Dans un premier temps, l'auteur estime que la démarche de la Commission consistant à faire la classification des occupations par définitions est vide de substance analytique, et donc non susceptible d'aboutir à la compréhension des phénomènes étudiés ni à la formulation de corollaires politiques.
Dans un second temps, l'auteur dégage deux principes d'analyse des professions : soit l'absence d'information des consommateurs sur la qualité des services professionnels et l'incitation que subissent les professionnels à se constituer en corporations « fermées » pour promouvoir leurs intérêts.
This paper is a critical comment of the report of the Commission on Health and Social Welfare, bearing on professions and professional organization. The basic weakness of the Commission's Report is to be found in its lack of any analytical substance, from which explanatory factors and policy implications could be derived. To state that professions are occupations requiring the knowledge of an art, a technique, or a science, is, in the author's view, mere classification by definition, of no help at all in understanding the foundations of professional regulation and organization.
Convinced that no useful conclusions can be drawn from this approach, the author suggests that two principles of economic theory should be used as a basis for a meaningful analysis: a) the lack of information of consumers on the quality of professional services, and the incentives to which ignorance givens rise on the part of both producers and consumers, mainly the need for protection, and b) the theory of collective goods, as an explanation of the tendency for professionals to form closed corporations, in order to further the interests of their members.
From the existence of informational inequality between producers and consumers of professional services, four basic propositions are advanced, which the Commission did not consider, at a great cost in terms of understanding and solving problems :
1. — only differences in the knowledge of the utility of professional services is relevant, not the knowledge of the methods of production; otherwise almost all occupations would be classified as professions;
2.— as more and more professional activities are carried out by salaried people in group practice, within organizations, the protection of consumers as a basis for regulations looses much of its traditional foundations;
3. — another important element of identification of a profession is the absence of
market mechanisms capable of guaranteeing quality and security of products, like producers' guarantees, or through which risks of failure to benefit from them could be transferred to third parties, like insurance;
4. — finally, in order to qualify as a profession, the provision of services must involve important consequences, and errors of judgment must be considered very serious by consumers, like when the physical and moral integrity of a person it at stake.
Given these properties of professional services, institutions arise which serve as substitutes for the lack of information and for the difficulties of obtaining insurance coverage. The relationship of trust and delegation, and in general the whole ethics of professional behaviour are examples of substitutes to market mechanisms. In that respect the professional organizations, together with their rigid entry requirements, can be regarded as devices designed to assure that the norms of behaviour are satisfied by professionals.
For having failed to state the problems within an analytical framework, the Commission was in no position to raise and solve such basic questions as the following: What are the occupations involving so great a danger of misuse on the part of the consumer that some kind of regulations and controls by the state are called for ? Even within a given discipline, should all activities be regulated or are there only some tasks that require professionalization ? Are the educational standards and other licensing conditions positively conducive to higher quality of services ?
The second incentive behind regulations and the organization of professional activity is to be found in the desire of professionals to further their own interests, most specifically to increase their income through unionization. The theory of collective action teaches us that the objective is best promoted when coercion (licensing) is relied upon to stimulate "participation" by members. The Commission implicitely takes this process for granted, without any attempt to assess the value of other mechanisms like certifications, as a means of providing information to consumers and at the same time protecting the public from the danger of monopolistic practices. In view of the tendency for regulated industries to turn regulations to their advantages, the transfer of responsibility from professional corporations to government services, with respect to license requirements and educational standards is considered by the author as a naïve and short-sighted suggestion. Similarly the breaking-up of professional organizations into public service corporations on the one hand, and professional associations on the other hand, is viewed as unrealistic and unfair to liberal professions.
On the whole, due to its lack of analytical framework, the conclusions and recommendations of the Commission, while sometimes acceptable in their objectives, 1. — are found to be unlikely to promote the objectives sought: by the Commission; 2. — they often do not follow from the analysis; 3. — some suggestions are unrealistic and 4. — only formally interesting.
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