The Favorite: Big Brown had been the dominant winner of the Kentucky Derby and Preakness Stakes. Despite rumors of hoof problems that plagued the colt leading up to the race, he was the heavy favorite and seemed unbeatable. The Spoiler: People are probably still asking themselves where Da' Tara came from.
In large part the insignificance of the clauses has been based on restrictive readings of the clauses by the U.S. Supreme Court. Article IV provides that The Citizens of each State shall be entitled to all Privileges and Immunities in the several states..
Privileges are specific to services provided at the location, for example, primary care, surgery, diagnostics, and so on. The elements are the facility, equipment, qualified staff, and financial resources. Privileges can only be granted by the organization for services that are performed in the environment or the organization's location/building.