Cancer Intersections

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Cancer Intersections is an ethnographic analysis of the complex and paradoxical efforts to access neoliberal, market-based oncological treatments in Colombia, a country where all patients are legally guaranteed access to medical services, including high-cost ones. Drawing on years of fieldwork in the city of Cali, Camilo Sanz explores the deep entanglements between medical, legal, and policy practices that share a common goal of treating and curing cancer but are hindered by bureaucratic procedures, pernicious financial interests, and class politics. Cancer Intersections shows how the interplay of these hurdles dictates the rhythm at which patients access treatment and how even in resource-rich settings, patients suffer because of market imperatives that shape how cancer treatments unfold. Through careful and measured observation, Sanz unveils how a neoliberal universal health care regime delays access to care for those reliant on public assistance, which means that some patients will start expensive treatments only after it is unlikely to change the course of the disease.

Camilo Sanz is Assistant Professor of Anthropology at the University of Oklahoma.

"Essential reading for anyone who wants to understand why systems meant to save our lives end up killing us instead. Camilo Sanz's heartbreaking account of the harm of profit-driven medicine in Colombia is full of insights for health systems everywhere."—Scott Stonington, author of The Spirit Ambulance: Choreographing the End of Life in Thailand 

"A richly detailed and theoretically innovative ethnography, Cancer Intersections illuminates how neoliberal health care systems can undermine a legally guaranteed right to health care."—Amy Cooper, author of State of Health: Pleasure and Politics in Venezuelan Health Care under Chávez

"Beautifully narrated, Cancer Intersections shows how universal health insurance in Colombia has exacerbated rather than resolved class-based inequalities in access to health care. While the rich receive a kind of care that is 'in sync' with cancer protocols, the poor waste whatever remaining months or years they have fighting the system's bureaucracy. As untreated or inadequately treated cancers become untreatable, pharmaceutical and insurance companies secure exponential profits and physicians struggle with how to best care for their patients even when it is too late. This book has much to offer to anthropologists, clinicians, bioethicists, philosophers, and policymakers who want to understand how inequities are remade and reframed by market-based health care reforms."—César E. Abadía-Barrero, author of Health in Ruins: The Capitalist Destruction of Medical Care at a Colombian Maternity Hospital

"Sanz’s empathetic and sharp-eyed ethnography charts paradoxical encounters between a constitutional right to health, market logics, high-cost biomedical treatment, and social inequality in Columbia. Time is a central motif, a medium through which these paradoxes are stratified, embodied, and challenged."—Noémi Tousignant, author of Edges of Exposure: Toxicology and the Problem of Capacity in Postcolonial Senegal

"In this moving ethnography of the social inequalities of cancer, Sanz shows how patients in Colombia navigate cancer care in a world where health is both a right guaranteed by law and a commodity in a competitive insurance market. To receive treatments, patients from lower-income backgrounds often endure delays and denials before they can claim health as a universal right. In the time it takes for this right to be invoked, deferred, and reclaimed on official documents and legal paper, tumors grow and cancers spread."—Carlo Caduff, author of The Pandemic Perhaps: Dramatic Events in a Public Culture of Danger

"Cancer Intersections shows the double binds of cancer care in Colombia, where a fundamental right to health gets operationalized under neoliberalism. Sanz traces how the resulting nexus of legal entitlement and insurance bureaucracy socioeconomically cleaves universal health care. Sobering, sensitive, and deeply poignant."—Kaushik Sunder Rajan, Professor of Anthropology, University of Chicago