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Competition in the Wild

Reconfiguring Healthcare Markets

Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands, zuiderent{at}bmg.eur.nl

Michel Callon’s work on ‘the performativity of economics’ raises interesting theoretical challenges for the social study of markets. Callon proposes that laws of markets do exist, but mainly because they are performed, shaped and formatted through the way economics develops ‘spaces of calculation’. The performativity thesis proposes that if markets are not natural entities, but are instead performed by economics, this may open up the reconfiguration of market practices to many previously excluded actors, including STS scholars. However, Callon’s focus on the role of materialities in performing spaces of calculation and the role of economics in creating these materialities, easily leads to over-enthusiasm for the potential of STS scholars to engage in reconfiguring markets. Based on an interventionist research project on performing healthcare markets as ‘value’-driven, rather than ‘cost-saving’driven, I argue that markets can ‘work’ despite the absence of well-functioning materialities. This problematizes the approach pursued by Callon, and I therefore propose to temper the ambitions of STS scholars involved in the reconfiguration of markets to direct them towards the analysis of historically grown prevailing market regimes and market practices as ‘forms of the probable’ for such reconfiguration. Analysing such probabilities may be fruitful for reflecting on the risks that such experimental interventions entail for reconfiguring markets.

Key Words: healthcare markets • interventionist STS • Michel Callon • performativity of economics • reconfiguration

Social Studies of Science, Vol. 39, No. 5, 765-792 (2009)
DOI: 10.1177/0306312709104433


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