Last year, my daughter’s elementary school science teacher surprised me with a midday phone call. During a nature center field trip, my eight year old fell off a balance beam and seriously hurt her arm. I picked my daughter up and drove straight to the children’s hospital, where I knew she would get everything she needed. Hours later, we were headed home, injury addressed, pain controlled, appropriate follow-up secured, and her arm in a cast after x-rays revealed fractures across both forearm bones.
That children’s hospital, part of a regional academic medical center, is thirty minutes away from our home. Its proximity assures me that we have access to everything my kids could possibly need medically. Until this year, I took this access for granted. Now, as the structure of the classroom yields to summer’s longer, more freeform days, some of the nation’s most important programs scaffolding kids’ health could collapse under the pressure imposed by proposed legislative budget cuts. As a pediatric doctor and as a parent, slashing Medicaid concerns me the most.
Pediatric funding, availability, and access represent America’s biggest current challenges. Proposed cuts negatively impact individual children. But all kids suffer with diminished availability and accessibility of pediatric healthcare. Threats to children's healthcare started simmering long before this Congress convened and this presidential administration took office, but the size and scope of the cuts in the House draft budget have made that threat existential.
While Medicaid most visibly serves under-resourced individuals and communities, it also bolsters services and institutions that benefit everyone, especially children. Though my family has private insurance coverage through my employer, my kids would not be able to access the depth and breadth of care available without Medicaid, which directly and indirectly supports pediatric programs and professionals.
The risk to children’s hospitals, which rely heavily on Medicaid funding, is often unrecognized. These hospitals, only 1% of all hospitals nationally, represent a lifeline for children, providing primary care, subspecialty medical access, and community programs for children and families of all socioeconomic backgrounds. By contrast, community hospitals comprise nearly 85% of hospitals in the U.S. and are increasingly unlikely to offer pediatric-specific care.
In political battles over Medicaid funding, people obscure the larger but essential question in medicine: should every child have healthcare? On the one hand, the answer is obvious. Pediatricians know every child requires medical access, parents want their children to have what they need, and the American Academy of Pediatrics believes that “the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality comprehensive health care.”
Yet since 2008, the number of pediatric inpatient units in general hospitals has declined by nearly 30% and inpatient pediatric beds outside of children’s hospitals decreased by almost 20%. A disconcerting number of hospitals, especially those in rural areas, face full closure. Over the last fifteen years, more hospitals have closed than opened.
As a pediatrician trained in neonatal critical care, I’ve watched with alarm as pediatric units and neonatal-perinatal services constrict faster than adult services and programs. This isn’t because of a lack of demand; in fact, demand for pediatric-specific care has only increased. In areas where there is no pediatric care available, families must go without or travel far for what they need, sometimes spending hours in transit and even crossing state lines. More cuts will only exacerbate that trend.
Increasing gaps in care and coverage mean that emergency medical services and medical providers without extensive pediatric expertise are seeing more children. But this is not an adequate substitute for pediatric experts. Children are not small adults, neither anatomically nor physiologically.
Clinicians who predominantly care for adults can be fooled by pediatric patients. In fact, interventions that heal adults may harm children. Consider extremely high blood glucose levels in patients with diabetes. An adult’s sugar might normalize with rapid intravenous fluid boluses, whereas a child is at risk for brain injury without carefully calculated fluid administered over time. Averting medical danger means recognizing and responding to subtle signs and changes that a pediatric specialist can spot.
Children’s health needs greater investment, not less. Our children embody our greatest potential. To fully realize that potential, it’s time for our national budget to cultivate, not decimate, investment in children’s health—the core of individual and national possibility.
Dr. Brooke Redmond is a neonatal critical care physician at the Yale School of Medicine and a Yale Public Voices fellow of the Op-Ed Project. The views expressed are her own.
image of U.S. President Donald Trump is displayed on a digital billboard in Times Square in New York on April 8, 2026.
Trump is stuck between two realities. Neither serves the American people
Normally, I worry that events may overtake a column. But not so with the Iran war.
I don’t worry about running afoul of a headline or Truth Social post from the president because what is said about the situation is no longer very relevant to the reality.
On April 8, Nick Catoggio, my Dispatch colleague, dubbed an earlier stoppage with Iran “Schrödinger’s ceasefire.” This was a reference to the famous thought experiment by the physicist Erwin Schrödinger, who was trying to explain the weirdness of “superpositionality” in quantum physics. A cat in a box is both dead and alive at the same time until you open the box. Schrödinger meant to illustrate the absurdity of the idea that particles aren’t any one thing, but a “cloud of probabilities.”
The Trump administration is stuck in a word cloud of probabilities of his own making. The war is over. The war is on. The war isn’t a war. We have a deal, but we don’t have a deal, but we’re about to have a deal. We destroyed Iran’s military. No, we left it intact. We want regime change. No we don’t. We already accomplished it. We “obliterated” Iran’s nuclear program a year ago. We had to go to war in February to prevent nuclear war. The Strait of Hormuz is open, closed, or something in-between. No deal without “unconditional surrender.” Let’s make a deal!
This everything-all-at-once vibe can be disorienting, particularly since most Americans didn’t have a war with Iran on their bingo cards until the shooting had already started. President Trump didn’t prepare the country or consult with Congress beforehand because he thought it would all be a smashing success in a matter of weeks.
The miscalculation that started it all: killing Iran’s Supreme Leader, Ayatollah Ali Khamenei, and much of Iran’s senior leadership, on the first day of the war. To “the great proud people of Iran, I say tonight that the hour of your freedom is at hand,” Trump announced on Feb. 28. “When we are finished, take over your government. It will be yours to take. This will be probably your only chance for generations.”
I support regime change in Iran and shed no tears for Khamenei or his goons. But when you start a war by killing the regime’s top leaders, it’s not unreasonable for the remaining ones to conclude that you really intend regime change.
Khamenei was a murderous fanatic, but he was a fairly cautious one. He liked to threaten closing the Strait of Hormuz or attacking our regional allies, but he was reluctant to actually do it, fearing it would invite a regime change war. The mullahs and IRGC goons believed, not unreasonably, that if they lost their grip on power, they’d be lynched by the Iranian people they’ve brutalized for decades.
By starting with a regime change war, Trump removed any reason for the regime not to go for broke. When you have nothing to lose — particularly when you are a millenarian religious fanatic — a Persian Alamo strategy makes a lot of sense.
So Iran closed the Strait of Hormuz and attacked its neighbors.
But it turns out this wasn’t the Alamo. In the contest of wills, Trump blinked. The Iranian regime’s tolerance for punishment proved — so far — to be greater than Trump’s and that of our gulf allies. Militarily we could finish the job, but that would require ground troops and much greater economic turmoil. In a conflict Trump launched unilaterally without the prior support of Congress, NATO or the American people, Trump doesn’t have the political capital for that.
But that’s only half the problem. Trump wants the war over, but he doesn’t want to pay — militarily, economically, politically — what that would cost. So he wants to make a deal that ends it. But there is no deal available that wouldn’t come at an equally undesirable cost. Any deal that looks like what President Obama struck with the Iranians would be too embarrassing to bear. But the Iranians are convinced that they can get just such a deal, and they’re willing to drag things out as long as it takes.
The result: Trump’s in a box of his own making. He thinks he can talk his way out by simply asserting a reality that doesn’t exist. When the financial markets get nervous, he announces a breakthrough that is, at best, a possibility. When the Iranians agree to a deal that looks similar to one Obama might negotiate, Trump goes back to his threats.
It can’t go on forever. But I’m sure it’ll last until long after this column is forgotten.
Jonah Goldberg is editor-in-chief of The Dispatch and the host of The Remnant podcast. His Twitter handle is @JonahDispatch.