by Olivier Gayot (Clersé, University of Lille)
Compte-rendu en français
The Economics of Convention and Social Policies study day was held at the University of Lille on 10 November 2023. Organized by Cécile Vasseur and Olivier Gayot, with the support of Guillemette de Larquier, and funded by Clersé (UMR 8019) (https://clerse.univ-lille.fr/), the day provided an opportunity to share questions and the results of numerous studies at different stages.
The day brought together around twenty-five researchers, including nine participants, to discuss economics of convention and social policies. Several categories of work were presented: chapters of collective works, state of the art, results of surveys and calls for projects or articles. The diversity of these works and convention theory gave rise to rich exchanges.
The day was organized around three workshops: (1) economics of convention and the question of work, (2) economics of convention and forms of justification for social and ecological action, and (3) economics of convention and health.
1. The economics of convention and the question of work
Géraldine Rieucau, Olivier Gayot et Philippe Semenowicz
Philippe Semenowicz – The contribution of convention economics to the understanding of inclusion policies
Philippe Semenowicz presented part of his chapter on work integration in the Handbook of Economics and Sociology of Conventions (https://conventions.hypotheses.org/handbook-of-economics-and-sociology-of-conventions). This presentation, based on a review of the literature on convention theory to work integration, shows that work integration policies can be divided into two categories: those aimed at employers and those aimed at people in work integration.
An analysis of inclusion policies aimed at commercial companies shows that the aim of inclusion organizations is to influence companies’ human resources policies by influencing their perceptions of inclusion. In order to do this, inclusion organizations, as intermediaries in the field of integration, rely on a range of actions that help to shape these uncertainties (skills assessment, partnership relations, etc.).
An analysis of policies aimed at beneficiaries shows that support for these people is provided “below the conventions”, i.e. upstream of the recruitment process, in order to make it easier for them to pass the various “tests” that give them access to the labor market.
However, convention theory’s analysis shows that these measures tend to individualize the issue of unemployment and encourage the sorting of jobseekers on the basis of behavioral and psychological criteria, which accentuates discrimination in recruitment. These actions have been further reinforced by the recent introduction of activation policies. These policies are based on conventions of individual responsibility, the management of unemployed people who enter into their private lives and the production of judgements about the usefulness and uselessness of certain professional activities by Pôle Emploi, the French institution that aims to decrease unemployment.
Philippe Semenowicz concludes that, in the light of the analyses already carried out, it might be appropriate to focus more on people in work-integration, particularly the uses of work-integration, or to analyze the work-integration process in certain specific professional sectors.
Géraldine Rieucau
Géraldine Rieucau – Jobs, work and the ecological transition: elements for a approach of convention theory
Géraldine Rieucau presented an ongoing research project funded by ADEME, the aim of which is to establish the link between public policy measures for ecological and social transition and the world of work. The project, known as COMETES, began in 2022 and brings together seven partners in two areas with a high incidence of poverty and unemployment (Picardy and Seine-Saint-Denis).
The project has a number of different objectives: identifying green jobs, developing “good quality” green jobs and promoting these jobs. To do this, the author relies on around sixty semi-structured interviews carried out in the two areas, some of which were with directors of organizations involved in integration through economic activity.
First, the analysis reveals three categories of green jobs: 1) green jobs, where the tasks are ecologically oriented; 2) greening jobs, which include ‘green’ tasks; 3) support jobs, which support the ecological transition without tasks specifically oriented towards ecology.
Second, the presenter highlights the fact that transition jobs are currently mainly jobs in the work-integration sector. This raises the question of the continuity of these jobs, insofar as they tend not to provide specific outlets outside the integration structures in the field studied. In this way, the ecological transition is putting pressure on jobs that are a priori low-skilled and temporary, whereas this transition requires long-term investment. This paradox raises the question of how these jobs should be valued in public policy, how economic players should coordinate their efforts and how ecological tasks should be justified in the world of work. These various questions, studied with the help of the powers of valorization, conventions-institutions and the articulation between the registers of ecological justification and the other forms of justification present in capitalism, are still being analyzed. However, it would appear that a form of compromise is emerging between commercial and industrial conventions and a new form of ecological justification that is still struggling to be valued within the current institutional framework.
Géraldine Rieucau concluded with the idea that, if the ecological and social transition is to succeed, green jobs need to be developed and made sustainable. First, by enhancing the individual career paths of people on integration schemes. Second, by further developing training and awareness-raising on the ecological transition, while seeking to avoid distorting existing schemes.
Olivier Gayot
Olivier Gayot – Social clause facilitators as intermediaries in the work-integration labor market
Olivier Gayot presented the main findings of an article (accepted for publication) on the role of social clause facilitators in training and stabilizing the work-integration labor market.
The presentation sought to show how these facilitators, by encouraging the introduction of social clauses in public procurement contracts, are helping to create the conditions for the emergence and stabilization of the work-integration market. This particular market, seen as a form of sub-market adjoining the labor market, aims to promoting access to the labor market for people in situations of integration through economic activity.
The contributor shows how, by carrying out various tasks on behalf of local authorities, social clause facilitators act as intermediaries in this market and participate in the commodification of the work-integration market. First, by shaping the uncertainties involved in recruiting people for work-integration schemes using “profiles” based on objectified social characteristics. Second, by helping to define the price of an hour of work experience. In this way, facilitators help to make the work-integration labor market run more smoothly and ensure its two main characteristics: the presence of a workforce and a price to coordinate exchanges.
The facilitators also help to stabilize the work-integration market. First, by identifying the supply side of this market (beneficiaries of social clauses) and the demand side (hours of work experience included in public contracts). In this way, they seek to influence local authorities in the implementation of social clauses in order to stabilize, or even increase, the number of hours of work-based integration included in public contracts from one year to the next. What’s more, by helping to identify the beneficiaries of the social clauses, the facilitators ensure that they have the workforce available to meet the demand for the work-integration schemes that they are helping to create.
Finally, the author shows that two quality conventions for social clauses coexist, and that these two conventions modify the way facilitators carry out their missions. The first, known as the “quality convention for social clauses directly aimed at integration through economic activity structures”, tends to favor people who are further away from employment and female beneficiaries. The second agreement, known as the “quality convention for social clauses aimed at commercial enterprises”, emphasizes the competitive rules that dictate the operation of public contracts. By promoting these competitive rules, the facilitators are also helping to ensure that social integration structures compete with each other and with commercial enterprises. What’s more, the application of these rules reinforces the logic of “sorting the unemployed” according to their “distance” from the labor market, which translates into competition between beneficiaries.
Olivier Gayot concludes that, through their actions, facilitators have the power to regulate the work-integration labor market, and that this form of regulation varies according to the quality of the social clauses they implement.
2. The economics of convention and forms of justification for social and ecological action
Rainer Diaz-Bone
Rainer Diaz-Bone – Epistemological evaluation of convention theory – evaluation research with convention theory
In his presentation, Rainer Diaz-Bone suggested that evaluation should be seen as a field to be explored by the economics and sociology of conventions. More specifically, he invites researchers in this field to get involved in the issue of program evaluation, which is a form of evaluation that exists both within and outside the academic world and should be based on convention theorists’ foundations.
Rather than a simple evaluation carried out after the implementation of a public policy, program evaluation can use the tools of economics and the sociology of conventions to explore the different stages of evaluation. First, by questioning the objectives of the evaluation, the way in which it is constructed and the choice of criteria used. Then, by drawing on the various approaches in convention theory: the institutional approach, the dispute, the question of values and valorization, the emergence of standards, indicators and categorizations in measurement. Finally, by producing an evaluation of the policy in terms of its objectives and the way in which it has been deployed by public players and received by users.
All these tools, already used in current convention theory, make it possible to question program evaluation at different levels: how it is created, why it is created, what the different stages will be, etc., but also to question the gap between what is expected of a public policy and its effects on the territories in which it is applied. Rainer Diaz-Bone points out that convention theory, thanks to its realistic approach and the fact that it already includes questions about evaluation and value, is today the best approach for training and discussing with evaluation professionals.
However, there are two points of friction between convention theory and program evaluation: 1) convention theorists systematically stand back from their object of study, which is undermined by evaluation processes that involve personal involvement; 2) convention theory is not very well equipped to question its own practices and conclusions in the short time available for evaluation.
In conclusion, Rainer Diaz-Bone suggests two areas for improvement: 1) to gear convention theory towards an ex ante analysis of the implementation of public policies, so that conclusions can be drawn quickly and clearly at the time of evaluation; 2) to improve communication between public authorities and universities in order to overcome the lack of data that limits the work of researchers.
Andriamanalina Razafindrakoto
Andriamanalina Miorintsoa Razafindrakoto – Coordination issues for public players in the social construction of a children’s flour market
Andriamanalina Miorintsoa Razafindrakoto came to present the main findings of her thesis on public health policies relating to infant milk in Madagascar. The Madagascan government is aware of the challenges posed by child malnutrition in a country where 81% of the population lives below the poverty line, and has been taking preventive health action on this issue for 25 years.
The author highlights the successive forms of coordination of these policies: initial national management, based on the actions of the World Bank; regional management, coordinated by UNICEF and the Madagascan Ministry of Health; and current management, based on decentralized cooperation between the Madagascan government and the social enterprise Nutri’zaza.
The author shows that the coordination methods are based on different conventions. The first convention used, a market convention, failed to match the profitability objectives of the social enterprise with the population targeted by public policy. As a result, the coordination of players based on this agreement was abandoned. The second form of coordination is based on a compromise between a civic convention (social aspect) and an industrial convention (production aspect), giving rise to a social action whose hybrid management raises questions.
This hybridization has enabled the social action of distributing infant milk to be maintained over time and to reassure investors and private funds, shareholders in the social enterprise that produced the milk in the first place (industrial agreement). However, local political institutions, which wish to see the distribution of the product as a form of public service (civic agreement), sometimes refuse to apply tax benefits to the social enterprise because they consider that this policy should not result in the generation of profit for a private company. Thus, the compromise at the origin of the institution is made visible by the existence of an ethics committee within the association that distributes the products, a marketing activity (to sell the product) and an activity focused on nutritional education.
Andriamanalina Miorintsoa Razafindrakoto concludes that the implementation and roll-out of this public child nutrition policy, in the form of a hybrid social action, is creating points of tension across the country. The National Nutrition Office, which coordinates the policy across the country, promotes three principles: the principle of free access to the public service, the empowerment of beneficiaries and a principle of non-exclusivity. These three principles are in contradiction with the industrial agreement that enables the social action to be maintained over time, which sometimes obliges the Regional Nutrition Office to buy the products directly and distribute them free of charge in order to achieve the objectives of the public policy.
Anaïs Henneguelle
Anaïs Henneguelle – The greening of French social protection: in search of lost indicators
Anaïs Henneguelle presented the results of a survey, funded by social protection, on the “greening” of this administration. The project, called Proseco, was the result of a call launched by EN3S and was carried out between September 2021 and June 2023.
The call for tenders had two objectives: to identify the environmental pressures caused by social security and to highlight the obstacles and levers for creating more environmentally-friendly social protection. The main question was how to ensure that social protection would be less polluting in the future.
Anaïs Henneguelle explains that the solutions initially envisaged by the social protection system were to make benefit payments conditional on more ecological use, or to pool health transport. For the time being, these solutions have been shelved. However, the project led by the author, Alexandre Berthe (University of Rennes 2) and Lucile Marchand (Agrocampus Rennes), focused more on the very idea of ‘greening social protection’, and the effects that this environmental injunction may have on this institution.
The analysis carried out for this report was based on three questions: 1) why produce indicators; 2) what are statistical indicators used for; 3) who are they used for?
In response to the first question, the presenter explained that several studies exist on the ecological effects of health and its environmental impacts (Shift Project, Ademe). These studies reflect a form of political injunction to produce ecological health indicators. In this way, the production of indicators makes it possible to put people in “working order” by means of figures and objectives, and to justify the implementation of action. The solution favored by the social security system was to use a carbon footprint, despite the irrelevance of some of these indicators to the activities managed by social protection (the carbon cost of paying pensions, for example).
On the second question, the authors show that the statistical indicators used are in fact based on an industrial convention. This convention, which was ill-suited to social security, was nevertheless not called into question, and the use of carbon footprints was generalized to the various regional departments. In so doing, the administration was able to respond to the political injunction to produce figures, even though these were not particularly relevant to the activity of social protection. The contributor shows that, in reality, the figures produced by the administration take the form of ex post justifications for numerous internal organizational changes rather than serving as decision-making aids. Their use therefore allows a form of coordination in the absence of a common representation of the notion of the greening of social security (multiple representations and justifications of what this greening is).
To the third and final question, the presenter explained that the figures created (carbon cost, number of drugs thrown away by doctors, etc.) are not really used in explicit governance policies. If there is a suspicion of implicit governance using these figures, it is not clearly identified and specified by the administration. Nevertheless, the authors of the report show that a narrative is developing around the production of these figures, rather than the figures themselves. This narrative is based on the need to quantify an action and its effects before taking action, which makes it possible, when figures are not available, to justify a certain form of inaction, or to justify certain actions that have already been implemented in another context.
To conclude, Anaïs Henneguelle points out that despite the various existing ecological reports, the actions implemented by the regional social security funds do not offer any scenario for getting “below two degrees”.
Rainer Diaz-Bone, Anaïs Henneguelle et Nicolas Postel
3. The economics of convention and health
Hélène Croguennec – Le Saout
Hélène Croguennec – Le Saout – The commodification of old age in public EPHAD: from user to customer
Hélène Croguennec – Le Saout presented the results of a field study conducted as part of her thesis on the supposed dynamics of financialization in public EPHADs. The study, based on semi-directive interviews and passive observation, revealed that several conventions run through these EPHADs.
The first convention identified by the author is a market convention. It applies to all public EPHADs and is reflected in: standardization of the offer, competition between public and private players in EPHADs within a market that is intended to be homogenous, and the introduction of regular evaluations and a benchmark of good practice. The second agreement is a civic agreement, based both on the fact that these establishments are public and on the health service they provide.
According to the presenter, the predominance of the commercial agreement in EPHADs is leading to two phenomena. The first is the invisibility of public funding (departmental council and social security contributions) for these establishments in favor of private funding (accommodation provided by users). The second is the use of standardized indicators and the systematic use of equations to determine the care and dependency packages that influence the funding of these facilities.
Nevertheless, the two conventions (industrial and civic) coexist and, for the time being, a fragile compromise is emerging. This compromise is expressed by the author as the fact that the market convention is valued in practice as long as it does not imply a lack of quality in the support (civic convention). However, this state of affairs is systematically called into question and is subject to change whenever there is a situation of tension (requests from residents that are not anticipated or considered unwarranted by staff) within the establishments.
Hélène Croguennec – Le Saout concluded with the idea that it might be relevant to extend her analysis not only to private EPHADs, but also to other sectors (disability and early childhood) in order to analyze existing agreements and compare the way in which compromises are made in these structures.
Nicolas Da Silva
Nicolas Da Silva – The industrialization of healthcare and its critics
Nicolas Da Silva presented a summary of the chapter he wrote for the Handbook of Economics and Sociology of Conventions (https://conventions.hypotheses.org/handbook-of-economics-and-sociology-of-conventions). The chapter focuses on the evolution of convention theory applied to healthcare, moving from an analysis of the mechanisms by which healthcare is commodified to the phenomenon of the industrialization of healthcare. The presentation focuses on the question of the industrialization of healthcare, showing how this has become an integral part of medical practice over time.
The author shows that doctors have constructed their representation of healthcare in contradiction with the market and its imperative of profitability. They are also opposed to the state, as employer, which has the power to change the way doctors work, just as it has the power to change the quality of patient care.
Thus, the convention that dominated medical practice until the 1980s was the result of a compromise between the inspired city (creativity, innovation, medical art) and the domestic city (taking into account the individuality of each patient). In this way, the medical practice that was valued was that based on interpersonal relations between doctors and their patients: a good doctor is one who knows his patients.
However, the domestic convention that predominated in the compromise that underpinned medical practices was criticized. This criticism is based in particular on the deleterious effects of medical paternalism, the cognitive limitations of doctors who have difficulty keeping their knowledge up to date, and a form of denunciation of medical opportunism (abuse of the asymmetry of information between doctor and patient). In this way, the compromise between the inspired city and the industrial city has been destabilized, and is tending to be replaced by a conception of health derived from the industrial city (efficiency).
The influence of this approach on medical practices is reflected in the development of randomized clinical trials, which make it possible to compile data and provide information deemed more relevant than that produced by “traditional” practices. In addition, the industrial city is giving rise to: the creation of norms (standards, certifications produced by health agencies, etc.); the monitoring of practices; the introduction of financial incentives to encourage doctors to adopt certain practices considered to be “quality”; the introduction of financial penalties for practices considered to be deviant; the introduction of soft law and self-regulation by doctors; payment for performance (compliance with imposed norms).
The author concludes that the introduction of industrial logic into the way doctors work implies at least two criticisms: 1) the relationship with illness, which may be seen as a break with a standard state (industrial city) or because the patient feels ‘different’ (previous compromise), is poorly defined; 2) the tendency for doctors to become hyperspecialized, which leads them to distinguish between ‘technical’ care and ‘intellectual’ care, tends to limit the effects of care from a systemic point of view. In so doing, the author shows that the State and doctors tend to promote the industrial convention, without giving it the means to function.
Cécile Vasseur, Hélène Croguennec – Le Saout, Nicolas Da Silva et Léo Delpy
Cécile Vasseur
Cécile Vasseur – The use of healthcare networks by mutual insurers: a market-industrial compromise
Cécile Vasseur presented the results of her thesis, defended on 23 November 2023 at the University of Lille (https://www.theses.fr/s336693). The work, which focuses on mutual health insurers, uses a conventionalist approach to show how these organizations, which claim to be non-profit-making, tend to adopt practices and behaviors similar to those of private insurers.
On the one hand, the author highlights the fact that the care network section is a blind spot in the economic analysis of mutual insurance companies. Yet it is within these networks, which are partnerships between mutual insurers and optical, hearing aid and dental care professionals, that mutual insurers adopt the most competitive practices. On the other hand, by analyzing the players’ discourse, Cécile Vasseur highlights the existence of an industrial market compromise. Thus, the practices of mutual insurance companies are based both on the development of standards and norms (industrial agreement) and on competitive logic (market agreement).
The industrial agreement is mainly used in the development of care networks because it makes it possible to set ceiling prices and control the expenditure of the mutual health insurance companies. By promoting an industrial approach to healthcare networks, mutual health insurers are encouraging the emergence of regulated standards and practices, which are not always readily accepted by healthcare professionals. The growing importance of healthcare networks is forcing hearing aid, optical and dental professionals to become part of these networks, even if this integration contradicts the representations of healthcare that they value.
The commercial agreement enables mutual insurance companies to maintain their position in a competitive environment established by various governments and the European Union through a succession of laws. This legislation, which tends to deny the special nature of mutualist players (no profit motive, democracy), pushes these organizations to adopt practices similar to private insurance. In so doing, the author notes an erosion of mutualist values, in particular the democratic aspect of decision-making (reduced representation of customers in decision-making, professionalization of mutual directors). This agreement also influences the relationship that mutual insurers have with their healthcare networks (competition between healthcare providers, competition with other mutual insurers, etc.).
Finally, Cécile Vasseur concludes that despite the discourse of the mutuals, they play an important role in the development of this competitive environment. The players within the mutual health insurers can thus adopt an anti-competitive position through their discourse, while at the same time favoring practices taken from the world of private insurance. By adopting practices similar to those used by private insurers, mutual health insurers reinforce the commercial conception of their activity. In the same way, by importing some of their practices into their organizations and their healthcare network, mutualist players encourage the emergence of a market conception of healthcare. In so doing, the presenter shows that the players act within the institution when they apply the rules imposed on them, but also on the institution when they help to reinforce certain conventions or representations of health.
