Last week, while selecting a birthday card for my brother, I ran into a lovely 84-year-old woman in the greeting card aisle.

She was talking to a young woman who said something about being excited about celebrating her 23rd birthday. The older woman and I got a chuckle over that, since I'm old enough to be that young woman's older sister (OK, mother) and she was old enough to be her great-grandmother, although had she not told me her age, I would have guessed she was in her 60s.

What she said next, though, befuddled me. She launched into a tirade about President Barack Obama and health-care reform.

"He's going to ruin our country with all that socialized medicine."

It sounded sort of strange coming from someone who had qualified for Medicare nearly two decades ago. Do people on entitlement programs not understand that they're already on a government health-insurance program?

I'm not saying a government-run health-care system is just what the doctor ordered for the nation's health-care reform. In many respects, government programs are the tail that wags the dog in terms of reimbursement models.

We will continue to have government programs. There's no use in pretending otherwise.

The question is, what will the rest of the health-reform picture look like?

But there are a number of private-sector options that can be refined to further cut costs, boost quality, improve efficiencies and make people more responsible for their health.

I'm continually fascinated by people I encounter in medical-clinic waiting rooms who absolutely refuse to see health-care providers other than doctors. My experiences with physician assistants and nurse practitioners have been stellar. They tend to spend more time with my child or me than doctors can. If an issue is beyond their scope of practice, they bring in a physician. It's the best of both worlds, I think.

But some people will insist on seeing "the doctor," even if it means they will wait two hours in the office for the 10-minute visit a receptionist has been able to shoe-horn into the schedule.

What's worse, seeing a physician assistant who has much of the same training as a physician, or seeing a physician who has seen a patient every 10 to 15 minutes that day, with the exception of the lunch break, if he or she takes it?

Most medical issues aren't life or death. If you need a flu shot, is there some reason that can't be accomplished at the little clinic in your neighborhood grocery store?