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As we start a new decade, we can see hopeful signs of improvement for people with disabilities. At the same time, its hard not to notice more negative trends evidence that in some ways we may be heading in the wrong direction on disability issues and culture.

What will life be like for disabled people ten years from now? Will todays worrying trends turn into frightening realities? Or will we finally achieve some of the access, equality, and opportunity breakthroughs we have been working on for decades?

Lets first look at three ways things could end up much worse for disabled people in 2030, given current trends:

1. Division

The disability community could become even more bitterly divided than it is already by race, gender, and sexual orientation, between haves and have-nots, among conflicting political identities, and between groups of people with different kinds of disabilities.

Disability is an incredibly diverse set of experiences, encompassing physical, cognitive, sensory, and emotional impairments and hundreds of specific diagnoses. And disability itself intersects with all other flavors of human experience and social identity. Despite this, the overall trend over the last 30 years has been for the disability community to come together as much as possible. Cooperation has contributed to historic advances, and these advances have in turn helped reinforce the value of unity.

Yet even now, we see that external threats and zero-sum, circle the wagons thinking threaten to overwhelm the drive for solidarity, shared experience, and collective action. It would be tragic for the disability community, (such as it is), to once again shatter into competing and mutually resentful camps tragic, but entirely possible.

2. The sinister side of innovation

Medical and technological advances could increasingly make disability seem like something people can choose to fix, and should further stigmatizing people with more persistent, ongoing disabilities.

Many people, including many with disabilities, view innovations in medicine, technology, and wellness as hopeful opportunities to cure and essentially conquer disability itself. Its a major component of technological utopianism, the belief that ever-advancing technology holds the key to fixing our most difficult social problems. And its true that technology has done a lot to liberate disabled people, through better wheelchairs and prosthetics, relatively cheap adaptive products, and of course computers and the internet. Medicine, too, is largely responsible for vastly improved everyday health and longevity for people with disabilities that once cut lives short.

Unfortunately, the impressive contributions of technology also fuels more problematic attitudes and sinister goals. People who believe that any affliction or disability can be fixed with the right tool, treatment, or lifestyle tend to develop a judgmental view of disabled people generally. And its not just about treatment. Already we can see an alarming interest in eliminating disabled people entirely from society, through prenatal screening, a renewed interest in eugenics, and an ever more permissive and sympathetic approach to assisted suicide. These threats may seem far-fetched and abstract now, but in ten years, how will society regard disabled people whose continued existence doesnt seem to belong in a world where every problem has a shiny new solution?

3. Back to institutions

Nursing homes, institutions and other controlled care facilities of various kinds could again be widely promoted and used as the solution to disabled peoples needs.

A large portion of the story of disabled people in the last 20 years has been the effort, on several fronts, to move disability care and services away from nursing homes, institutions, and other types of centralized facilities. Instead, we have moved towards disabled people being able to live in their own homes, on their own terms, with whatever services and support they need provided individually, in the community, and as much as possible under their own control. Disability policy has come a long way on this, benefitting people with physical disabilities, including older people with age-related impairments, people with developmental or intellectual disabilities, and people with mental health diagnoses, among others. The fairly obvious personal preference for greater independence, and the relative cost-effectiveness of these models can make continued progress seem inevitable.

However, it seems that there is literally no belief or practice of the past so awful that it cant be revived. Against all expectations of just a few years ago, there is a renewed interest in defending and even expanding disability service models that emphasize institutionalization, control, protection, and segregation. Traditional nursing homes still enjoy at best lukewarm acceptance. But innovators are hard at work coming up with exciting new communities and assisted living campus programs that are little more than high-end institutions with the same segregation and day to day control of disabled peoples lives that contributed to outrages like Willowbrook, which helped launch the movement against institutions in the first place. Straightforward advocacy for a wholesale return to institutions is becoming more common and accepted.

Maybe its just a fleeting fashion a nostalgic flirtation with old ways of doing things. But it could easily become a real trend, perhaps in response to underfunding, perceived unpredictability, and occasional failures of more individualized models like home care. Plus, misunderstood and fabricated financial pressures, and the fear of bad things happening always threatens to overwhelm hopes and ambitions for independence. Will most disabled people live independently in 2030? Or, will we be back inside closed facilities, wondering how we got here again?

Now that we have reviewed some realistic fears, lets look at three entirely feasible hopes for how life could actually be much better for people with disabilities by 2030:

1. Health insurance for everyone

There will no longer be any such thing as eligibility for complete health care, and long term services and supports for disabled people. It will be automatic for everyone.

Whether this means Medicare For All or some other hybrid model, the key is not just affordability, but stability. Today, people with disabilities have to worry constantly about sudden, even accidental loss of health insurance. Many of us rely on health insurance not just for standard health care, but also for adaptive equipment and home care. As a result, the constant need to maintain fragile eligibility factors into every major decision we make, including whether to marry, and whether and how much we can work if we have the opportunity.

Taking health insurance off the table, and fully covering home care for all who need it, would liberate disabled people even more than the landmark Americans with Disabilities Act of 1990. It would once and for all make unwilling placement in facilities impossible, and fulfill the true promise of independent living.

2. End of the poverty trap

Disabled people will be able to work, earn money, and save much more than they can now without fear of losing support benefits.

There are many factors that influence whether or not any particular disabled person is working for pay. As already noted, maintaining steady health insurance is both essential and complicated. The same is true for other financial benefits like Social Security, food stamps, and housing subsidies, not to mention any support services people with particular disabilities need to maintain safety and independence.

Eliminating any financial downside to working, or working more, would be a huge step in the right direction for disabled people, regardless of our ability and opportunity to work at any given time. Figuring out how to do this isnt difficult in the technical, policy sense. Whether or not the political will exists to do it will go a long way towards deciding how life with disabilities will be in 2030.

3. Accessibility is done

Physical and communication barriers in workplaces, businesses, and transportation will be almost unheard of.

Maybe it really will just take longer than we thought before the promise of the ADA is finally realized in full. Maybe the legal and practical tools are already in place, and we will reach some sort of final accomplishment by 2030 of full accessibility largely through time and the natural process of repairing and replacing the infrastructure. Or maybe we will ramp up the effort, (so to speak), with some combination of stronger mandates, tighter enforcement, and targeted funding.

Will we simply coast towards this final elimination of practical barriers to full liberation, equality, and mobility for disabled people? Or will it require something more? And can we do it in another ten years or less?

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These two lists were informally brainstormed, not carefully surveyed and sorted. Ask any disabled person and they might produce completely different predictions. However, these negative and positive forecasts do accurately reflect the pessimism and optimism that exist side-by-side among people with disabilities.

Its also interesting that all of the predictions on the darkest timeline list are social threats, while the optimistic hopes are all about concrete policy. It could just as easily be the reverse. After all, the disability community faces dozens of policy threats too, while disability culture is arguably more vibrant and collaborative than ever before.

Stil, policy advancement alongside social stagnation or decline would be consistent with the disability communitys history. Our legal and policy victories have always tended to run a few laps ahead of our progress on social attitudes and beliefs about disabled people. Big systemic improvements have often been followed by backlash something we may be seeing right now, and not just with the disability community.

What if both lists come true by 2030? What if the disability wins strong material victories, but loses cohesion, community in effect, its soul]? What if portions of the disability community gain power, freedom, and respect, while we sacrifice the rest of us to rejection, shame, and confinement?

Of course, there are infinite possible futures for all of us. But the disability community has unique opportunities to shape the world it will inhabit in 2030. We just have to be clear about what we want, and what we are and arent willing to do to get it. Now is a good time to think about it, and seriously.

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Disability Life In Ten Years: Fears And Hopes For 2030 - Forbes