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".
He often said that if he felt his technique sliding, then it was back to Paganini to regain his first-class form, with the help of studies, transcriptions of Chopin and Brahms, and scales in octaves and thirds.
The North East may face a tricky choice - accept a mayor or get a second-class form of devolution.
He had already proved himself as a fine one-day player, but had very little first-class form with Middlesex.
Indeed, while every other member of the world's top 10 is an established member of their country's Test and one-day set-ups, his quest to force his way into England's plans in the longer forms of the game has been hampered by a dramatic dip in his first-class form.
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.
The town has a thriving university, two first-class sixth-form colleges, an internationally renowned choral society (plus a junior school choir that has won many national awards), two high-quality amateur orchestras, a lovely little theatre, a successful rugby league club and many good restaurants which reflect its cultural diversity.
Drinkers are second-class citizens, forming an obedient second tier, a peanut gallery, balancing their cocktail glasses carefully for the mountainous trip over the shoulders of diners, locked together like the Rockies, through the hazardous passes of talking heads and moving arms, back and forth to the bar.
Last year, the BBC invited two Chinese teachers to take over a sixth-form class in the documentary Are Our Kids Tough Enough?
