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Value Practices in the Life Sciences and Medicine$
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Isabelle Dussauge, Claes-Fredrik Helgesson, and Francis Lee

Print publication date: 2015

Print ISBN-13: 9780199689583

Published to Oxford Scholarship Online: April 2015

DOI: 10.1093/acprof:oso/9780199689583.001.0001

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Critical composition of public values

Critical composition of public values

On the enactment and disarticulation of what counts in health-care markets

Chapter:
(p.119) 6 Critical composition of public values
Source:
Value Practices in the Life Sciences and Medicine
Author(s):

Teun Zuiderent-Jerak

Kor Grit

Tom van der Grinten

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199689583.003.0006

The work of Callon on the ‘performativity of economics’ and of Latour on the notion of ‘composition in economics’ proposes to analyse how markets are constructed and what their consequences are for (public) values. This empirical turn would allow social studies of market scholars to analyse how ‘valuemeters’ shape such values in practice. Following the construction and use of a funding scheme in Dutch hospital care, the chapter shows that this market device indeed profoundly shaped the values it was supposed to ensure. Quality for example became shaped rather exclusively in cost-saving terms. Since this happens despite the wide availability of value-meters that try to articulate quality as not merely financial, the chapter concludes that the composition of values in governance practices should be both about enacting and about disarticulating certain values. Composition should therefore not be presented as the antonym of critique; composition urgently needs to become critical composition.

Keywords:   health-care markets, regulated markets, public values, critique, composition

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