Archives mensuelles : décembre 2021

From calculation to deliberation: the contemporaneity of Dewey

Patrycja Kaszynska (2021):

Culture, Theory and Critique, 62(1-2), pp. 154-166.

The word crisis comes from Ancient Greek κρίσις which can be translated as ‘power of distinguishing’ and is related to modern κρίνω which means ‘to pick out’. This is apt, because the pandemic of 2020 has exposed the limitation of approaches to social governance premised on calculation. The – some would argue false – choice between either saving lives or the economy, is the highest profile example of the necessity to ‘pick’ between different qualitative options. This has brought into relief something suppressed by the calculation approach, namely the need to adjudicate between multiple and competing value orientations in public life. With this, an alternative way of decision making in the public domain is needed, one that does not revert back to mere politics and subjective decisions. This article turns to the writings of John Dewey to look for alternatives. It shows that the model of deliberative inquiry found in Dewey, even though not without its own challenges, presents a viable option to replace metrics-based valuation approaches, without falling back on the whimsy of political judgement. This suggests that Dewey is not just contemporaneous, but that translating his insights into action could not be more urgent.

Extract: “Quantification, commensurability, calculation
Many – some would say most (Zelizer 1994, 2000) – things can be calculated. This, as described below, is due to the fact that calculation has effectively served for a while as the cornerstone of modern societies (Deringer 2018; Desrosières 1998). It has become a method of decision making, certainly in the allocation of public funding but also beyond in that, through Weberian instrumental rationality, it has colonialised the social by presenting itself as a way of deciding the course of social action that is not only more efficient (Taylor 2004) but also, paradoxically, more democratic (see the section discussing the market below).
Important in this process was the establishment of statistical science in the nineteenth century (Desrosières 1998) and the solidification of the dominant place of economics vis-à-vis politics (Mirowski and Plehwe 2009), but as Diaz-Bone and Didier point out, there were a number of developments that came to coincide: ‘The establishment of the metric system in Europe in the 19th century, the upcoming of industrial production, the unification of currencies, the processes of nation building and of internationalization promoted the importance of quantitative information, which are endowed with a huge scope in space and time, which also facilitate comparisons between units and points in time (Diaz-Bone and Didier 2016: 8).’ Facilitating comparison is the key phrase here. The very idea of calculation requires some form of commensurability and typically presupposes quantification. Quantification describes the replacement of entities with numerical surrogates. Espeland and Stevens define it as ‘the production and communication of numbers’ (Espeland and Stevens 2008: 401). And yet, in spite of this deceptively simple formulation, Espeland and Stevens (1998), Espeland and Sauder (2007), Thévenot (2009), Fourcade (2016) and others have shown that quantification is a complex process involving distinctive decisions over which entities should be abstracted and how these new units of analysis come to be defined (to use Fourcade’s terminology ‘nominalised’).”(p. 156).

Link to the article

Statistical Conventions and the Forms of the State: A Story of South African Statistics

Juliette Alenda-Demoutiez (2021)

New Political Economy. Online first

Abstract. Central for governance, official statistics are far from natural artefacts. The purpose, meaning and interpretation of statistical conventions evolve across time and space, in relation to social and political aspects. If criticism of indicators is growing since several years, less is understood on the process of quantification himself, especially in non-Western countries. Understanding quantification processes in different contexts is even more important as statistics are widely used in the development field. With a different complexity compared to Northern societies, African countries appear as privileged fields for this understanding and its connection with state-building. By using the analytical framework of the conventions school, I reread the case of official statistics in South Africa. Based on process-tracing, I show the history of the quantification process through its relations with the state, from a racial state during the apartheid to a developmental state nowadays.

Link to the article

L’organisation de la santé en France depuis 1967. Vers un gouvernement marchand ?

The organization of health care in France since 1967. Towards a market government?
PhD thesis

Victor Duchesne (2021)

Thèse de doctorat en économie, soutenue le jeudi 9 décembre 2021 à 10h à l’Université Sorbonne Paris Nord

Jury :
Philippe BATIFOULIER, Professeur des universités, Université Sorbonne Paris Nord, CEPN (Directeur de Thèse)  
Jean-Paul DOMIN, Professeur des universités, Université de Reims Champagne-Ardenne, REGARDS  
Olivier FAVEREAU, Professeur émérite des universités, Université Paris Nanterre, Economix  
Sophie HARNAY, Professeure des universités, Université Paris Nanterre, Economix (Rapportrice)
Florence JANY-CATRICE, Professeure des universités, Université de Lille, Clersé (Rapportrice)  
Mehrdad VAHABI, Professeur des universités, Université Sorbonne Paris Nord, CEPN

Résumé. Cette thèse a pour ambition de mettre en évidence le rôle de l’Etat central dans le changement institutionnel en santé des années 1960 à aujourd’hui. Pour y parvenir, nous adoptons une perspective théorique conventionnaliste et une démarche historique. A partir d’un moment fondateur, mais oublié de l’histoire de la Sécurité sociale, la réforme de 1967 dite Jeanneney, nous montrons comment l’Etat a progressivement pris le contrôle sur le système de santé au nom de ses objectifs économiques.
Ainsi, dans une première partie nous montrons à partir de l’analyse des justifications de la réforme de 1967 que cette réforme constitue le moment où la Sécurité sociale est désormais subordonnée aux objectifs de politiques économiques portés par l’Etat. L’Etat prend le pouvoir politique des mains du monde du travail et met fin à la démocratie sociale incarnée par la Sécurité sociale de 1945.
Dans une deuxième partie nous montrons que l’Etat pour assoir son pouvoir s’est équipé d’une administration sous forme d’agences, nouvelle bureaucratie technique intimement liée à l’Etat et à un mode de gouvernement néolibéral. Nous mettons en évidence la continuité historique avec la réforme de 1967 et la capacité d’adaptation au service de l’Etat des agences sanitaires notamment des Agences Régionales de Santé. Les agences constituent la solution organisationnelle pour concrétiser le contrôle étatique sur le système de soins et la Sécurité sociale.
Enfin dans une troisième partie nous montrons que la réappropriation de la Sécurité sociale initiée en 1967 par l’Etat est aussi celle de la solidarité. Le choix par l’Etat de recourir au marché plutôt qu’à la Sécurité sociale l’a conduit à développer un ensemble de règles afin de concilier impératif de solidarité et logique marchande.
Si l’effort de réglementation des Organismes d’Assurance Maladie Complémentaire peut être perçu, comme une tentative de contrainte étatique au détriment de la liberté concurrentielle, nous montrons que bien au contraire l’étatisation produit le marché et assure son développement par le transfert de l’impératif de solidarité.

Mots-clés : Histoire de la protection sociale, Economie de la santé, Economie des conventions, Agences Sanitaires, ARS, New Public Management, Sécurité sociale, Assurance santé

Abstract. This thesis aims to highlight the role of the central state of institutional change in health care from the 1960s to the present. To achieve this, we adopt a conventionalist theoretical perspective and a historical approach. Starting from a founding but forgotten moment in the history of social security, the 1967 Jeanneney reform, we show how the state gradually took control of the health system in the name of its economic objectives.
Thus, in the first part we show, based on an analysis of the justifications for the 1967 reform, that this reform constitutes the moment when social security is henceforth subordinated to the economic policy objectives of the state. In other words, it was the moment when the State wrested political power from the hands of the world of work and put an end to the social democracy embodied by the Social Security of 1945.
In a second part we show that the State, in order to assert its power, has equipped itself with an administration in the form of agencies, a new technical bureaucracy closely linked to the State and to a neoliberal mode of government. We highlight the historical continuity with the 1967 reform and the capacity of adaptation to the service of the State of health agencies, in particular the Regional Health Agencies. The agencies constitute the organizational solution to concretize the state control over the health care system and the Social Security.
Finally, in the third part we show that the reappropriation of Social Security initiated in 1967 by the State is also that of solidarity. The State’s choice to resort to the market rather than to Social Security led it to develop a set of rules in order to reconcile the imperative of solidarity with the logic of the market. While this regulatory effort may be perceived, particularly by the private health insurance organizations, as an attempt at state constraint to the detriment of competitive freedom, we show that, on the contrary, state control produces the market and ensures its development through the transfer of the solidarity imperative.

Keywords: History of social protection, Health economics, Economics of convention, Health agencies, ARS, New Public Management, Social security, Health insurance