Categories of managerial understanding for “customer relationship management” in a primary health insurance fund in France

Abstract

"Customer relationship management" has been imposed at the reception desks of health insurance organizations for twenty years, in a context aimed at reforming and "modernizing" public services without giving up a logic of downsizing. It disadvantages the most vulnerable populations for access to health coverage. The training provided to reception agents leads them to (de) classify the various categories of users to adjust to local standards of flow management. Social and moral judgments, based on the dominant hierarchical discourse, legitimize the introduction of "customer relationship management" at reception desks where "populations in difficulty" are dealt with. This rhetoric influences the way receptionists think and act. The data presented here were collected during an ethnographic survey carried out within a social security organization in the Paris region.