How Scientific Breakthroughs and Social Innovations Shape the Evolution of the Healthcare Sector

In Lechevalier Sébastien editor, Innovation Beyond Technology: Science for Society and Interdisciplinary Approaches is available on and will be perpetually maintained on SpringerLink, 2019, Springer, p. 89-120.


The chapter argues that the conventional scientific determinism does explain the long term evolution of health care systems. First the illness and the medical knowledge and techniques are socially constructed and historically determined .Second the methods for financing and organizing care shape the intensity and direction of medical breakthroughs. Third scientific advances generally do not reduce the medical costs because the new therapies diffuse and more complex diseases challenge medical expertise.   It is thus important to replace a static equilibrium-based approach with an evolutionary and institutionalized vision that takes into account   the two sided causalities between social innovations and the invention and diffusion of new therapies. The performance of the health care sector cannot be measured by usual productivity indexes since so many factors determine the life expectancy in good health of the population .A large diffusion of education exerts positive spill overs upon the prevention of diseases and the preservation of health. This calls for a society wide approach to health as a component of a genuine to, “anthropogenic” mode of development. Clear social innovations are required for this mode to prosper and not only purely medical breakthroughs.

Modèle anthropogénétique comme horizon du 21e siècle (le) : Le cas de la santé

Modeleanthropogenetique2 Présentation lors du séminaire d’économie politique de la santé, Maison des Sciences Economique, Paris, 7 juin 2013,


Comment changent les modes de régulation sectoriels

Postface à l’ouvrage de Gilles Laferté : L’image de la Bourgogne et de ses vins : Le contrôle politique et culturel du marché, Albin Michel, Paris, 2006, p. 251-262.

Riscrivere il futuro. Strategie di profito, forme di internazionalizzazione e nuovi spazi nell’industria automobilistica

(avec Michel Freyssenet), in Rosangela Lodigiani, Monica Martinelli, Dentro e oltre i post-fordismi: impresa e lavoro in mutamento tra analisi teorica e ricerca empirica, Vita e Pensiero, Milan, 2002,  p. 155-175.

Fusions-acquisitions et ‘stratégies de profit’

(en collaboration avec Michel Freyssenet), Revue Française de Gestion, n° 131, Novembre-décembre 2000, p.20-28.

O Mundo que Mudou a Maquina Sintese dos Trabalhos do Gerpisa 1993-1999

(en collaboration avec Michel Freyssenet), NEXOS Economicos, Vol 2, n° 1, Outubro 2000, p.15-47.

Une compétitivité en complet renouvellement

dans  J. SABOURET Ed. L’État du Japon, La Découverte, Paris, Novembre 1995, p. 314-319.

L’Après fordisme


(en collaboration avec J.P DURAND), Éditions Syros, Paris, 1993. Nlle édition 1998.



2nde edition, 2001






En Anglais: After Fordism. (en collaboration avec J.P DURAND), Traduction Sybil MAIR, MacMillan Business,Basingstoken Hampshire UK, 1997.