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The Medicare-for-all hearing in House Ways and Means, explained

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House Democrats are holding their second-ever hearing on Medicare-for-all, as the party tries to sort out what its next big step on health care should be.

The Ways and Means Committee hearing on Wednesday differs from April’s historic hearing on Rep. Pramila Jayapal’s Medicare for All Act, which would cover every American in one government insurance plan, in two important ways: For one, it’s being held in a committee that actually has significant jurisdiction over health care policy, and two, the single-payer proposal is being reviewed alongside more incremental plans to expand health coverage.

Democrats broadly agree on expanding government health insurance to more people, but they don’t agree on whether every American should be covered by the same program, as single-payer envisions, or whether more people should simply have the option of buying a public insurance plan if they want to. Otherwise, they could continue carrying private coverage. Jayapal’s Medicare for All Act has more than 100 co-sponsors, but that is still less than half of the House Democratic caucus.

The public and even lawmakers are still familiarizing themselves with the particulars of the single-payer debate, and surveys show opinion is still moveable. Many Democrats, both members of Congress at the Capitol and voters in Iowa ahead of the 2020 election, are still undecided on the best next steps for health care reform.

“Probably a difference I would have would be whether or not … there was still an alternative for people that did not want to do Medicare-for-all,” Rep. Karen Bass (D-CA), a co-sponsor of Jayapal’s Medicare-for-all bill, told Vox ahead of the hearing. “I think it’s an important debate, and it doesn’t mean that everybody in the caucus is wedded one way or another, but if you don’t have the discussion, how do you figure out where you land?”

Recent polling of Iowa Democratic voters found single-payer Medicare-for-all trailing behind other issues, like climate change and abortion and gun control, as a “must-have” when they were evaluating 2020 presidential candidates.

Single-payer advocates feel they have long been fighting not just to sell voters on the issue, but also with their own party’s leadership to get a voice in the debate about the future of health care. As these hearings demonstrate, they have succeeded in moving their preferred plan to the forefront of the health care discussion.

But they still have persuading to do. Wednesday’s Ways and Means hearing and, maybe more important, the 2020 campaigns will be their next chance to make their case to the broader electorate.

The various Democratic health care plans, briefly explained

The official purview of the Ways and Means hearing is “pathways to universal health coverage.” House Democrats have gradually been collecting information and input about how they could construct a single-payer plan or some other expansion of government coverage since they took the majority. The Congressional Budget Office recently issued a report on the different decisions lawmakers would have to make.

“We’re all for universal health care. All of us are for universal health care. Medicare-for-all is just one way to get there,” Rep. Donna Shalala (D-FL), who was Bill Clinton’s health secretary, said. “And the question is ‘Do you want to take that route? Or are there faster, more efficient ways to get everybody covered?’ These hearings are very worthwhile.”

Her undecided House colleagues, Shalala continued, are concerned about “an upheaval in the entire health care system and that people in their districts want to protect the private health care they have, including union members.”

Democrats have a lot of ideas for what they should do next to expand health care. Vox recently examined nine different proposals in Congress. The plans fall into two categories. There are some that would replace private insurance and cover all Americans through the government. Others would allow every American to buy into government insurance (like Medicare or Medicaid) if they wanted to, or they could continue to buy private insurance.


Javier Zarracina/Vox

We learned these plans are similar in that they envision more Americans enrolling in public health plans. They would all give the government a greater role in everything from setting health prices to deciding what benefits get included in an insurance plan. Experts say all these bills would almost certainly create an insurance system that does better to serve Americans with high health care costs.

But the Democrats’ plans differ significantly in how they handle important decisions, like which public health program to expand and how aggressively to extend the reach of government. Some would completely eliminate private health insurance, moving all Americans to government-run coverage whereas others still see a role for companies providing coverage to workers. Some bills require significant tax increases to pay for the expansion of benefits — while others ask those signing up for government insurance to pay the costs.

Medicare-for-all supporters believe they have momentum on their side.

“I think more and more people are realizing that Medicare-for-all makes economic sense, and not just moral sense,” Rep. Ro Khanna (D-CA) said.

The Democratic establishment versus Medicare-for-all

Before the first hearing on Medicare-for-all in April, there was a procedural spat between the plan’s supporters and Democratic leadership. The former criticized the latter for having a heavy hand in organizing the hearing and initially leaving off any strong Medicare for All supporter from the witness list. Activist Ady Barkan was added to the panel, though, and he gave powerful testimony on behalf of single-payer at that historic hearing.

House Democrats have sidestepped any such complaints this time: Don Berwick, a former leader of the Centers for Medicare and Medicaid Services and a forceful supporter of Medicare-for-all, will testify on Wednesday. He is a powerhouse witness for the single-payer cause.

“I think Don is an all-star,” Rep. Earl Blumenauer (D-OR) told Vox. “I think he’s the best possible witness we could have for that provision.”

But the witness dispute still laid bare — once again — the very serious fractures between the Democratic establishment and the activist left pushing Medicare-for-all, a drama likely to reoccur again and again with the 2020 presidential primary well underway.

Democratic leaders like to say that everybody inside their party is in favor of expanding health care; they’re just debating over how to do it. Still, Nancy Pelosi herself has sounded skeptical about single-payer specifically in interviews over the last few months. In an interview with Rolling Stone in February, she repeated a few times: “How do you pay for that?”

She described herself as agnostic to the Washington Post in April:

“I’m agnostic. Show me how you think you can get there,” Pelosi said in an interview with The Washington Post. “We all share the value of health care for all Americans — quality, affordable health care for all Americans. What is the path to that? I think it’s the Affordable Care Act, and if that leads to Medicare for All, that may be the path.”

She also suggested that Medicare-for-all had become more of a buzzword among political activists in the run-up to the 2020 campaign, a loosely defined concept that few people understood in concrete terms.

“When most people say they’re for Medicare for All, I think they mean health care for all. Let’s see what that means. A lot of people love having their employer-based insurance and the Affordable Care Act gave them better benefits,” said Pelosi, who shepherded the ACA through Congress in 2009 and 2010 in her first speakership.

Adding to that picture were comments one of Pelosi’s advisers made to a group of health insurers last November, first reported by the Intercept, in which he suggested Democratic leadership would be a bulwark against the left’s enthusiasm for single-payer:

Pelosi adviser Wendell Primus detailed five objections to Medicare for All and said that Democrats would be allies to the insurance industry in the fight against single-payer health care. Primus pitched the insurers on supporting Democrats on efforts to shrink drug prices, specifically by backing a number of measures that the pharmaceutical lobby is opposing.

Primus, in a slide presentation obtained by the Intercept, criticized single payer on the basis of cost (“Monies are needed for other priorities”), opposition (“Stakeholders are against; Creates winners and losers”), and “implementation challenges.”

A lot of Democrats are still figuring how they feel about Medicare-for-all

There is real energy for ambitious health care reform after Democrats beat back Republican attempts to repeal the Affordable Care Act. More than half of Democrats say in a vacuum that they strongly support Medicare-for-all. But there is also a real question of tactics. Even supporters like Elizabeth Warren have been more cautious in commenting on what might be possible in the near term.

Democratic voters also don’t seem convinced yet that the party should be rushing to pass single-payer as soon as possible. A CNN survey found that a little less than half of potential Iowa caucus-goers think supporting Medicare-for-all is a “must-have” for them to consider supporting any of the 2020 Democratic presidential candidates. A Kaiser Family Foundation poll last summer found 37 percent of Democratic voters consider a candidate’s position on Medicare-for-all the single most important factor in picking a candidate in 2018 versus 45 percent that said it was very important but not the most important issue. Other surveys have indicated Democrats would prioritize improving the Affordable Care Act over passing single-payer.

The best forum for this debate won’t be Wednesday’s hearing but the 2020 presidential campaign. Sen. Bernie Sanders (I-VT) has already staked out ground as a forefather of Medicare-for-all. But former Vice President Joe Biden, a more moderate voice than Sanders on health care, is leading the polls. Democrats will get a chance to sound off with their votes on the thorny question of idealism versus pragmatism that undergirds so much of this debate.

The health care industry has mobilized against Medicare-for-all because it sees the idea, and even more incremental proposals, as existential threats. But the industry views the vice president as the guy on their side.

“This encapsulates a liberal versus a moderate in people’s minds. People want to beat Trump. They know a socialist can’t. The government isn’t going to fix everything,” a Democratic health care lobbyist told Vox recently. “To that extent, people are waiting for” a candidate like Biden who wants more incremental improvements.

This debate is far from over. Wednesday’s House hearing is the next opportunity for the competing sides to get in front of the public and try to win over their colleagues and their voters back home.

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Internet Users Shared Their Head-Scratching Findings That Are More Like Riddles Until You Realize What They Actually Are

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You can find nearly anything on the internet. And people who bump into something unusual turn to it to find answers. On Reddit, there’s a topic where users easily solve challenging riddles. They know everything about mysterious marine creatures, extraordinary tools, and exotic musical instruments.

Bright Side likes to learn more and more about this world, and internet users are ready to share their knowledge with us. Enjoy!

18. “Found these unusual scissors. They’re uncomfortable to hold, in either hand, 2 or 4 fingers.”

These are children’s training scissors for preschoolers. The extra holes are needed to let a grown-up co-scissor and help the child.

17. “What is the purpose of these mirrors? I came across them in Trosa, Sweden.”

In Sweden, these mirrors are called “Skvallerspegel” which can be translated to “gossip mirror.” In the Netherlands, they’re called Spionnetje, or “small spy.” These mirrors allow you to see what’s going on in the street from the comfort of your couch. They can be also found in Norway and Finland.

16. In Spain, why are there water bottles outside all the driveways and entrances?

Citizens use this approach to fight cats’ and dogs’ urges to mark their territory. Maybe animals don’t want to pee where they can drink water or the bottles serve as obstacles that confuse them.

15. “I found this in an old church.”

This is used to fill multiple communion cups with wine at the same time. The way this tool works is depicted in this picture created with the help of Photoshop.

14. “My girlfriend found this shell on the beach.”

13. “What is this tube full of balls in the wall?”

This is a tool that helps to detect termites at home. Its indicator lets you know if there are termites in your house.

12. An unusual tree

It’s the Agave Americana in blossom.

11. “What is this animal? This image was caught on a trail camera.”

This is a fisher, it’s a member of the mustelid family. Sometimes it’s also called “pekan.” Despite its name, the animal doesn’t always eat fish.

10. “I saw this in a shop near Manchester.”

It’s a tool that helps you get your boots on and off. The way it works is shown here. Inside the tool there are hooks that help you put your boots on.

9. “20 years of research and the internet is my last hope!”

These are the teeth of a Black Drum fish, they’re also called corbs.

8. “Found this at an antique festival near Atlanta. It’s 17” by 5.5″.”

It’s for rolling newspapers into a “log” for the fireplace.

7. I found some kind of jellyfish on the beach.

The Portuguese man o’ war (Physalia physalis) is a marine hydrozoan (invertebrate.) A big transparent bladder is filled with gas, which lets it float on the water’s surface. Its tentacles have stinging cells and the poison is dangerous for human beings.

6. “My friend found this thing in the water.”

This is an Orisha figure used in Santeria. One hand holds a snake, the other hand holds a mask. These figures are kept in water 100% of the time in accordance with the rules of the religion.

5. “Something’s falling out of the sky.”

No, it’s not a UFO. It could be a condensation trail produced by an aircraft. Contrails are composed primarily of water, in the form of ice crystals.

4. “Found this in my grandfather’s basement.”

This is called an ocarina, and it’s an ancient musical wind instrument. It’s used all over the world: in China, Latin America, Africa, and Eastern Europe. In Europe, this instrument is more like a toy for kids.

3. “Found this figurine in the forest near my house.”

It’s a broken part of a candle holder. Though some people use it as an ashtray.

2. “I found this on the Caribbean side of Eleuthera in the Bahamas at low tide.”

It’s a sponge. They don’t have nervous, digestive, or circulatory systems. They consume oxygen, filtering water through their bodies.

1. “What is this fish for?”

Iron deficiency is a serious problem in developing countries. These fish help people get enough iron if they boil these figurines in water.

Have you ever found anything unusual?

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14 Ads From Marketing Gurus Who Are at the Top of Their Game

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It’s great that commercials are no longer something unbearable or something that distracts you from watching your favorite movie. Modern marketers sometimes create such amazing masterpieces that they captivate your attention and you forget that this is just something that is supposed to sell you a product.

You probably already know that the Bright Side team loves advertisements that are made by talented people. So we would like to highlight these commercials that we think you might love.

1. The IKEA designers recreated the designs of the living rooms from The Simpsons, Friends, and Stranger Things

2. Adidas inspires you to climb all the mountains.

3. BMW: More power, less consumption.

4. The National Geographic Wild channel shows predators and their prey.

5. McDonald’s is sure that children love Happy Meals because they can be eaten with their hands.

6. This is LG’s way of telling you that delicate and non-delicate fabrics can be washed together.

7. Rota Uniprag pest control will make all the bad insects leave your house.

8. This bookstore knows that some books trap you from the very first pages.

9. Burger King, for those who love grill

10. Stabilo: highlighting the most important things

11. There is no way you can miss this STIHL blower magazine ad.

12. Nivea’s way of letting you know they can help you get rid of cellulite

13. Wilkinson Sword shows us how individuality is created.

14. PlayStation is the best way to train your fingers.

Which of these commercials do you think deserves a round of applause? And we would also like to know if you have ever bought things because of good commercials or do you always try to shut down your emotions while shopping?

Preview photo credit Sony

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Big Little Lies season 2, episode 2: “Tell-Tale Hearts” recap

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If Big Little Lies second-season premiere was the calm before a storm of consequences, then the second episode, “Tell-Tale Hearts,” is a whole new maelstrom of melodrama.

This episode sees our five scheming socialites falling deeper into the web of secrets and lies that have surrounded them, as family tensions, spousal betrayals, and devastating reveals about sexual assault and domestic violence all churn to the surface. It probably shouldn’t be as fun to watch as it is, but Big Little Lies has always been pretty gleeful about its sordid affairs.

Strap in, because a lot happens in this episode.

Celeste and Bonnie are both trapped in isolating guilt spirals

“Tell-Tale Hearts” gives everyone a squalid tale to tell, and the result is that their stories spill forth almost immediately. This is partly because, as the bard once said, “Children will listen,” and all the kids of Big Little Lies have not only been listening to their parents, but also talking among themselves. The repercussions are significant, and I’m excited to watch how the sons and daughters of the group, who are now dubbed “the Monterey Five,” deal with the sins of their parents.

Celeste (Nicole Kidman) is still so plagued with guilt and tortured memories of her late husband, Perry, that she’s having trouble sleeping. But while on Ambien, she sleep-drives and crashes her car in the middle of nowhere, leaving her searching for a way to explain her behavior to Perry’s already suspicious and ever-watchful mother, Mary Louise (Meryl Streep).

While giving Celeste a lift home, Madeline (Reese Witherspoon) spots Bonnie (Zoe Kravitz) walking aimlessly along the deserted highway. Bonnie’s own spiraling guilt over Perry’s death at the end of season one has left her increasingly listless and disconnected from her friends and family. While Bonnie resists Madeline’s concerned scrutiny, Celeste seems to know exactly how Bonnie feels. “That woman’s not well,” Madeline tells Celeste, ignoring the obviously unwell woman right next to her.

In another parallel with her kindred spirit Celeste, Bonnie’s emotional detachment has caused her husband, Madeline’s ex Nathan, to call in Bonnie’s mom, Elizabeth ( Crystal Fox), to come stay with them, without telling Bonnie in advance. Her mother’s arrival — and her practice of witchcraft, which leads her to do things like sneak around at night, leaving animal bones in Bonnie’s room — only escalate Bonnie’s unease and exacerbate the tensions between Bonnie and Nathan. But Elizabeth does identify the basic thing that’s wrong with her daughter, the thing no one else seems willing to say outright: She saw Perry Wright die (at the end of season one), and she’s traumatized.

Bonnie’s mom seems to be the only person willing to fully and openly discuss what’s going on under their noses. That is, apart from the kids. And when the kids start talking, the dominoes start to fall.

The spilling of one closely-held secret causes a cascade of new problems

When she’s back home, Celeste dodges Mary Louise’s questions, only to have to break up an increasingly familiar bout of violence erupting between her sons, twins Josh and Max. This time, Max hits and swears at Celeste, who reacts by pushing him away and accidentally knocking him to the ground, screaming that she won’t let Max become like his late dad. Tick another box in the obvious mental checklist — “Signs your daughter-in-law killed your son” — that Mary Louise is keeping. (Oh, and she’s making plans to rent an apartment nearby, so that she can continue to keep an eye on Celeste.)

Dire as this situation seems, it’s just the beginning of new troubles for Celeste. Josh and Max have been picking up gossip from Madeline’s younger daughter, Chloe. Thanks to Madeline’s glib discussion of her friend circle and its fraught dynamics, Chloe’s sussed out that the twins’ late dad, Perry, is also the father of another boy at their school — Ziggy, the daughter of the fourth member of the Monterey Five, Jane (Shailene Woodley). Now she’s shared the big secret with the twins and Ziggy, unbeknownst to their parents. Josh and Max have, in turn, told their grandmother about their other brother.

The repercussions of this revelation are immediately sobering. Mary Louise is understandably confused about why Celeste didn’t tell her that she has another grandchild. This means that Celeste has to tell her the truth — that Ziggy is a product of a sexual assault. Jane is also thoroughly shaken by the news that Chloe, Josh, and Max are all privy to the secret of her son’s paternity — one she had wanted to tell Ziggy herself first. She makes the difficult choice to be honest with him about how he was conceived.

Meanwhile, Madeline, in the middle of trying to scold Chloe for spreading private secrets among her classmates, runs into trouble with her own husband, Ed (Adam Scott), who’s weirdly shocked and angry that Madeline didn’t tell him about her friends’ big secret. (Ed is presumably meant to seem hurt by his wife shutting him out of her life, but he mostly just ends up looking like a giant gossip, because, as Madeline points out, he’s asking her to fill him in on her friend’s sexual assault. Not cool, Ed!) This uncomfortable moment of conflict between Madeline and Ed is rapidly overshadowed by a revelation from the elder of Madeline’s daughters: While high school senior Abigail continues her ongoing argument with her mom about why she doesn’t want to go to college, she lets slip that Madeline had a short-lived affair last year with the local theatre director … and Ed overhears her. After processing this second, more legitimate bombshell, he tells Madeline their relationship is over.

And the hits just keep coming: When Celeste tries to talk to Mary Louise about Perry’s sexual assault of Jane, Mary Louise flatly rejects the idea that her son could be capable of committing rape and labels Jane a liar. She also implies that Celeste is disloyal for believing Jane, and then goes even further by disbelieving Celeste herself when Celeste tells her that Perry has a history of domestic violence. Insisting on branding Jane’s rape an “affair,” she coaxes the confession out of Celeste that she only learned of the assault the night of Perry’s death.

This is clearly a smoking gun to Mary Louise in terms of motive. Armed with all this new circumstantial evidence and an incendiary timeline, she tells Celeste she’s going to the police to report all the secrets that Celeste has been keeping: the existence of Perry’s other son, their combative history, and Celeste’s secret plans to leave him once and for all — arrangements Celeste was making last season on the eve of Perry’s death.

This episode asks whether the family that shares its secrets can survive them

The spilling of all these secrets all tie into the episode’s overarching theme — the concept of family and what the hell that even means, anyway. “Tell-Tale Hearts” suggests that there’s ultimately not much difference between a dysfunctional family that shares its secrets and a dysfunctional family that doesn’t. In an early scene, Celeste tries to tell her sons that they can talk to her about their dad, only to have them accurately inform her that she’d rather avoid the whole subject. “I shouldn’t do that,” she admits. “Families should be open with one another.”

“I don’t think we’re that kind of family,” her son Max replies shrewdly.

He’s echoed later on by Ed, who coldly challenges Madeline’s idea that there is an “us” during their breakup. “What does that even mean?” he asks. “It can’t mean honesty, truth, or trust.”

But if this episode makes a pretty strong case that the only way to keep your household happy is to never open your mouth, it also reminds us that, even then, the truth will come out. Which brings us to the fifth and final member of the Monterey Five. Just as she’s on the cusp of national prominence, Renata (Laura Dern) finds out that her useless husband has been committing fraud — when the feds show up to arrest him. Not only that, but he’s been squandering her fortune as well as his.

Renata reacts to his confession by flying into a hilarious rage and yelling, “I will not not be rich!” This is highly relatable, and also amazing — but she still winds up bailing him out and giving him a lift home from jail, which, let’s face it, is pretty much as great a show of loyalty as this show can deliver.

So far this season, Renata has mostly popped into the unfolding drama of her friends’ lives to be busy and important, which is typical Renata. I’m intrigued to see how the show will weave her storyline back into the larger narrative, but even if it doesn’t, and Laura Dern’s job this season is to drop in and have empowered tantrums every now and then, Big Little Lies will be five-star viewing. The crime melodrama is one thing, but if you can’t have a self-aware sophisticate screaming about her right to a slice of the patriarchy, what’s the point?

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