The Crisis in U.S. Cancer Care: Law, Markets, and Privatization

Cancer is surging among youth and young adults in the U.S., yet instead of public regulation addressing its root causes, we have outsourced the management of cancer to the private sector. A suite of laws, embodying faith that corporations will cure cancer, has subsidized the cancer biomedical enterprise and transformed quasi-public institutions into marketized, profit-seeking entities. These changes, across patent law, healthcare law, innovation law, and Food and Drug Administration (FDA) law, have privatized cancer. The market failures I describe in U.S. cancer care raise larger questions about who we entrust with managing critical social problems. This Article provides theoretical clarity on the trans-substantive use of the term privatization. I theorize that privatization underscores a shift from community-centered approaches to ones centered on individuals and firms. Further, in contrast with the traditional, economic understanding of privatization, I deconstruct privatization into five categorical forms: delegation, individualization, marketization, capture, and cultural privatization. From climate change to reproductive justice to cancer, privatization has undermined public goals by warping systems in a way that promotes corporate interests and individualized framings over the common good. We must take seriously the harms to all Americans from unbridled privatization and push for a renewed promise of government intervention in the world we inhabit.