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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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Facebook’s Mark Zuckerberg’s CEO ranking plummeted this year

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Facebook employees have long been known for their fierce loyalty to the company and its founder Mark Zuckerberg. In the aftermath of numerous privacy debacles, including ones in which Facebook has exposed users’ personal information and facilitated attempts to undermine American democracy, that enthusiasm seems to have flagged.

The Facebook CEO saw his ranking among top US CEOs plummet this year, from No. 16 in 2018 to No. 55 this year, though he does have an approval rating of 94 percent, according to new data from Glassdoor, a site where employees can anonymously rate their jobs and their CEOs. His approval rating was 96 percent last year.

The average CEO approval rating among the 900,000 employers reviewed on Glassdoor is 69 percent — so Zuckerberg’s 94 percent approval is well above average, even if it’s not as high as it used to be.

Back in 2013, when Glassdoor first started ranking CEOs, Mark Zuckerberg was ranked as the No. 1 CEO in the US, with a 99 percent approval rating, and the company overall was considered the best place to work. This year it dropped to the seventh-best place to work, from No. 1 in 2018.

Last year, even after Facebook had undergone a brutal 18 months of scandals and reshuffling, Recode’s Kurt Wagner wrote that “no one in Facebook’s upper ranks ever seems to leave the company.” That changed this year when two of the company’s most important executives — both named Chris — left. The company has also seen defections from leaders of the companies it has acquired, including the founders of WhatsApp and Instagram.

Employees at tech companies including Google, Uber, and Amazon have become increasingly vocal in their criticism of their employers. Facebook largely has avoided such blowback, but increased employee dissatisfaction could portend protests among Facebook workers as well.

Why Zuckerberg — and Facebook — are only now losing favor with some employees is unclear, though recent comments on Glassdoor about the company’s leadership provide some clues:

“Start taking your morale issue seriously. Leadership needs to take several steps back, really listen, and show that you are serious by taking action.” —Lead Data Specialist

“Due to the recent scandals, the company has become cautious to an extreme and every privacy decision is taken with painstakingly slow speed because it’s been vetted by layers and layers of people. It’s also a very fast paced and competitive place, so some people find it hard to keep up.” —Product Manager

“Very competitive environment. No[t] possible to succeed if you don’t work 60+ hours. Focus on short term impact due to performance cycle every 6 months. No clarity on expectations of roles. Mix signals from leadership about culture.” —Data Scientist

General public sentiment toward Facebook has become more negative in the last few years as the company has struggled with a number of issues on its platform, including Russian interference in the 2016 presidential election and several privacy mishaps related to storing passwords on unencrypted servers and buggy software.

As a result, Zuckerberg and his company have been under fire from the media and politicians alike. The Federal Trade Commission is also reportedly preparing for a potential antitrust investigation of Facebook.

Facebook did not respond to multiple requests for comment for this story.

Other notable takeaways from the Glassdoor report: The CEO of enterprise software company VMware, Pat Gelsinger, has been buoyed by positive employee reviews and now ranks No. 1, a huge jump up from No. 78 last year. Salesforce CEOs Marc Benioff and Keith Block made the top 100 for the first time, ranking No. 17. Microsoft’s Satya Nadella jumped up from 20 to No. 6. The rank of Google CEO Sundar Pichai remained steady, dropping one to 46. Apple’s Tim Cook rose from 96 to 69.

Glassdoor’s large company CEO ratings were tabulated using reviews written by current and former employees between May 2, 2018, and May 1, 2019. Glassdoor uses a proprietary algorithm that considers quantity, quality, and consistency of reviews to calculate the exact approval rating. Only companies with at least 100 reviews each from both rank-and-file employees as well as senior management are considered in these rankings.


Recode and Vox have joined forces to uncover and explain how our digital world is changing — and changing us. Subscribe to Recode podcasts to hear Kara Swisher and Peter Kafka lead the tough conversations the technology industry needs today.

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20 People Whose Looks Smash Ordinary in the Face

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A flawless body, big eyes, plump lips, a straight nose, thick hair, and perfect skin — all these so-called beauty standards are not only outdated and old-fashioned, but also a little boring and distorted. Freckles, unusual eye colors, and skin and body features — these are what truly fascinates and catches one’s eye.

Bright Side has collected 20 pictures of people with unique appearances that will definitely get your attention.

1. Sem Kobelyan has vitiligo that affects his hair and even his eyebrows — and it creates an even more unique look!

2. TK Wonder is not only a writer and a singer, but she is also the owner of unbelievably voluminous hair.

5. This blue-eyed child with vitiligo won our hearts.

6. Yulianna Yussef’s birthmark covers most of her back and she raises positive awareness of CMN through her Instagram.

8. Ia Östergren’s legs are extremely long — her height is 5’8″ and the length of her legs is 3’5″.

9. Mekhi Lucky gained people’s attention thanks to his striking eyes — one is blue and one is brown.

10. This beautiful baby girl with albinism is Nova Winter and her parents have their own blog — the Larson family.

11. Samuel Silva — a unique-looking kid model with vitiligo

12. Cassandra Naud, a professional dancer, says her big birthmark is exactly what distinguishes her from everyone else.

13. Russian illustrator, Maria Oz amazes everyone with her non-standard appearance and huge beautiful eyes.

15. James Stewart calls himself a “13-year-old kid with grey hair” and openly tells his audience what life with vitiligo is like.

16. Hamad Jaman has embraced his freckles and made a modeling career out of his unique appearance.

17. This textile-design student, Gao Qizhen, started her modeling career thanks to her non-standard look.

18. Daria Svertilova is a photographer who captures non-obvious beauty as she embraces her own.

19. This young makeup artist, Lauren Elyse, doesn’t let vitiligo stop her from showing the world her amazing skills.

20. Stef Sanjati is a video blogger who is famous for her non-standard appearance due to a rare genetic condition.

Which unusual traits are there in your appearance? We’d be happy to hear from you in the comment section below!

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Reddit Users Talk About the Awkward Situations They Will Remember for the Rest of Their Lives

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We’re pretty sure that everyone has been in a situation when they were super embarrassed and just wanted to disappear forever. However, these otherwise awful situations prove to be quite interesting and unique which is why they’re enjoyed by hundreds and thousands of people online. The stories we’ve collected here are by far the best and we couldn’t help but share!

We at Bright Side think that if you can transform your unpleasant memories of an embarrassing situation that happened years ago into a funny story, you should. And that’s exactly what the people in this article managed to do.

  • I get into the elevator with some guy. We start going and he asks me, “Do you want to go to a cafe?” I smiled at him and said, “I do.” He looked at me in a weird way and pointed at his Bluetooth earpiece. So, have you ever wanted to jump into an elevator shaft?
  • The 2 things that our camp guides were most scared of were losing someone and someone getting pregnant. And so my friend Mary (we were 12 years old) told the camp guide that she seemed to have gotten pregnant (she just loved attention). The camp counselor was terrified and whispered, “From who?” Mary was scared and whispered back, “Does it have to be from someone?” The counselor yelled at her so loudly that I think half the camp woke up. -NikkiKi
  • I snapped this intriguing shot while driving. I captioned it with something like, “When you have a crazy day and a lot of work but you can’t forget about beauty because your skin won’t take care of itself”.
  • I was in the elevator area of my former job and wearing a skirt that was a little too big for me. Luckily, I had one of those long sweaters on over it because I was talking to the maintenance guy and the skirt just dropped to the floor like, “and we’re done here…” and the guy and I just stared at each other for a small eternity. — © sinicuichi
  • I’ll never forget how on one of my first days in college, I met a guy whose name was Chandler. When he asked me for my name, I told him I was Monica. My friend witnessed this conversation and later asked me why I lied. I said I wanted us to be like the characters from Friends. And he was like, “Are you nuts? Your name is Rachel, and there was a Rachel on the show!”
  • Once, I had this really weird conversation with a guy. I think he was too nervous:
  • I ran face first into a street light lamp post because I was staring (while walking) at a beautiful girl walking toward the direction where I was coming from. It was in front of the main gate of our university. Hundreds of students saw it. My friends laughed so hard. — © KiwiPin0
  • I’m a very responsible person. But once, after a crazy party, instead of setting my alarm clock, I entered “8:30” in my calculator.
  • Yesterday, after a bachelorette party, we went to a water park where I almost drowned. The next day I was very angry that the employees didn’t care about the safety of the visitors. But then my friends sent me this photo and it just turned out that it was me who was crazy and thought I was drowning in a pool for children.
  • A blind woman wanted to know where the front of the bank was and I pointed and said, “It’s over there.” — © Kirjath
  • My wife and I went out for a drink one night. We walk into a bar and I see someone I know with their back turned. I walk up behind them and tickle their sides. Turned out, I didn’t know this person, they just gave me a weird look and walked away. Got their spot at the bar though. — © buefordbaxter

  • My wife and daughter gave me an iPhone. I had never used one before and I decided to text a voice message. This is what I sent to my daughter:

  • I took my grandmother to Starbucks for the first time. A barista asked her a standard question: “What name should I put on the coffee?” Grandma was amazed, looked at him, then turned to me and said, “He wants to give my coffee a name. Is he a junkie? How was he even hired in the first place?”
  • It happened in my childhood. My mom was in the kitchen with her friend who was complaining that men don’t care about her at all. Then I said, “This is very bad. I also didn’t take care of my fish and now it’s dead. It’s sad, you are still so young.”
  • Before the prom, I went to a salon and asked to make the hairstyle like the one in the left photo to look like a princess. But I ended up looking like our principal:

Which of these stories did you like this most? Maybe you could tell us about some other similar situations from your own experience!

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