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Scenes from the always-emerging class struggle.

Friends and strangers send me links to Instagram ads, portholes into identically extravagant offices. The waiting rooms are plush mid-century modern, the exam rooms an assortment of delicate monochromes washed in halos of light. There is usually a jungle of plants somewhere in the frame. This week, it was Tend, the dentist’s office that is miraculously also a “studio” and a “dental wellness brand,” where patients brush with Italian Amarelli licorice toothpaste and arrive to find their favorite HBO dramas pre-loaded on a screen. For its expansion it brought in $36 million late last year. A few months ago it was Parsley Health, the functional medicine startup that operates outside the indignities of the insurance system. “Primary care is broken,” according to its founder, and the solution, as rendered by Parsley, is a whole-body approach that includes microbiome and genetics testing. (Supplements, rather than medications, are encouraged but not typically included in the membership fee.)

For those who desire a more overt technological flex in their healthcare journey, there is Forward, another subscription-model primary care doctor where membership grants access to a whole-body biometric scanner and patients view an interactive double of their body during visits. Women have Tia, the members-only gynecologist, or Maven, the virtual prenatal clinic that proudly labels itself “insurance free,” or any of the plush fertility startups Wall Street salivates over as they gaze at market predictions that curve steeply North. At the outer limits, there is the baffling monolith The Well, a private “wellness club” with a dizzying array of offerings within its white-washed walls, including Chinese medicine, energy healing, and $850 consultations with a licensed MD.

Most of these places are trying to replicate, or at least latch on to, the massive success of One Medical, a membership-based primary care franchise that operates nearly 80 locations and went public last week with a valuation of over $1.5 billion, a modest sum given its projected success. Unlike similar startups treating local populations or Medicare patients, One Medical has become the industry’s blueprint, a fantastically valuable company that can also say it is “fixing” healthcare with a straight face. (Scooping up the segment of a $3.5 trillion industry that has decent insurance and extra cash lying around is generally understood to be lucrative as hell.)

Molly Osberg

There are five signs that foreshadow the death of a god. His body’s inherent brilliance, usually visible from a league or several miles distant, grows dim. His throne, upon which he never before felt weary of sitting, no longer pleases him; he feels uncomfortable and ill at ease. His flower garlands, which before had never faded however much time passed, wither. His garments, which always stayed clean and fresh however long he wore them, get old and filthy and start to smell. His body, which never perspired at all before, starts to sweat. When these five signs of approaching death appear, the god is tormented by the knowledge that he, too, is soon going to die. His divine companions and sweethearts also know what is going to happen to him; they can no longer approach, but throw flowers from a distance and call their good wishes, saying, “When you die and pass on from here, may you be reborn among the humans. May you do good works and be reborn among the gods again.” With that they abandon him. Utterly alone, the dying god is engulfed by sorrow. With his divine eye he looks where he is going to be reborn. If it is in a realm of suffering, thetorments of his fall overwhelm him even before those of his transmigration have ended. As these agonies become twice and then three times as intense, he despairs and is forced to spend seven gods’ days lamenting. Seven days among the gods of the Heaven of the Thirty-three are seven hundred human years. During that time, as he looks back, remembering all the well-being and happiness he has enjoyed and realizing that he is powerless to stay, he experiences the suffering of transmigration; and looking ahead, already tormented by the vision of his future birthplace, he experiences the suffering of his fall. The mental anguish of this double suffering is worse than that of the hells.

Patrul Rinpoche

Then the tests came quicker and more frequently. One in four jobs had an assessment attached, he estimates. He got emails prompting him to take an online test seconds after he submitted an application, a sure sign no human had reviewed his résumé. Some were repeats of tests he’d already taken.

He found them demeaning. “You’re kind of being a jackass by making me prove, repeatedly, that I can type when I have two writing-heavy advanced degrees,” Johnson said, “and you are not willing to even have someone at your firm look at my résumé to see that.”

Johnson also did phone interviews with an Alexa-like automated system. For one job, he was asked to make a one-sided video “interview” of himself answering a list of company-provided questions into a webcam for hiring managers to view at their convenience. Or maybe an algorithm would scan the video and give him a score based on vocal and facial cues, as more than 100 employers are now doing with software from companies like HireVue.

Nick Keppler

This central class divide now runs directly through the middle of most parties on the left. Like the Democrats in the US, Labour incorporates both the teachers and the school administrators, both the nurses and their managers. It makes becoming the spokespeople for the revolt of the caring classes extraordinarily difficult.

David Graeber

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