The Trojan horse of efficiency: Sphere transgressions and the marketization of healthcare through digital technologies

The entrance of private technology companies into the healthcare sector is increasingly justified through efficiency narratives. Facing systemic pressures such as scarcity of personnel, time, and funds, the healthcare field has been turning to digital technologies as a remedy, and the private tech sector has been positioning itself as the provider of solutions. These narratives present efficiency as a neutral value, taken for granted as something to be unquestionably achieved.

This presentation asks how efficiency narratives facilitate the transgression of industrial and market actors into the healthcare field, and what are the consequences of framing digital health technologies introduction in these terms.

Defined as the use of "adequate and sufficient power and nothing more", efficiency was historically rooted in industrial production (Alexander, 2009), shifting from characterizing machine-related outputs to social value. When transplanted into healthcare, it transforms existing practices and what is considered "good" care. To analyze this process, this study builds on Sharon's framework of sphere transgressions (Sharon & Gellert, 2024), which draws on Boltanski and Thévenot's (2006) sociology of justification and Walzer's (1989) political philosophy of spheres of justice, arguing for keeping social spheres sufficiently separated to preserve their internal ordering principles and prevent inter-sphere domination and corruption. The presentation examines how the private tech sector uses efficiency as a justificatory resource to legitimize digital tech introduction into the sphere of healthcare, where flourishing of life and sustaining living systems (should) constitute the dominant organizing principles.

This analysis contributes to the discussion on the marketization and privatization of healthcare, showing how efficiency operates as a prescriptive value transplanted from the industrial sphere, presupposed as inherently good, with the risk of progressively marginalizing the constitutive values of healthcare.

Part of panel: Digitalization as sphere transgression - part 2