Search

This article starts with a discussion of the analytical issues of the Programmatic Action Framework (PAF); based on the hypothesis that small groups of individuals, sharing a similar analysis of a policy problem sustaining a common policy change program (including orientations, arguments, and instruments) giving them a collective identity, and behaving strategically as a collective actor, can be main drivers of policy change. We then present the methodological implications of the empirical analysis of such programmatic groups and policy change programs. The methodology of the Programmatic Action Framework combines tools coming from the sociology of elites (positional analysis, analysis of professional trajectories, relational analysis) and the sociology of the policy process. It was first applied in empirical researches on health insurance reforms in France and the United States since the 1980s, shedding the light on the key role of specialized policy elites (specialized senior civil servants in France, long‐term insiders in the United States). We conclude by stressing that, because of its systematic and encompassing empirical methodology, the Programmatic Action Framework can be used in a comparative way, in other policy sectors than health care.

International audience; This article proposes an endogenous perspective on policy change, combining the analysis of the policy process (policy framing, decision and implementation) with the analysis of the transformation of professional groups and their organizational representation. It deals with the case of territorial undersupply in primary care provision, which has become a key issue in healthcare policies in France and Germany since 2000 (the analysis goes up to 2018). Policy changes in these two health insurances systems cannot be explained only by the salience of the problem, framed as “medical deserts” in France and as “lack of physicians” in Germany. We propose an explanation based on the internal fragmentation of the medical profession, playing a paradoxical role: as limiters of change (for the established and institutionalized organizations) and as promoters of change (for the medical entrepreneurs shaping new organizations defining and supporting new primary care service structures).

Dossier policy transfer, diffusion and circulation; International audience

The French welfare system is usually classified as a case of a corporatist–conservative welfare regime because its main components clearly reflect the Bismarckian tradition of social insurance. The economic, social, and political functions of the French welfare system developed after 1945 explain the subsequent difficulties in transforming it following the economic crisis of the 1970s. We show that until the 1990s the main goal of welfare policies was the rescue of the French model based on financial measures. It is only since the end of the twentieth century that French social programs and institutions have been progressively (and partly) reformed to adapt to the new economic and social environment. This reform trajectory has been changed only slightly since the 2008 crisis, despite growing European intrusiveness.

To what extent have the recent re-enforcement of the EU budgetary competences lead to a stronger capacity of the EU to prescribe welfare state reforms in France? To answer this question, we compare the situation before and after the regulatory changes at the EU level. We first analyse long-term trends in French welfare reform since the early 1990s until 2009. We underline a strong consistency between EU recommendations and French reforms, despite an absence of explicit reference to EU guidelines when French politicians are presenting the reforms. Governments were afraid that referring to Europe would reinforce opposition to already unpopular welfare reforms. Second, we focus on the reforms adopted when France has been subjected to Excessive Deficit Procedure (in 2009 and since 2013). French authorities have (re)-discovered that the EU has gained two means of pressure: first, the need for deficit reduction is now explicitly integrated into French political discourses and policies (thus having a strong impact on control over social spending) and, second, the EU is able to demand evidence of reform. Finally, we show that France has maintained some flexibility on the timing and content of the reforms. Because, on the one side, welfare state reforms need to be negotiated domestically and, on the other side, of growing market concern about public debt, it remains difficult to claim that Brussels is the main driver of welfare state reform.

Cet article compare l’evolution de l’organisation politique et institutionnelle des systemes d’assurance maladie francais et allemand. Si, dans les annees 1990, les deux systemes ont plutot diverge, une convergence est a l’œuvre dans les annees 2000. Ce rapprochement est analyse en termes d’affirmation d’un gouvernement a distance de l’assurance maladie. Pour l’expliquer, l’accent est mis sur la structuration d’acteurs programmatiques lies a l’Etat et confrontes a des enjeux de pouvoir similaires dans les deux pays (limitation du role des caisses et des medecins pour rendre les systemes d’assurance maladie plus efficients).

To what extent have the recent re-enforcement of the EU budgetary competences lead to a stronger capacity of the EU to prescribe welfare state reforms in France? To answer this question, we compare the situation before and after the regulatory changes at the EU level. We first analyse long-term trends in French welfare reform since the early 1990s until 2009. We underline a strong consistency between EU recommendations and French reforms, despite an absence of explicit reference to EU guidelines when French politicians are presenting the reforms. Governments were afraid that referring to Europe would reinforce opposition to already unpopular welfare reforms. Second, we focus on the reforms adopted when France has been subjected to Excessive Deficit Procedure (in 2009 and since 2013). French authorities have (re)-discovered that the EU has gained two means of pressure: first, the need for deficit reduction is now explicitly integrated into French political discourses and policies (thus having a strong impact on control over social spending) and, second, the EU is able to demand evidence of reform. Finally, we show that France has maintained some flexibility on the timing and content of the reforms. Because, on the one side, welfare state reforms need to be negotiated domestically and, on the other side, of growing market concern about public debt, it remains difficult to claim that Brussels is the main driver of welfare state reform

Il est possible de parler de l’emergence d’une « elite du Welfare » pour deux raisons principales. La premiere est la structuration d’un milieu homogene de hauts fonctionnaires partageant un certain nombre de proprietes (notamment l’appartenance a certains grands corps et une longevite dans le secteur), de ressources (d’expertise et de pouvoir du fait des positions institutionnelles occupees), et de conceptions (en particulier sur les reformes a mener pour preserver le systeme francais de protection sociale). La seconde est le poids de ces hauts fonctionnaires dans la decision publique (l’analyse porte sur les politiques de protection maladie et en matiere de prestations familiales depuis 1981) ce qui traduit une autonomie relative par rapport aux acteurs politiques.

Resume : L’introduction de ce numero special propose de mettre en relation deux approches de l’analyse de la transnationalisation des politiques publiques : les travaux portant sur la diffusion et les transferts, d’un cote, et ceux traitant de la convergence, de l’autre. Il plaide pour une demarche comparative – qualifiee de comparaison transnationale – n’isolant pas les differents niveaux d’action publique et centree sur les acteurs en interaction afin de comprendre les processus de traduction, entendus comme operation cognitive de re-creation d’un modele et comme produit de negociations entre differents acteurs.

National audience; Cet article présente les résultats d'une recherche sur le temps de travail des médecins hospitaliers dans cinq pays européens : l'Allemagne, le Danemark, l'Espagne, la Lituanie et le Royaume-Uni. Son objet est d'expliquer la persistance de différences de temps de travail entre les pays et à l'intérieur de chacun malgré l'existence d'une directive européenne. Cette explication est développée en trois temps : tout d'abord, la transposition de la directive dans le droit national donne lieu à des interprétations qui s'écartent plus ou moins de la norme européenne selon les pays. Deux séries de facteurs sont ensuite avancées. La première renvoie au rôle de la négociation collective dans chacun des pays qui conduit à des différenciations en fonction du statut des médecins hospitaliers, du type d'hôpitaux et des territoires considérés. La seconde renvoie au contexte hospitalier dans son ensemble. Le temps de travail apparaît comme un enjeu secondaire dans les pays étudiés, inscrit dans le contexte plus général des enjeux et des évolutions des politiques hospitalières nationales et de la démographie médicale. Les enjeux de la transposition de la directive européenne sur le temps de travail dans le secteur hospitalier prennent donc sens avant tout par rapport à ces enjeux nationaux.

International audience; In France, Germany, and Spain, state-strengthening reform of national health policies in the past two decades have been enacted at a time when economic globalization and neo-liberal ideology were combining to encourage the retreat of the state from other areas of economic management and social policy. This article suggests two elements of explanation for that seeming contradiction. The first of these is an increasing reliance on regulatory instruments that allow increased state influence in a context of budgetary rigor. In addition, we find in all three cases that the competition among programmatic for legitimate authority over policy decisions worked to enhance the autonomy of sectoral decision-makers.; En France comme en Allemagne et au Royaume Uni, un renforcement de l'État dans les politiques de santé dans les vingt dernières années coïncide avec une époque ou la globalisation économique et l'idéologie néolibérale encouragent le retrait des États non seulement de la gestion économique mais aussi d'autres secteurs de politique sociale. Cet article met en avant deux éléments d'explication. Le premier se trouve dans le rôle croissant des instruments de régulation, qui permettent l'action étatique dans un contexte de rigueur budgétaire. Nous démontrons également dans les trois cas nationaux que la concurrence entre acteurs programmatique pour exercer l'autorité légitime sur un secteur de politiques publiques contribue à renforcer l'autonomie des décideurs sectoriels.

Out of steam or search for a second wind ? public policy analysis à la française In France, public policy analysis is currently in search of its second wind. Indeed, today it has to a certain extent run out of steam due to a tendency to look inwards and cut itself off from the rest of political science but also, and above all, to a lack of methodological reflection. This is particularly so in one of the flag-bearing parts of French approaches to public policies : the so-called cognitive approach. In order to get their second wind, these approaches could usefully reframe themselves within apolitical sociology perspective. In particular, analysis of the arti­culation between policy and politics appears to offer a stimulating way forward, so long as one avoids getting bogged down in the (impossible) quest for « the » relevant political variable. Ins­tead, the way forward is to investigate the legitimation and the politicisation of public policy-making., L'analyse des politiques publiques en France est aujourd'hui à la recherche d'un second souffle. En effet, un certain essoufflement la guette du fait d'éléments de cloisonnement sur elle-même de cette sous-discipline de la science politique et surtout à cause d'un déficit de réflexion méthodologique. Celui-ci est net dans le cas, emblématique pour l'analyse des politiques publiques en France, de l'approche cognitive. Ce second souffle peut notamment passer par une problématisation des politiques publiques en termes de sociologie politique. L'analyse de l'articulation policy/politics offre des pistes de recherche stimulantes, à condition de dépasser la quête (impossible) de « la » variable politique pertinente, en s'intéressant notamment à la légitimation et à la politisation des politiques publiques., Hassenteufel Patrick, Smith Andy. Essoufflement ou second souffle ? L'analyse des politiques publiques « à la française ». In: Revue française de science politique, 52ᵉ année, n°1, 2002. pp. 53-73.

Since the early 1990s, three issues have progressively become sustained objects of debates within French policy analysis: the causal role of ideas within public action; the relationship between institutions and actors; and how studying public policies reveals both the state and politics. Indeed, this progression mirrors the way specialists based in France have engaged in international debates over the last three decades. If, in the 1990s, this field of study was essentially autonomous from extra-national developments, by contrast the following decade was marked by wholesale importation of approaches initiated elsewhere. Since the end of the 2000s, however, greater cross-fertilization between endogenous and exogenous perspectives has emerged, alongside a greater willingness to participate assertively and cumulatively in international scientific fora.

This chapter discusses the persistent monopoly of the grands corps in the production and mobilisation of policy analysis in the French context. Top officials have historically built their legitimacy on detention of ‘generalist’ policy knowledge, transmitted within administrative grandes écoles, and mobilised at the central level. However, the diversification of policy experts within French administration and the rise of alternative legitimate knowledge has questioned this ‘generalist model’. Two significant evolutions are the increasing influence of ‘numbers’ compared to more traditional literary or legal skills and the shift of policy expertise downstream the policy process, as top civil servants’ work has been increasingly oriented toward policy evaluation and performance measure. Their ability to master these new types of policy knowledge certainly conditions the persistence of their power over rival actors both inside and outside government, to address the growing policy expertise of consultants, private-sector experts and members of interest groups.

DOI de l'ouvrage : 10.1332/policypress/9781447324218.003.0001; International audience; The subject of the present chapter attempts to ‘deconstruct’ the French territorial question and demonstrate that territorial policy analysis can break free from the limitations imposed by the primarily ‘statist’ conceptual framework in which it has hitherto been viewed. In the first section of the chapter, we indicate the scale and nature of the present political and administrative territorial structures and comment also on the paucity of academic research work on this subject. In the second section, we highlight the main changes in the territorial framework of policy building, through an evolution from vertical to horizontal dialectic of powers and capacities. In the third section we discuss territorialisation, as the results of a double process. On the one hand, the role of ideas in territorial policy building; on the other hand, the dynamics of differentiation that put the French model into question. Thus, focusing on policy analysis in French local policies – in a global comparative perspective – sheds light on the huge challenge it causes for the coherence of ‘national models’. As in other countries, local policies in the French context are simultaneously influenced by globalisation and decentralisation, opening new scenes for vertical and horizontal interactions toward the provision of public goods and service.