shy from dealing with all the core issues” dividing Israelis and Palestinians, he said. Chief among these are the status of contested Jerusalem, final borders and a solution for Palestinian refugees from the war around Israel’s 1948 independence.

In a New York Times op-ed published on Monday, even the Zionist hawk and Israel Lobby denier, former U.S. Ambassador to Israel Martin Indyk, spoke up in defense of the Obama administration concerns:  

“This is no longer just about helping a special ally resolve a debilitating problem. With 200,000 American troops committed to two wars in the greater Middle East and the U.S. president leading a major international effort to block Iran’s nuclear program, resolving the Israeli-Palestinian conflict has become a U.S. strategic imperative.”

Today, all seems quiet on the Middle Eastern front, except for those bulldozers eating up more Palestinian land in East Jerusalem. But there are also stirrings behind the scene that we don’t hear much about.

Living and working in Washington, it’s not unusual to run in to famous people. No, not "movie star famous." At least not most of the time. But people who hold important positions or people whose work and actions have made history, and made a difference in the lives of countless others.

Dr. Dorothy Height was one who fit all of the above criteria. I never formally met Dr. Height, but in my one experience with her she impressed me with the depth of her understanding, and I came away knowing a bit more about how she could work so tirelessly for so long.

A few years ago, I was a guest on an NPR show, along with Dr. Height. The show focused on the question  “What makes a healthy family?”, specifically where black families are concerned. The host asked Dr. Height for her thoughts about families like mine, with two same-sex parents.

CHIDEYA: So, Dr. Height, let’s start with you. Every year, the National Council of Negro Women puts on the black family reunion celebration and the event focuses on what you call traditional values of the African-American family. What would you say those are?

Dr. HEIGHT: Well, I think the history will show that the African-American family has always been a family that values its faith and it also has been a family that has valued education because education was so long denied. And I would say we valued our, what I would call, kinship ties. We’ve taken kinship seriously. And the extended family often is made up of people who are not exactly related, but they have a sense of kinship. And of course, we’re very much a family that has traditionally been forced into it, but also that we accept hard work. And I think we work harder.

CHIDEYA: So when you think about a family like Terrance Heath’s – two, gay men raising a son – does that fit into the traditional values structure that you’re taking about? Is it a structure that is open to families of different composition and it’s more about the energy you bring to it or do you make a distinction between different kids of families?

Dr. HEIGHT: No, we recognize that in this country we accepted the nuclear family, but we also recognize many different kinds of families. And the important thing about it is the extent of which the family cares one for the other and that they take care of each other and that they have a sense of – a commitment to being a part of life together.

I thought about that, day and those words, when I heard of Dr. Height’s passing. She has been remembered as a ceaseless worker for justice, and a giant of the civil rights movement, the women’s movement, and others. Undoubtedly, she was and is. As I remembered that one moment with Dr. Height, I understood what made her all that and more.

Dr. Dorothy Height "got it." She understood the difference between justice and "just us." That’s why Dr. Height — who is said to have attended the National Black Family Reunion every year — didn’t hesitate or equivocate when ask about gay families and whether a distinction should be made. Because when it came to family, she knew her history; she knew our history.

It’s so not strange because it’s what African Americans have done since the moment they came to North America. Only then it was slavery that ripped apart families, when a mother or father was “sold off” and separated from family for any number of reasons. And, then as now, other family members or unrelated members of the community (the “village,” if you will) stepped in to care for those — old or young — who were left behind. Maybe later in history it was the violence of lynching, or economic necessity during the Great Migration that separated families, but the basic pattern of other stepping up and creating family bonds has stayed the same.

Like I said above, it ought to go without saying, because if we stop and think about it for a minute black folks already know that families come in many configurations. And whatever those configurations are, we know the important ways members of those those families benefit from the care and support they receive. We know the importance of protecting those families, and how our communities benefit by extension. When it comes to same-sex marriage we just need to act like we know, because we — your gay, lesbian, bisexual and transgendered sons, daughters, aunts, uncles, cousins, neighbors, etc. — are family too. We always have been.

So, thank you. Dr. Height, for your understanding and for dedicating your life to working for justice — instead of stopping at "just us."

I wish that we had more African-American leaders today with your depth of understanding. It’s a shame that we don’t.

While the Daily Caller takes a look at how the Tea Party might affect various Senate races, I’d like to look at a broader set of concerns related to how our midterm elections might shake things up in both major parties.

The big enchilada is obviously Majority Leader Harry Reid’s reelection campaign. If he loses, regardless of who he loses to, it will be a big story and it will in some ways serve as a mark against the legitimacy of what the Democrats have done over the first two years of Obama’s presidency. It will also set off a battle royale between Sens. Dick Durbin and Chuck Schumer to serve as leader of the Senate. Reid is currently trailing even little known Republican challengers, and he has an eleven-point RCP Average deficit against the front-runner, Sue Lowden. However, Lowden’s health care plan of bartering chickens in exchange for medical attention is bizarre enough to make you wonder if she can stand the spotlight of a high profile campaign. This is also a race where a Tea Party candidate(s) might split the anti-Reid vote, handing him a fortuitous victory.

Next in prominence is the contest in Florida where Marco Rubio has surged so strongly that he appears to have forced Gov. Charlie Crist out of the Republican Party altogether. Yet, just as Rubio seems to be on a smooth sail to the nomination (and piling up major endorsements), the IRS and FBI announced that they are investigating his abuse of party credit cards. Could the Tea Partiers have succeeded in denying Crist the nomination only to see their champion’s campaign implode? If so, and it’s still too early to tell, could this open the door to Crist winning as an independent? And would he then caucus with the Democrats? While some may see this as good news for Democrat Kendrick Meek, he needs the right to split their votes fairly evenly. A total implosion is not in his interests.

The next most compelling Senate race is probably in Kentucky where Minority Leader Mitch McConnell has endorsed Trey Grayson, while retiring Sen. Jim Bunning has endorsed the anti-choice libertarian-running-as-a-Republican, Rand Paul. Establishment Republicans are so concerned about Rand Paul’s anti-imperial views that Dick Cheney and Rudy Guiliani have accused him of Blaming America First and having zero commitment to their endless humping of 9/11. Socially conservative Kentucky is not a likely candidate for a libertarian surge, but the polls favor Rand by a wide margin. The Democrats have a contested primary, too, between Attorney General Jack Conway and Lieutenant Governor Daniel Mongiardo. Conway appears to be the near-universal preference of progressives, but he remains narrowly behind in the polls.

Some question whether Rand Paul’s odd views can stand up to scrutiny over a long campaign. In this political environment, I believe they can, and will. And if he behaves in the Senate like his father Ron does in the House, we’ll see obstruction on an epic level that disturbs the Republicans nearly as often as the Democrats. There’s not a serious committee that the Republicans will want see Paul serve on because he will not be a reliable vote on anything.

In all three of these races, there is an unusual amount of uncertainty, and how they play out will have profound affects on our national politics. What happens to Reid will drive perceptions about Obama’s agenda leading into primary season. If he survives because of a splintering of the right between the GOP and Tea Party candidates, it will be a source of much anger and recriminations on the right.

If Rubio flames out and Crist is elected and caucuses with the Democrats, the Tea Party will earn even more wrath from the Republican Establishment. If Rubio and Crist split the Republican vote and hand the seat to Kendrick Meek, we’ll have an African-American senator from Florida, reinforcing the message that the moment has arrived for blacks to win in statewide elections.

And, if Rand Paul beats out Mitch McConnell’s hand-picked candidate, it will make the Minority Leader look foolish. If Paul wins the seat, he’ll be a thorn in the side of Senate Democrats and Republicans alike. It could be the beginning of a libertarian boomlet in the Republican Party with very unpredictable consequences on matters of military spending, foreign policy, and financial and banking matters. If a Democrat wins in Kentucky (particularly over Rand Paul), it would amplify the perception that the Tea Party isn’t helping the Republican Party regain its former glory.

Stay tuned.