The main aim of this paper is to shed the light on the contribution of the “programmatic action framework” (Hassenteufel, Genieys, 2021 ; Bandelow, Hornung, Smyrl 2021) to the policy advisory system literature (Halligan, 1995; Craft and Howlett, 2012; Hustedt and Veit, 2017). This approach, combining the sociology of elites and the study of the policy process, goes beyond the analysis of the profile and characteristics of ministerial advisers by taking into account two main dimensions:
. The careers of ministerial advisers after and before working for a minister, in order to understand no only why they access to this kind of position in the backrooms of government, but also how it gives them the opportunity to hold other relevant positions in a policy field (even to shape them) and to follow a specialization path giving them increasing expertise resources.
. The role of these actors in the policy process, not only in policy formulation and decision processes as ministerial advisers but also in the implementation process in other relevant policy position in the public administration.
The programmatic action framework is a way to analyze sociologically how ministerial advisers can, over time, play the role of a programmatic elite, formulating, deciding and implementing a policy change program in a policy field.
To illustrate empirically this contribution we take the example of the French “Welfare elite”, which was structured in the 1980s around a policy change program, to govern the French health insurance system over time by gradually playing the role of custodians of these policies (Genieys 2012 ; Genieys, Hassenteufel, 2015). We focus on its more recent institutionalization, based on the creation of new steering, expert and implementation institutions and the circulation of its members within an 'iron triangle', including these, ministerial staffs and the Social Security Directorate (DSS) of the Ministry for Health and Social Affairs. It makes it possible to understand the continuity over time of different generations of this policy elite, coming from the backrooms of government and progressively in the frontline for health insurance cost containment policy and the transformation of the French health insurance system through universalization and territorial reorganization. This result can be highlighted by mobilizing the methodology of the programmatic action framework for the empirical analysis of the profile, trajectories and role of the last generation of these “governmental social managers”, from to 2007 to 2020.
