When you say, "reasonable public access," I assume you're referring to CRP ground. I did not know that. Yes, in SD, some of it goes into the WIA, CREP, CHAP, etc. programs. But do I have reasonable access to the vast majority? Absolutely not. The highest bidder does. In my experience, that's usually the local ophthalmologist.
Maybe that's reasonable???
(FWIW, this is one reason I briefly considered ophthalmology as a career path. But since I chose otherwise, it's now one reason I avoid patronizing ophthalmologists at all cost.)