This paper aims to investigate how equal treatment is put into practice in the context of health care services in Sweden. Theoretically as well as methodologically, intersectionality is used as a strategy to explore the in-built tension in the concept of equal treatment between formal and substantial equality. Swedish policies and laws put great emphasis on the right to equal treatment in the context of health care. For example, the Health and Medical Services Act, which regulates the care and the rights of patients, requires that all patients are to be treated equally. In addition, the Discrimination Act prohibits discrimination in the area of health care. At the same time, however, research and reviews reveal that people are de facto not treated equally in Swedish health care. For instance, women do more often than men complain on the treatment received and women do also more often than men report being discriminated against by health care providers. Drawing on 59 semi-structured interviews with health service users, who all are migrants but of different gender, ages and social positions, and health professionals, we show at a split between formal and substantial equality in the context of health care. Though health professionals in general uphold formal rights and normative ideals of treating everybody the same, the lived experiences of the health service users indicate that sameness of treatment may in fact reinforce inequalities as people do not have the same abilities and resources to exercise their rights in the context of health care. In particular, we show that interpretations of equality as sameness of treatment may block or even harm substantial equality for migrant women living at the intersection of multiple socioeconomic disadvantages.
