I remember a time when our family doctor made house calls. If we visited the hospital the doctor knew us and if we were good kids he give us a lollipop.

Times have changed. Now, you don't always get to see the same doctor when you visit the doctor's office or the hospital and a doctor visiting you at your home is unheard of.

If you follow me at all you know that I believe health care is facing a number of challenges. Not just financial challenges and reimbursement challenges but there are more people alive than there were 60 years ago. More than twice as many people in fact, because we've succeeded in making people live longer.

Patients are benefitting from treatments that simply weren't around 60 years ago.

When was the last time you flew on an airplane? Air travel is a great allegory for health care. Think about it, there are so many more people traveling today than 60 years ago. Airplanes are flying at full capacity. You can't find a place to park and when you're in the airport frequently there is no place to sit. If you're a frequent flyer like I am, and you pay for membership in one or more of the clubs, you'll notice all of the airline clubs are forced to renovate because the clubs were designed for fewer people.

Airlines are feeling financial pressures as well, just like health care.

The airline industry has its share of oversight but probably less oversight than health care.

What does all this mean you ask?

I predict that health care will develop a coach class, business class and first class. If you want first-class health care you're going to end up paying for it and if you can afford to pay for it you won't receive first-class health care. Look at what happened to the VA system.

I hope I'm wrong and I don't have the answer but I do see a parallel between health care and air travel.