“So, what do you think,” Sandra held up her new double Ds to her girlfriends at the barbecue.

“Wow, they must have cost a fortune!” Abby admired. As did several of the husbands hanging around the grill with Sandra’s husband, Doug. Their eyes were riveted to Sandra’s new breasts.

Doug smiled and flipped a burger, while the others sipped long neck beers.

“Insurance covered the whole thing,” Sandra gushed to the group of women.

“When did you get insurance,” Ramona spouted, “your husband is unemployed.”

“She means Medicaid, Ramona,” Abby answered.

~~~~

Dr. Sykes took a pull from his coffee mug on which was written ‘Beauty is skin deep!’ Gazing out the sliding glass into the waiting room, he mumbled to his receptionist, “Who are all these people?”

The place was filled with vagabonds, ne’er-do-wells, the obese, and the poorly dressed. “They are all scheduled today, Doctor.”

“For what? Welfare applications?”

“Remember last month when he had that temp Office manager. Well,” she said, pulling on her gum, “your insurance renewals came up, and he checked the box for Medicaid services.”

“How did Medicaid authorize Plastic surgery appointments?”

~~~~

In the doctor’s lounge adjacent to the Operating Room, several surgeons were relaxing between cases, “Did you see Sykes’ schedule today?”

“Forget that, did you see his patients?”

“Tummy tucks, buttocks implants, breast enhancements, chin lifts,” the surgeon said ignoring his colleagues comment, “at this rate, he should be buying that new yacht he has been talking about by the end of the month.”

“I heard that his cases are on the State’s dime,” chimed in a tall African American in scrubs as he walked in to the lounge. All eyes turned and stared at him.

“Say what?”

~~~~

On the steps of the courthouse, a crowd of protesters were waving signs while a woman with a bullhorn was trying to shout down the Mayor. Reporters and camera teams were uncertain which way to turn so covered both the Mayor and the protesters at the same time.

“Beauty is not just for the Rich!” “Dr. Sykes for Senator!” “Health Ration affects my Fashion!” “Plastics for the Poor” were scrawled on the waving signs.

“Please, please, ladies and gentleman, let me speak,” said the Mayor.

“Is it true Medicaid patients are getting nose jobs Mr. Mayor? How can the City . . .” but the reporter was drowned out.

“The new Affordable Care Act has done away with limitations on health care provisions,” the Mayor shrugged. “I’m just a civil servant.”

“How are you planning to fund the new program?” a ginger hair reporter asked.

“We will be making cuts to Police, Fire, and Municipal services.”

“What will you say to those that buy their health insurance?” she queried again.

“I’ve read in the New York Post that women from the Upper East Side are on junkets to Hell’s Kitchen to admire the new beautiful people and get surgical tips. What can be wrong with that?”

“Make Jamaica Plains beautiful, we demand more Plastic Surgeons!” the woman yelled from her bullhorn, interrupting the Mayor.

~~~~

“How did this happen?!” the Inspector General asked his assistant.

“From what I can gather, the Health and Human Services division of CMS hired a temp named Sandra in the Medicaid office. She authorized a plastic surgeon named Sykes to accept Medicaid for procedures.”

“Can we fire this, ah, Sandra?” asked the IG.

“No,” said his assistant.

“Why not?”

“Well, she’s already unemployed again. It was a temp job. No benefits. Besides the cat is already out of the bag. Now we are getting pressure from Ivanka to institute the program nationwide.”

“Oh God . . .” groaned the IG.

“You should hear the hue and cry from California. I have hundreds of letters from East L.A. mostly in Spanish. I had to hire a translator!”

“Don’t tell me, a temp?!”

The assistant just nodded.

~~~~

“Mr. President?”

The white house chief of staff pointed to the HUD Secretary, so he continued, “I’m proud to report that while we may not be making America great again, we are certainly making it beautiful!”

“And how is that . . .”

“Well, along with the cooperation of the HHS, we have begun a massive urban renewal project.”

“Why have I not heard of this? Fake news!” the President was hammering away on his Tweeter account, barely taking notice of his cabinet.

“We have introduced not only a health and wellness program for the poor, but also made plastic surgery and dermatology programs available through federal funding.”

“Who is responsible?” the President thundered, “I’m trying to cut spending here.”

“Well ah, your daughter told us you authorized it,” the HUD Secretary answered sheepishly, cowering.

~~~~

Back at the barbecue Doug was telling the guys, “You know, I have an appointment too.”

“Let me guess, you’re getting that six pack you always wanted!,” Abby’s  husband said.

“Not quite,” Doug blushed, “an implant. She uh, wants more of me.”

The guys all nodded, and took another pull on their beers at the same time. “Maybe I should make an appointment,” Abby’s husband said, which lightened the mood, and the guys tittered.

###

Dr. Raymond is a Family and Emergency Physician that practiced in eight countries in four languages. Currently living in Austria with a wife and an old stray dog. When not volunteering his practice skills with refugees, he is writing or lecturing. He has multiple medical citations, and also published stories and poetry in Flash Fiction Magazine, The Grief Diaries, The Examined Life Journal, and RumbleFish Press.