Global Platform of International Public Policies
The Case of Health Agencies

Policy Diffusion and Translation: The Case of Health Agencies

Patrick Hassenteufel, Daniel Benamouzig, Jérôme Minonzio e Magali Robelet

ABSTRACT
After a discussion of the concepts of policy diffusion, policy transfer and policy convergence, we put forward the analytical potential of the translation framework combining three dimensions: the discursive dimension, the actor’s dimension and the institutional dimension. With the case of the shaping of evidence-based bureaucracies using quality evaluation and cost benefit analysis in three western European healthcare systems (uk, France and Germany), we give an example of how this framework can be operationalized and explain why it enables to understand divergent convergence processes.

INTRODUCTION: FROM POLICY DIFFUSION TO THE ANALYSIS OF POLICY TRANSLATION

Even if the concept of globalization raises a lot of questions (How can it be defined? What are its different dimensions? When did it start? etc.), it is obvious that the supranational context of public policies has dramatically changed since the 1970s. In the field of policy studies, especially in political science, it has triggered two main research questions: the understanding of international policy diffusion processes and the convergence mechanisms related to globalization.

The first aim of this paper is to pinpoint how these questions are tackled by French policy studies discussing key concepts in the international literature: especially policy diffusion, policy transfer and policy convergence. The second aim is to put forward the analytical potential of the translation framework, which allows to grasp these different dimensions, by taking the case of the introduction and the development of evidencebased bureaucracies using quality evaluation and costbenefit analysis in western European healthcare systems.

Policy analysis itself has been introduced in France as the result of a double diffusion process: of policy sciences tools (especially the importation of predictive and budgeting tools) and of organisation’s sociology by authors such as Jean Claude Thoenig, Michel Crozier, Erhard Friedberg, and Jean Gustave Padioleau.1 It is only in the 1980s that it was developed in political science with more specific approaches leading to a dominant political sociology perspective in today’s French policy studies.2 Two main analytical specificities can be stressed. The first one is the importance given to the cognitive dimension of public policies, the core element of the “référentiel” model,3 which has been recently highlighted as the main component of a “French touch” in policy studies.4 The second one is the sociological analysis of policy actors, a dimension developed as well by the sociology of organizations than by the sociology of fields with different methodological tools. Studies on policy brokers,5 policy elites,6 programmatic actors driving policy changes7 or policy experts8 can be mentioned. These two perspectives, which can be combined,9 are very useful to analyse policy diffusion contents, processes and effects. The two dominant concepts to analyse the globalization of policy orientations, concepts, arguments and tools, in international literature — policy diffusion and policy transfer —, have been discussed by French scholars, especially in a historical perspective,10 who put forward two other notions: circulation and crossings.

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