From averages to best performers: use of comparisons in identity formation

Abstract

This article examines the use and interpretation of international comparisons in national policymaking in Finland and Portugal. By analyzing policy programs from a discourse-theoretically informed perspective the article addresses the question of how comparative discourses of international govermental organizations frame and shape the identity formation of their member states in the domain of public health policy. In the analyzed data the comparative information is mostly used to position the country at a disadvantage compared to others. Future objectives are set in order to overcome the disadvantage. However, the negative use of comparisons and assigned pejorative positions are also explicitly doubted. These doubts have opened the way for different self-identifications celebrating national originality. In temporal terms the detailed reading of policy documents covering four decades indicates that there has been a substantial change in the use of comparisons from averages towards best performers in the turn of the century.

Keywords:

• international comparisons
• identity formation
• IGOs
• nation states
• policy discourse analysis

Acknowledgements

I would like to thank the two anonymous reviewers, and professor Pertti Alasuutari and professor Eriikka Oinonen for their valuable comments on the earlier draft of this article. For financial support of this study I wish to thank Doctoral Programs in Public Health and Foundation of Emil Aaltonen.

Notes

1. In the area of public health, EU has legislation on blood, tissues, cells, organs, water and air quality (European Commission 2007, p. 2).

2. Several researchers have touched upon the issue of identity linked to the recent European policymaking. Noël (2006) writes how open method of coordination (OMC) contributes to construction of national identities and positions. According to Palola (2007, p. 13), the function of the persuasive story told about the European social model is to shape the identity of the member states so that they are favorably disposed to the desired political targets.

3. Schofer et al. (2009) in their paper discuss how the constitutive influence of social context on defining actors’ identities is treated in this literature.

4. Alestalo et al. (1985) and Alestalo and Flora (1994) have contributed to our understanding on how to study small and peripheral states from a comparative perspective.

5. While there are official English translations available of the Finnish documents, the Portuguese documents are only available in Portuguese. The author has for the purposes of this research translated the Portuguese documents into English.

6. In 1977, the World Health Assembly decided that the main social target of governments and the WHO in the coming decades should be ‘the attainment by all the citizens of the world by the year 2000 of a level of health that will permit them to live socially and economically productive lives’. This goal is commonly known as the ‘Health for All by the Year 2000’. The HFA policy framework was amended in 1999.

7. Comparisons play a pivotal role in OMC as its central idea is to encourage learning between nations on the basis of comparisons and the sharing of the so called ‘best practices’ (Jacobsson 2004, p. 363). Although OMC has not yet been strongly implemented in public health matters, it has influenced the general atmosphere and the overall discourse in social and health policy. Furthermore, the actual Health Strategy is aimed to be implemented by using the ‘structured cooperation mechanism’ which can be seen as an adjusted replica of OMC (European Commission 2007).

8. OECD statistics are used in relation to health care system performance. As the focus here is on public health policy, these comparisons related only to curative side of health policy are not included in the analysis.

9. For example, Navarro and Shi (2001) have used maternal mortality rates as one of the key indicators to measure the public health performance of the different welfare states.

10. Although the WHO reviews are not written by Finns and cannot directly be counted as a part of the formation of national identities, the reviews are based on interviews with Finnish public health experts, policymakers and other relevant stakeholders (WHO Regional Office for Europe 1991, pp. 1–11, 2002a, pp. 15–22). In addition, the translations of the reviews into the Finnish language have been made by Finns and reviewed and approved by Finnish policymakers. Thus it is important to study the positioning and terms used in also these documents.