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Although horizontal equity is considered a universal guiding principle in socialized health systems, most of the countries where such systems are implemented show social inequalities in health care services consumption.This thesis brings together four studies. It aims at contributing to the analyses of health system reforms regarding equity in access to health care services.The introduction provides a description of social inequalities in health care services consumption in France as well as of the main mechanisms which, inside the French health system, can give rise to these inequalities.In the first chapter we study the links between financial barriers in accessing healthcare and health status. We show that unmet needs for financial reasons are associated with worse future health status.The second chapter proposes an analysis of the doctor-patient interaction and how it can affects inequalities in health care consumption. We first study the categorizations operated by the doctors about their patients according to the patients' socioeconomic status. We then study how these categorizations interact with observed practices patterns.The third chapter brings together two analyses of the "preferred doctor reform". A first study analyses the reform and its context, with a focus on the role of the stakeholders. A second study investigates the consequences of the reform on financial access to specialist care. ; En dépit des objectifs énoncés de respect du principe d'équité horizontale, on observe des inégalités sociales dans la consommation de soins des pays dotés de systèmes de santé socialisés.Cette thèse se propose, au travers de quatre études, de contribuer à l'analyse des politiques publiques dans le système de santé, du point de vue de l'équité de recours aux services de santé. L'introduction propose des éléments descriptifs des inégalités sociales de recours aux soins en France ainsi que des principaux mécanismes qui, à l'intérieur du système de santé français, peuvent en être à l'origine.Le premier chapitre ...

Although horizontal equity is considered a universal guiding principle in socialized health systems, most of the countries where such systems are implemented show social inequalities in health care services consumption.This thesis brings together four studies. It aims at contributing to the analyses of health system reforms regarding equity in access to health care services.The introduction provides a description of social inequalities in health care services consumption in France as well as of the main mechanisms which, inside the French health system, can give rise to these inequalities.In the first chapter we study the links between financial barriers in accessing healthcare and health status. We show that unmet needs for financial reasons are associated with worse future health status.The second chapter proposes an analysis of the doctor-patient interaction and how it can affects inequalities in health care consumption. We first study the categorizations operated by the doctors about their patients according to the patients' socioeconomic status. We then study how these categorizations interact with observed practices patterns.The third chapter brings together two analyses of the "preferred doctor reform". A first study analyses the reform and its context, with a focus on the role of the stakeholders. A second study investigates the consequences of the reform on financial access to specialist care. ; En dépit des objectifs énoncés de respect du principe d'équité horizontale, on observe des inégalités sociales dans la consommation de soins des pays dotés de systèmes de santé socialisés.Cette thèse se propose, au travers de quatre études, de contribuer à l'analyse des politiques publiques dans le système de santé, du point de vue de l'équité de recours aux services de santé. L'introduction propose des éléments descriptifs des inégalités sociales de recours aux soins en France ainsi que des principaux mécanismes qui, à l'intérieur du système de santé français, peuvent en être à l'origine.Le premier chapitre ...

From the publication of the French translation of a book by Peter Winch, the article reverted to the tendency of political science and, more broadly, of social sciences to adopt the naturalist view that the phenomena they deal with existed independently from the point of view of the members of society involved in their production. In this sense, the opposing positions of Bruno Latour and Pierre Favre, published in RFSP issues 58 (4) and (5), are similar: they argue that it is possible to determine what is and is not political externally to specific practices. ; International audience Based on the French translation of a book by Peter Winch, this article reassesses the tendency in political science – and, more broadly, in the social sciences – to adopt the naturalistic view that the phenomena those sciences explore exist independently of the viewpoints of members of society involved in their production. In this sense, the contrasting positions taken by Bruno Latour and Pierre Favre, published in issues 58 (4) and (5) of the RFSP, turn out to be similar : both posit that what is and is not political can be determined without reference to specific practices. ; From the publication of the French translation of a book by Peter Winch, the article reverted to the tendency of political science and, more broadly, of social sciences to adopt the naturalist view that the phenomena they deal with existed independently from the point of view of the members of society involved in their production. In this sense, the opposing positions of Bruno Latour and Pierre Favre, published in RFSP issues 58 (4) and (5), are similar: they argue that it is possible to determine what is and is not political externally to specific practices. ; À partir de la publication de la traduction française d'un ouvrage de Peter Winch, l'article revient sur la tendance de la science politique et, plus largement, des sciences sociales à adopter le point de vue naturaliste selon lequel les phénomènes dont elles traitent existeraient indépendamment du ...

National audience ; L'Administration dispose de très larges pouvoirs sur les institutions privées sociales et médico-sociales allant de l'autorisation à la fermeture en passant par le contrôle de l'activité sous toutes ses formes. Cette soumission résulte de la participation de ces institutions à la réalisation de l'intérêt général c'est-à-dire du service public de l'action sociale et médico-sociale.

National audience ; L'Administration dispose de très larges pouvoirs sur les institutions privées sociales et médico-sociales allant de l'autorisation à la fermeture en passant par le contrôle de l'activité sous toutes ses formes. Cette soumission résulte de la participation de ces institutions à la réalisation de l'intérêt général c'est-à-dire du service public de l'action sociale et médico-sociale.

The deep crisis of medical practices raises issues regarding the existing legal framework. The health costs are skyrocketing and the government are loosing grip to the social security system. The general practitioner ( GP) doctors are the first receivers of measurements which aim to control a social security system and the current legal framework means that GP's are be controlled by strict sanctions. The legal framework governing doctors has been designed to superwise them, however due to the enforced sanctions this leads to their repression. Addressing this challenge between the GP'S and the National Health System is essential for doctors and also other health professions. As doctors are tied and bound by this regulation contract they must also he protected by human rights when he is controlled. The law pursuits of doctors will be studied under the spectrum of growing influence of the European Human Right Court. ; Alors que la médecine libérale traverse une crise profonde, se pose la question du cadre juridique de l'exercice de l'activité des médecins libéraux. Dans un contexte d'explosion des dépenses de santé, les médecins libéraux apparaissent comme les premiers destinataires de mesures destinées à mieux contrôler un système de sécurité sociale qui échappe aux pouvoirs publics, au moins sur le plan économique en ce qui concerne les dépenses. La sanction devient dès lors le moyen d'action des instances chargées de contrôler les médecins libéraux. Le principe d'attraction des médecins libéraux dans le système juridique du conventionnement semble mis en place pour mieux les encadrer et facilite en tout cas leur répression. La légalité de la convention passée entre médecins et assurance maladie, et la possibilité de contester cette convention, constituent un enjeu fondamental pour toute la profession, mais aussi pour les autres professionnels de santé qui fonctionnent à partir du conventionnement. Prisonnier du conventionnement, le médecin libéral doit bénéficier de la protection de libertés fondamentales ...

The deep crisis of medical practices raises issues regarding the existing legal framework. The health costs are skyrocketing and the government are loosing grip to the social security system. The general practitioner ( GP) doctors are the first receivers of measurements which aim to control a social security system and the current legal framework means that GP's are be controlled by strict sanctions. The legal framework governing doctors has been designed to superwise them, however due to the enforced sanctions this leads to their repression. Addressing this challenge between the GP'S and the National Health System is essential for doctors and also other health professions. As doctors are tied and bound by this regulation contract they must also he protected by human rights when he is controlled. The law pursuits of doctors will be studied under the spectrum of growing influence of the European Human Right Court. ; Alors que la médecine libérale traverse une crise profonde, se pose la question du cadre juridique de l'exercice de l'activité des médecins libéraux. Dans un contexte d'explosion des dépenses de santé, les médecins libéraux apparaissent comme les premiers destinataires de mesures destinées à mieux contrôler un système de sécurité sociale qui échappe aux pouvoirs publics, au moins sur le plan économique en ce qui concerne les dépenses. La sanction devient dès lors le moyen d'action des instances chargées de contrôler les médecins libéraux. Le principe d'attraction des médecins libéraux dans le système juridique du conventionnement semble mis en place pour mieux les encadrer et facilite en tout cas leur répression. La légalité de la convention passée entre médecins et assurance maladie, et la possibilité de contester cette convention, constituent un enjeu fondamental pour toute la profession, mais aussi pour les autres professionnels de santé qui fonctionnent à partir du conventionnement. Prisonnier du conventionnement, le médecin libéral doit bénéficier de la protection de libertés fondamentales ...

The paper looks into the integration debate among French sociologists and politists in the beginning of the 1990s, in the aftermath of the first "veil affair" at school. It shows that the authors, of various political and methodological tendencies (Schnapper, Noiriel, Taguieff, etc.) have taken a stand on French national identity. So doing, they have helped to make up the French national identity and to introduce in public opinion the "nationalist-republican" stance, which refers inconsiderately to the French statist tradition. ; L'article étudie la discussion sur l'intégration parmi les sociologues et politologues français du début des années 1990, au lendemain de la première " affaire de voile " à l'école. Il montre que les auteurs, de tendances politiques et méthodologiques diverses (Schnapper, Noiriel, Taguieff, etc.), ont pris position plus ou moins explicitement sur l'identité nationale française : leurs travaux sont des prises d'identité nationale. Ce faisant, ils ont contribué à la forger et à introduire dans l'opinion publique le " nationalisme républicain ", qui se réfère à la tradition étatique française d'une façon impensée

The paper looks into the integration debate among French sociologists and politists in the beginning of the 1990s, in the aftermath of the first "veil affair" at school. It shows that the authors, of various political and methodological tendencies (Schnapper, Noiriel, Taguieff, etc.) have taken a stand on French national identity. So doing, they have helped to make up the French national identity and to introduce in public opinion the "nationalist-republican" stance, which refers inconsiderately to the French statist tradition. ; L'article étudie la discussion sur l'intégration parmi les sociologues et politologues français du début des années 1990, au lendemain de la première " affaire de voile " à l'école. Il montre que les auteurs, de tendances politiques et méthodologiques diverses (Schnapper, Noiriel, Taguieff, etc.), ont pris position plus ou moins explicitement sur l'identité nationale française : leurs travaux sont des prises d'identité nationale. Ce faisant, ils ont contribué à la forger et à introduire dans l'opinion publique le " nationalisme républicain ", qui se réfère à la tradition étatique française d'une façon impensée

The paper looks into the integration debate among French sociologists and politists in the beginning of the 1990s, in the aftermath of the first "veil affair" at school. It shows that the authors, of various political and methodological tendencies (Schnapper, Noiriel, Taguieff, etc.) have taken a stand on French national identity. So doing, they have helped to make up the French national identity and to introduce in public opinion the "nationalist-republican" stance, which refers inconsiderately to the French statist tradition. ; L'article étudie la discussion sur l'intégration parmi les sociologues et politologues français du début des années 1990, au lendemain de la première " affaire de voile " à l'école. Il montre que les auteurs, de tendances politiques et méthodologiques diverses (Schnapper, Noiriel, Taguieff, etc.), ont pris position plus ou moins explicitement sur l'identité nationale française : leurs travaux sont des prises d'identité nationale. Ce faisant, ils ont contribué à la forger et à introduire dans l'opinion publique le " nationalisme républicain ", qui se réfère à la tradition étatique française d'une façon impensée

Today, Corporate Social Responsibility and Public Service logics, claiming to serve the general interest, are spreading within the management of for-profit public service networks in France; networks that have been historically privatized or on the way to becoming. The aim of this research is to bring an understanding to how these logics are opposed, juxtaposed and articulated in a managerial context that is dominated by a logic of maximized shareholder value.In this perspective, we rely on the notion of "device", as employed by Foucault, and the actor-network theory. We focus on the France Telecom company (FT) and its CSR "device(s)". We also use comparative insights drawn from additional case studies.Our results indicate that the official CSR "device" for FT is disconnected from public service logics, placing more importance on short term logics. Its priority is risk anticipation and communication, demonstrating FTs preference for the CSR Business Case. Nevertheless, in a decentralized and autonomous way, innovative CSR initiatives progressively emerge from within R&D, strategic marketing functions and strategic partnerships with key suppliers. These initiatives target profitability with environmental protection concerns, public service by proxy (providing benefits to utility services to help them better perform their missions) and digital divide overtake. However, in the social area, the FT CSR policy is embodied primarily through internal policies of diversity as well as control of the supply chain which was put in place to avoid major human rights violations. These policies seem to hardly touch the heart of the employment relationship, unless counter-powers seize the opportunity to do so, as shown through the case study concerning the International Framework Agreement on the fundamental social rights at work in FT. ; Aujourd'hui, RSE et Service Public dont les logiques prétendent servir l'intérêt général imprègnent le management des grands services publics de réseaux historiques français privatisés ou en voie de l'être. La recherche présentée vise à comprendre comment ces logiques s'opposent, se juxtaposent, et s'articulent concrètement dans un tel contexte managérial dominé par la logique de Maximisation de la Valeur pour l'Actionnaire.Pour ce faire, nous mobilisons le concept de dispositif forgé par Foucault ainsi que la sociologie de l'acteur réseau. Nous nous centrons sur le cas de l'entreprise France Télécom (FT) et de son dispositif RSE en y apportant quelques éclairages comparatifs.Nos résultats indiquent que chez FT le dispositif RSE officiel se déploie en se détachant des logiques de Service Public et en privilégiant le Business Case. Il poursuit prioritairement des objectifs de communication et d'anticipation des risques. Mais de manière décentralisée et autonome, émergent progressivement des initiatives RSE innovantes qui reposent sur la R&D, le Marketing stratégique et les partenariats avec les principaux fournisseurs. Elles visent la protection de l'environnement, le Service Public par procuration (en fournissant aux services publics des prestations leur permettant de mieux assurer leurs missions), et le dépassement de la fracture numérique, en même temps que la profitabilité. Dans le domaine social cependant, la RSE s'incarne surtout à travers des politiques de diversité (en interne) et de contrôle de la chaine d'approvisionnement pour éviter des violations majeures des droits de l'homme, ne touchant guère le cœur de la relation d'emploi, à moins que les contre-pouvoirs ne s'en emparent, comme nous le montrons dans l'étude du cas de l'Accord Cadre International sur les droits sociaux fondamentaux au travail de FT.

L'évaluation thématique des pollinisateurs, de la pollinisation et de la production alimentaire entreprise sous les auspices de la Plateforme intergouvernementale scientifique et politique sur la biodiversité et les services écosystémiques a pour but d'analyser la pollinisation animale, en tant que service écosystémique de régulation sous-tendant la production alimentaire, dans le contexte de sa contribution aux bienfaits que l'homme reçoit de la nature et à la réalisation d'une bonne qualité de vie. À cette fin, elle met l'accent sur le rôle des pollinisateurs natifs et domestiques, l'état et les tendances des pollinisateurs, les réseaux pollinisateurs-plantes et la pollinisation, les facteurs de changements, les impacts sur le bien-être humain, la production alimentaire face aux déclins et aux déficits de la pollinisation et l'efficacité des interventions menées pour y remédier. Le rapport présentant les résultats de l'évaluation est disponible dans le document IPBES/4/INF/1/Rev.1. Le présent document, établi à l'intention des décideurs, résume les informations figurant dans ce rapport.

National audience The study of public network services in relation to the characteristics of the French social model is rarely undertaken. This is the purpose of this article. The way in which network infrastructure is developed and the management of services by companies with a monopoly have in fact led to universal access to services and high "standard" levels of service provision — which is worth recalling the desired effects in the socially democratic states described by Gosta Espig-Andersen. ; National audience L'étude des services publics en réseaux en liaison avec les caractéristiques du modèle social français est rarement entreprise. C'est la visée de cet article. Le mode de développement des infrastructures de réseau et la la gestion des services par des entreprises en monopole ont abouti,de fait, à un accès universel aux services et à des niveaux de prestation "standard" élevés - ce qui n'est pas sans rappeler les effets recherchés dans les Etats de type social démocratie décrit pas Gosta Espig-Andersen.

At the intersection of social history, the sociology of law and the sociology of elites, the thesis goes back to the origin of a key concept of the French Republican State: public service. Between 1870 and 1940, this idea, which preceded the new regime, is reshaped by different types of actors in a more democratic sense, as an aggiornamento of state-thought. The legal circles (senior officials of the Conseil d'État and law professors) took a prime position during this update. They notably made advantage of the rise in importance of administrative litigation to legitimate their position as opposed to civil law specialists and impose a vision "from above" of public service, understood as true science of administration. By retracing the sequence of events that made a myth from the Blanco case of 8 February 1873, the thesis aims to give an account of the construction of a profession, that of a lawyer specialising in public law or in administrative law, at the same time as the creation of a "public" field. Actors distant from the legal field (state engineers, philanthropists, social theorists of all kinds, civil service trade unionists) gravitate to this field, struggling either not to let the State's conception of generosity to the public be imposed on them, or to get the point of view of those dominated in this field (lower and middle bureaucrats, primary school teachers) across. The enquiry therefore highlights the unequal and differentiated distribution of interest for the "public", visible in the understanding of the democratic claims of the time (the right to strike and unionise in the civil service, municipalism, the Act of Parliament on income tax), that certain actors consistently tried to translate into categories of law regarded favourably as the only right approach to the social world. Finally, in an effort to think within the contemporaries of the time's mindset (i.e. without reading history backwards and by taking virtual history into consideration), this socio-historical work enables the understanding ...

At the intersection of social history, the sociology of law and the sociology of elites, the thesis goes back to the origin of a key concept of the French Republican State: public service. Between 1870 and 1940, this idea, which preceded the new regime, is reshaped by different types of actors in a more democratic sense, as an aggiornamento of state-thought. The legal circles (senior officials of the Conseil d'État and law professors) took a prime position during this update. They notably made advantage of the rise in importance of administrative litigation to legitimate their position as opposed to civil law specialists and impose a vision "from above" of public service, understood as true science of administration. By retracing the sequence of events that made a myth from the Blanco case of 8 February 1873, the thesis aims to give an account of the construction of a profession, that of a lawyer specialising in public law or in administrative law, at the same time as the creation of a "public" field. Actors distant from the legal field (state engineers, philanthropists, social theorists of all kinds, civil service trade unionists) gravitate to this field, struggling either not to let the State's conception of generosity to the public be imposed on them, or to get the point of view of those dominated in this field (lower and middle bureaucrats, primary school teachers) across. The enquiry therefore highlights the unequal and differentiated distribution of interest for the "public", visible in the understanding of the democratic claims of the time (the right to strike and unionise in the civil service, municipalism, the Act of Parliament on income tax), that certain actors consistently tried to translate into categories of law regarded favourably as the only right approach to the social world. Finally, in an effort to think within the contemporaries of the time's mindset (i.e. without reading history backwards and by taking virtual history into consideration), this socio-historical work enables the understanding ...