Yet it's not only with regard to insurance that abortion services are being treated like a second-class form of medicine.
On June 30th, in its ruling on the legality of the Lisbon treaty, Germany's constitutional court declared that the parliament enjoyed only a second-class form of democratic legitimacy when compared with national parliaments.
The head of the prostate cancer program at Memorial Sloan-Kettering Cancer Center, Dr. Peter T. Scardino, said the procedure might prove useful for some special cases, but "for the treatment of the average ordinary prostate cancer, I think it's a second-class form of therapy".
The North East may face a tricky choice - accept a mayor or get a second-class form of devolution.
Having marshalled a first-class cast, and in dynamic form on the podium, it was Edward Gardner, in his final appearance as the orchestra's principal guest conductor, who masterminded the occasion, sparky and sparkling from beginning to life-affirming final chord.
Nobody considers movies — or, increasingly, television — a second-class art form anymore, but it is hardly a secret that the writer is not at the top of the totem pole in either.
But after an uncertain series with the bat against Sri Lanka, in which he only scored 27 runs in four innings, the Middlesex opener has made full use of the opportunity, offered to him by Somerset because his own county did not have a first-class game, to play himself back into form.
"Send a first-class mailer.
Forbidden Broadway doesn't just deflate Broadway's excesses or affectionately spoof stars, it is a potent reminder that a first-class comedy critique is an art form all its own.
