Weil-Dubuc P-L
Espace éthique Île-de-France, laboratoire d'excellence Distalz, université Paris-Sud Paris-Saclay, hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010 Paris, France.
Rev Epidemiol Sante Publique. 2019 Feb;67 Suppl 1:S19-S23. doi: 10.1016/j.respe.2018.12.060. Epub 2019 Jan 8.
Big Data, the production of a massive amount of heterogeneous data, is often presented as a means to ensure the economic survival and sustainability of health systems. According to this perspective, Big Data could help save the spirit of our welfare states based on the principles of risks-sharing and equal access to care for all. According to a second perspective, opposed to the first, Big Data would fuel a process of demutualization, transferring to individuals a growing share of responsibility for managing their health. This article proposes to develop a third approach: Big Data does not induce a loss of solidarity but a transformation of the European model of welfare states. These are the data that are now the objects of the pooling. Individual and collective responsibilities are thus redistributed. However, this model, as new as it is, remains liberal in its inspiration; it basically allows the continuation of political liberalism by other means.
大数据,即大量异构数据的产物,常被视为确保卫生系统经济存续和可持续性的一种手段。按照这种观点,大数据有助于基于风险分担和全民平等获得医疗服务的原则来挽救我们福利国家的精神。与第一种观点相反,第二种观点认为,大数据会推动去互助化进程,将越来越多的健康管理责任转移到个人身上。本文提议提出第三种方法:大数据不会导致团结精神的丧失,而是会促使欧洲福利国家模式发生转变。现在这些数据成为了集中管理的对象。个人和集体责任因此得以重新分配。然而,这种新模式尽管新颖,但其灵感来源仍是自由主义;它基本上允许通过其他手段延续政治自由主义。