The editorial “Sustaining Optimism”1 in the May issue of the ARCHIVES raises important questions, which I would like to answer from the perspective of a pediatrician in private practice. Like the residency applicants interviewed, I too spent time as a medical student and resident in clinics serving low-income patients. When I entered practice, we provided care to our share of Medicaid patients. Even though compensation failed to cover expenses, as pediatricians we held that children should not be denied first-class medical care because of parental financial circumstances.