The Canadian province of Quebec plans to reshape its public healthcare system to include more private medical care, in a move that has provoked strong support and virulent criticism across Canada. Quebec's premier, Jean Charest, has promised that hip and knee replacements and cataract surgery will be done within six months of diagnosis, even if it means that the provincial government has to pay for them to be done at private clinics. And if government funded hospitals extend waiting times to nine months, Quebec will pay to send patients outside the province, including to the United States.

Quebec's initiative is likely to be followed elsewhere. Already the provinces of Alberta and British Columbia are planning to increase private intervention in the public healthcare system. Also, the …