Visions of an American Future

A few nights ago, my son came down with a fever and was very sluggish. Two nights in a row he fell asleep on the couch without dinner, hours before he would normally wind down. His dad and I had trouble rousing him beyond getting him to raise his eyelids partway, giving us a glassy expression. He said his body hurt and he felt weak. We touched his leg, his back, and his neck and felt them all burning up. We worried that he’d spent too much time gaming in the den next to the wood stove, and had gotten dehydrated. He couldn’t muster enough energy to drink all the water and Gatorade we put in front of him.

Nobody wanted to spend our Saturday night in a hospital, but that’s where we ended up, in the emergency room. Cutting to the chase: my son was okay. His fever was high, but the medical staff found him to be adequately hydrated and he responded miraculously to a sweet-flavored liquid ibuprofen. The minute he woke up and started talking about Minecraft again, my husband and I chuckled with relief. Once again we had been those parents, the ones worrying too much about a standard pediatric fever, asking doctors about diagnoses and treatments that didn’t apply. I brought up heat exhaustion because the kid had spent too much time in a hot room, but the physician assistant dismissed that after seeing his revival from the ibuprofen. My husband mentioned an IV because we had seen that do wonders, once, for my old cat who had been acting sluggish and was merely dehydrated. Wisely, the PA said we should not poke the child with a needle if we didn’t have to. He also kindly warned us against too much Googling of symptoms. This was just a viral infection.

I had plenty of time to think while we waited to be seen. Like any parent, I started to worry about worst-case outcomes for my son before we found out he was alright. And like any thinking person in today’s America, I wondered what might change about this scenario over the coming months and years. We are frogs in boiling water. The demise of the society and culture we know today won’t, for most of us, end suddenly, but instead with a series of shifts. At our local ER we only spent about an hour in the waiting room; other patients had been there for far longer. They fast-tracked us likely because little kids can deteriorate quickly, and our soon looked rather poorly when we first came in. Next time we might not be as lucky. As jobs get cut, people will lose their health insurance and increasingly turn to the ER for primary care or treatment for non-urgent ailments. Private insurance is too costly for most, and with belts being tightened at the Consumer Financial Protection Bureau, insurance companies may be free to fleece their clients even more than they already do. I looked around our ER and imagined it filling up with more people who had nowhere else to go, and people suffering from injuries and ailments that have their roots in despair. With a government run by extremists and billionaires, what can we expect but more economic inequality and more lost jobs?

My own job, and therefore my health insurance, feels less secure than it did a few months ago. I work for a government agency that is largely funded by the feds. If the regime decides they are ideologically opposed to something our benefactor agency does, they could withhold funding or gut the department, and my position could be cut. Or what if they decide that, because I’m a woman, I was hired due to “DEI” and I shouldn’t be there? Or that I’m being overpaid because the agency conducted a pay equity study before sending me an offer, and policies containing any mention of “equity” are no longer allowed?

I expect to get a bill for my son’s hospital visit after the insurance claim is processed. Our current socioeconomic position should allow us to pay it easily, but if the cost of living (which is already high) shoots up due to import tariffs, lowered support for farmers, disease epidemics among farm animals, and unchecked corporate greed, it’s going to get harder to pay unexpected bills. Heaven forbid one of us gets an uncommon type of cancer that perhaps would have once qualified the sufferer for a clinical trial, but now doesn’t because of cutbacks at the National Institutes of Health. For non-emergency care, what if my son is one day diagnosed with ADHD, depression, or other mental illness? He may no longer have access to clinically proven drugs, or they might not be covered by insurance, because it’s the personal opinion of our new Secretary of Health and Human Services that those drugs are harmful. Maybe we’ll be encouraged to send him to a “wellness farm” instead. And what if he decides, when he’s older, that he doesn’t want to identify as a boy (or man) anymore? If we encourage that kind of expression, helping him to be his best self, he’s likely to be ostracized by peers who have bought into toxic and inaccurate messaging from the highest levels of government (and emboldened bigots all over the Internet) that his very identity is illegitimate. He might not be able to get affirming medical treatment. His risk of self harm and suicidality would increase. Even if that doesn’t affect our family directly, our local ER and social services will be busier with visits from gender nonconforming kids who are at risk.

Public health issues affect everybody, and our safety nets are being threatened. If voluntary vaccine exemptions go up, or certain childhood vaccines are formally discouraged or even outlawed, what will happen to my son’s protection? More kids in his environment will get sick with communicable diseases, and the herd immunity barrier will weaken. Kids with measles and whooping cough will pour into the hospital too. And if there’s another COVID-style pandemic, unmanaged because of cuts at the Centers for Disease Control and cultural aversion to any public health protection measures, hospitals could be easily overrun again. Should my son, an asthma sufferer, need emergency treatment at that time, staff and beds may not be available.

I think about doctors and nurses too. At our local hospital, they were extremely busy (I heard of a Code Blue happening behind the scenes), but attentive and calm. Nevertheless, I’m pretty sure most of them are underpaid and overworked. But they probably have some power through unionization. If authoritarians remain in power, unions will not be looked upon kindly. We’ve already lost medical professionals since COVID. The more unacceptable their working conditions become, the more of them will leave, and the longer we’ll spend waiting in the ER next time. Not to mention they are regular people and consumers occupying the same world as the rest of us, subject to the same stressors, on top of the specialized hardships of their jobs. Medical facilities are microcosms of a wider world in which people are increasingly selfish and untrusting of others, especially experts. Our pediatrician’s office has signs everywhere begging people to be courteous to the staff. I’ll bet those signs weren’t up before 2020.

In no way am I suggesting these things will converge in some catastrophe upon my family, or even necessarily affect us directly. The changes being set in motion will take longer to infiltrate blue states like ours, if they aren’t blocked outright. Change any of the factors currently in our favor—place of residence, skin color, gender identity, sexual orientation—and I can only imagine how that would amplify the anxiety and make the hypotheticals more real. I would love to be proven wrong about my hypotheses, and have these worries dispensed with just like the unfounded worries about my son in the hospital, but the callousness and ignorance of the people in charge now give me little hope. I don’t know for sure how things will change around me. All I can do is try to notice.