Proposal of Universal Healthcare to Carrefour Group

Problem

CARREFOUR follows traditional healthcare strategies: it involves general healthcare costs and support. The problem is that different countries have different social and healthcare policies, so many employees are deprived of a chance to receive adequate and quality healthcare. Also, the current strategies of CARREFOUR do not cover temporary workers and immigrants. Deficits and shortcomings in the financing and delivery of health care are, however, only part of the story.

There are also impressive accomplishments of the health care system that have propelled France into a position of leadership in terms of the quantity and quality of health care services available to the majority of its population that enjoys good insurance coverage. The United States has in place the most advanced biomedical research enterprise in the world, and its pharmaceutical industry is unparalleled.

The absence of universal healthcare standards leads to an increased level of illnesses and work-related diseases. The fact that private behavior often evokes public distress is well known. Although many concerned citizens are working hard to reduce the incidence of imprudent personal choices and many policies have been formulated to reduce such choices, greater and more effective effort is urgently needed. Economic tools are also useful in devising effective policies. Here the basic tools of economic incentive and disincentive, the tax and the subsidy, are joined to the concept of elasticity, which bits of advice of the effectiveness of price incentives.

The link of economic theory to that of education, sociology, psychology, biology, and medicine strengthens our behavior modification efforts. The three legs that best support those efforts are education, research, and pragmatism. Some policies are even counterproductive in that they may encourage the kind of behavior that needs to be discouraged, prevent people from reducing their risk exposure, or exacerbate the social costs arising from poor behavioral choices. The intention of this volume is to help identify those strategies that will work and urge their implementation if they have not been adopted or their strengthening if they have.

Introduction

Universal changes in the healthcare system and new technologies allow medical institutions to deliver quality healthcare services for a wide target audience. Thus, many employees do not receive adequate universal healthcare because laws and regulations free employers from this duty. If the company under analysis, CARREFOUR, applies the principles of universal healthcare to all employees, it would benefit both the organization and people, the local community, and medical health in general. With hospital care becoming more critical to modern medical practice and with hospital costs rising as a consequence of new and improved technology and more highly skilled personnel, the costs of hospitalization became an increasing burden for patients who paid out of pocket for their care (Carrefour, 2008).

Background

CARREFOUR is a leading international hypermarket chain. Carrefour, a French hypermarket chain, has capitalized on these recent changes and is now the largest company in the industry. Carrefour is the largest hypermarket group in France. The Carrefour group has been growing at a phenomenal rate in France through acquisitions and is growing in other countries as well. Before Carrefour’s two 1991 acquisitions, it operated 75 stores in France and 123 worldwide.

It currently employs 461,260 (2007) worldwide (Carrefour, 2008). Under the combined stimuli of expanding research and development, the growing physician supply, the enlargement and upgrading of the nation’s hospital plant, and the growing source of new funding from private health insurance, many modern companies like CARREFOUR underwent a substantial reorientation.

In order to properly address the above problems, this research will focus on the following:

• What is universal healthcare?
• What are the main benefits of universal healthcare?
• What are the main benefits of universal healthcare for CARREFOUR?
• How well does it work to improve the healthcare of employees?
• What resources are required to introduce universal healthcare?

Purpose & Scope

The purpose of this report is to properly weigh the adoption of universal healthcare to be provided to Carrefour Group employees. Carrefour is a leading global corporation that aims to retain or competitively maintain a positive, trailblazing image not only on the existing business entity it was able to carve but also towards an internal process that encompasses the welfare of their employees. The scope will include appropriate evaluation of universal healthcare, presentation, and evaluation of Carrefour profile and capacity, as well as the corporation’s goals and aims that affect their employees.

Assumptions

This paper takes the position that Carrefour Group aims to maintain competitiveness not only in providing service and products to its customers but also in terms of their workforce. The study will proceed to bear the information that to maintain a competitive workforce, they expect the best of benefits not only in the form of compensation but also in the provision of health care services or programs that equate to a quality workforce, quality environment, and quality service to Carrefour customers.

Limitations

Certain limitations of this paper include the detailed estimate of healthcare expenses or expenditures, differences of existing models of healthcare between countries where Carrefour operates, as well as the health care options available for the employees that might be considered by Carrefour Group. The paper is limited to an overview of what is universal healthcare, about Carrefour, the implication of universal healthcare, and the advantages of the provision of health care programs for employees.

Criteria

The criteria of evaluation will be an assessment of the presently available data on the subject as well as subtopics mentioned. The applicability and practical implications of adopting universal healthcare for Carrefour will also be dependent on the general outcome of identifying the business and economic relevance of universal healthcare.

Discussion

Universal Healthcare

Universal health care is health care coverage provided to all citizens or permanent residents of a given governmental region. While the term “universal health care” seems to mean globally accepted programs, these vary widely in their structure, funding mechanisms, and the degree to which they are publicly funded. At most, health care costs are shouldered by the population through compulsory health insurance or taxation, or a combination of both (PNHP, 2008).

In addition, universal health care systems have government involvement in the forms of enacting legislation, mandates, and regulation. To some extent, government involvement also includes direct management of the health care system. However, many countries use mixed public-private systems to deliver universal health care as many citizens have access to health care services not usually found within their country’s jurisdiction.

In Europe, most citizens in Germany in the 1880s were covered by the mandatory health care system of Otto von Bismarck. The United Kingdom’s National Health Service (NHS) established in 1948, however, is widely accepted as the world’s first universal health care system provided by a government. It is to be noted that universal health care is provided in developed countries and in many developing countries. Interestingly, the Institute of Medicine of the National Academy of Sciences claimed that the United States is the only wealthy, industrialized nation that does not provide universal health care (Physicians for a National Health Program, 2008).

The universal health care concept is broad and implemented in several ways but the common denominator for all programs is government action extending access to health care to as many populations as possible. Many countries implement universal health care through legislation, regulation, and taxation directing that care be provided, to whom, and on what basis. Some costs are usually shouldered by the patient and some are subsidized by taxation and compensated to the patient by the government. Governments use programs with compulsory insurance in order to meet their goal. The National Audit Office (NAO, 2008) suggested that other programs are paid for entirely out of tax revenues and provide default coverage for every citizen or resident of a country.

All of Europe that includes Austria, Belgium, Bosnia-Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Finland, Estonia, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Malta, the Netherlands, Norway, Latvia, Liechtenstein, Luxembourg, Poland, Portugal, Romania, Russia, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, and the United Kingdom has publicly sponsored and regulated health care programs.

Funding

The five primary methods of funding health care systems are:

• direct or out-of-pocket payments – individual and voluntary choice of individuals for available health services
• general taxation – inclusion in common taxes
• social health insurance – a separate collection of payment from direct out of pocket or general taxation
• voluntary or private health insurance – provision of government or non-government healthcare program funded by choice among the public
• donations or community health insurance – a social and philanthropic program that serves as equilibrium for the spread of health care services (Gilead, 2008).

A recent study found a lack of systematic relationship between the cost efficiency of health care systems and the type of financing used of which it concluded “that almost all financing choices are compatible with efficiency in the delivery of health care,” (Gilead, 2008)

Characteristics

Health care has the following characteristics:

• The provision of critical health care treatment is often regarded as a basic human right, regardless of whether the individual has the means to pay—some treatments cost more than a typical family’s life savings.
• Health care professionals are bound by law and their oaths of service to provide lifesaving treatment.
• Asymmetric information
• High-risk level

Benefits and Advantages of Universal Healthcare

While a common denominator has been defined previously when it comes to “universal” healthcare, differences, as also noted, between countries are evident. One such case is of France and the United Kingdom of which general practitioners in the UK serve as gatekeepers for secondary o hospital care resulting in fewer in-patient admissions while France has no such function. Another example may be between countries with a bigger older population compared to a country with a younger population where expenditure per head on healthcare is expected to be higher than the former.

Just the same, the aim for a lower mortality rate is a universal aim. This requires important variables such as occupation, followed by a number of doctors. The following table provides information about the number of practicing physicians for a thousand people in the population among developed countries:

The presence of a sufficient number of physicians to attend to patients has a direct implication on the benefits of universal health care: the immediate response implementation in case of health care needs.

Other specific benefits from a universal health care system:

• Perform diagnostic or therapeutic procedures
• Managed labor or obstetrics
• Cure illness and provide definitive treatment of the injury
• Perform necessary surgery
• Relieve symptoms of illness or injury
• Reduce the severity of an illness or injury
• Protect against exacerbation or complication of an illness or injury (NAO, 2008).

Proponents of universal healthcare also pointed out that:

• A universal healthcare system would replace private/employer spending with taxes, thus, the total spending would decrease for individuals and employers (PNHP, 2008).
• The system could save up to $286 billion a year in overhead administrative costs and paperwork (Public Citizen, 2008)
• Universal health care would provide for uninsured adults who may forgo treatment needed for chronic health conditions (UACHC, 2005)
• Reduction of waste and inefficiency in the delivery of health care (Krugman and Wells, 2006)
• It could align incentives for investment in long term healthcare productivity, preventive care, and better management of chronic conditions (Krugman and Wells, 2006)
• It could act as a subsidy to businesses without added cost (Krugman and Wells, 2006)
• Quality of care increase as doctors would no longer be guaranteed patients solely based on their membership in a provider group and regardless of the quality of care they provide (PNHP, 2008)
• Healthcare practitioners support a universal health care system because they are unable to decide patient care and patients who are unable to afford care (PNHP, 2008).
• Reduction to as much as 50% of healthcare dollars spent on healthcare that went to various middlemen and intermediaries. The streamlined, non-profit, universal system increases the efficiency with which money is spent on healthcare (Public Citizen, 2008)
• Presence of an alternative between public universal health care and private health care where both are available (PNHP, 2008)
• Protection on the right to privacy between insurance companies and patients (Public Citizen, 2008)
• The health care system may also be used as an independent third party in disputes between employer and employee pertaining to related issues (PNHP, 2008).
• In France, the government spends $569 less per person on health care than in the United States allowing the U.S. to adopt universal health care, while simultaneously cutting government spending and cutting taxes (PNHP, 2008).

HealthCare Models

There had been identified health care systems models, one is a purely private enterprise health care system which is rare and is usually for a well-off subpopulation in a poorer country with a poorer standard of health care, such as private clinics for a small, wealthy expatriate population. Some countries have a majority-private health care system with residual public service.

Other major models for health care are public insurance systems:

• The Social security health care model has workers and their families insured by the State.
• The publicly funded health care model has the residents of the country insured by the State.
• The Social health insurance of which the whole population or a majority belongs to a sickness insurance company (Public Citizen, 2004).

Carrefour as Employee

Carrefour has over 490,000 employees with 140,000 of them in France. It is currently ranked amongst the top 9 private employers in the world. In 2006 alone, the group recruited some 100,000 new employees around the world. This 2008, it has planned to fill in 60,000 vacancies with people from France. As an employer, Carrefour aspires to be seen as a benchmark in human resources management and social responsibility. It attracts, trains, supports, and secures the loyalty of employees by supporting the development of its staff members which it considers as ambassadors in dealing with the company’s customers.

The group places its emphasis on the skills needed in its stores, where employees come into close contact with customers. Key, traditional retail roles are given particular attention: department managers, checkout operators, and self-service assistants.

It cultivates an entrepreneurial spirit among its employees, in order for them to develop their sense of customer service and to help them rise to the challenges of commerce. It depends on the contribution of employees with highly specific expertise for its back-office activities: logistics, IT systems, accounting, and finance, amongst others. The table below illustrates the general activity breakdown of Carrefour.

The expertise the Carrefour stores possess with regard to food adds credibility when assuming traditional roles, such as those of butcher, baker, fishmonger, and caterer. To ensure they continually adapt to changes in consumers’ lifestyles and in order to develop new services, the stores call on the expert knowledge of specialists in electronics, hi-fi, and new technologies. Likewise, they constantly draw on input from professionals in the pharmacy, insurance, travel, credit, home delivery, and Internet industries in order to introduce new concepts and services, of which the range is constantly expanding (Carrefour, 2008).

The website claims, “The Carrefour group strives to continually adapt its human resources policy to meet the expectations of its employees, while recognizing their individual and collective performance. The group gives priority to internal promotion, which it combines with an active policy of training and career management.”

Carrefour’s key goals is to become an exemplary employer and has put in place feedback mechanisms that allow it to understand employee expectations regarding career development and to help them in acquiring new skills. Internal promotion is one of the key pillars of its human resources policy. As an approach to career management and support, employees are offered a range of opportunities for professional development such as the option to train toward different responsibilities and to progress to management if they have the potential. They also give opportunities to transfer between its different formats and the areas where it has a presence.

Sustainability

In the company’s 2007 Sustainability Report encompassing “economic progress, social progress and environmental progress”, fiver answers to key challenges to society include:

• Balanced diet
• Responsible consumption
• Manufacturing social conditions
• Being a responsible employer, and
• Climate change.

In the company’s “Managing the approach day-to-day” (2006) report on “Sustainable Development”, it claimed that this involves everyone at Carrefour with the objective to involve all teams in the field every day.

1. For the Carrefour group, Sustainable Development combines three issues of quality, risk management as well as responsibility with regard to the stakeholders that include employees. It is therefore expected that healthcare in universal level is implemented if not a priority for its employees’ list of benefits.
2. The Sustainability policy is driven by the Group Sustainability Department belonging to the Group Quality Responsibility and Risk department. It defines the requirements and approach at the Group level by drawing on the Quality, Sustainability, Safety and Insurance services.

Consequently, it claims that, “Gathering the Quality Responsibility and Risk Management functions at the Group level has helped to develop closer cooperation between these fields and to extend the notion of Quality to the notion of corporate responsibility regarding its stakeholders,” which has strengthened policy of prevention in the area of safety, meaning safety at the level of products, goods and people (Carrefour, 2006).

In addition, sustainable development has become a part of an overall policy to “transform risk into opportunity while taking on the Group’s responsibilities to all its stakeholders through a strategy of prevention and a comprehensive quality approach.” (Carrefour, 2006)

The various Executive committees implemented the standards defined at the Group level and the Quality and Sustainability policy, in each country and banner. “The Sustainability Department has developed a functional organization of dedicated people, the Quality and Sustainability Network, which provides support for the cross-departmental operational networks,” which includes the Human Resources, Merchandises, Assets, Logistics, Finance and IT (Carrefour, 2006).

In promoting dialogue, diversity and equality of opportunities, Carrefour deal every day with the challenge of multiculturalism through emphasis of professionalism and development of genuine career opportunities.

Carrefour manages teams on a participatory basis and developed a survey tool for in-house satisfaction, “Listening to staff”. This is conducted by neutral outside facilitators in a dozen of countries where managers measure the social atmosphere within their teams and identify and correct problems. This also optimizes the organization of work and training programs.

In promoting local recruitment, diversity within the heart of human resources policy is observed. It signed in October 2004 the Corporate Diversity Charter to address diversification and fight discrimination, which each banner applies to its own particular situation.

In promoting integration of disabled workers, Carrefour have implemented programs aimed at promoting disabled workers employment. In France in 2005, Carrefour hypermarkets have committed to hiring 250 people with disabilities within three years. “Mission Handicap” program had by the end of 2007 employ 3,351 disabled workers. In Spain, though Fundacion Solidaridad, Carrefour committed to hiring 150 disabled workers within three years. In Colombia, Carrefour signed an agreement with the Teleton Foundation to create jobs for disabled workers which was able to employ 89 disabled workers by the fall of 2006. Carrefour Poland employed disabled workers and signed in 2006 an agreement with the Polish Union of Deaf.

The Organizational Chart of the Sustainability Department involves all business lines and levels of the Group that drive policy forward by bringing issues before the Executive Board, ensuring the implementation of set strategies and spreading the use of best practices. This is duplicated at country and banner level through the Sustainability (QSD) that relays operational and cross-functional departments of the Business Units to apply the Group’s Sustainable Development policy from the highest level down to the stores, adapting to local contexts where necessary (Carrefour, 2006).

Improving Health Care of Employees

As mentioned by advocate groups, universal health care is almost viewed as a basic human right of which there is equal treatment no matter what the economic status of a patient could be. Same thing may be said for when Carrefour adopts a universal healthcare for all its global employees. There could be certain limitations as to the provision of same quality health care treatment dependent on locality or even country as what may be available in most of Europe’s Carrefour employees may not be accessible at a practical level amongst its employees in poorer regions such as Indonesia or Colombia.

While it may be the aim of the company to employ a method that works for all, level of expenditures incurred must be a concern. According to Fuchs (1996), the level of expenditures incurred in healthcare delivery has increased precipitously and sudden rise in cost can be attributed to intellectual advances, greater availability of information, and the ever-increasing demand for such service. The dedication of organisations spending on health care services results to various economic sacrifices.

The direct costs of delivering healthcare include purchase of medicines, establishments of medical institutions, and hiring of personnel knowledgeable of health services. Other costs which get a large chunk of expenditures are research and development, the most critical item being propagated by organisations. In addition, the marginal cost of health care needs to be evaluated as unlike the total cost, which is an aggregate, marginal cost accounts the movement in the cost.

For private entities such as Carrefour, provision of a universal health care system may serve practical for its operations and sustainability. Aside from maintaining a positive image with its stakeholders inside and out, the practice will culture good relations within the group and exude a positive towards Carrefour’s consumers or customers.

Disadvantages of a Universal Healthcare

The cost as well as equal implementation across countries where Carrefour operates is one of the bigger challenges of implementing a universal healthcare for Carrefour. While international health insurance companies may provide an equal coverage, availability of an equal health care service with every country may vary. Developed counties may have first rate health care services while less developed countries need a lot of coping.

Resources Required to Introduce Universal Healthcare

The need for an internal medical team to serve as gatekeeper will facilitate a sustainable but universal healthcare within the global operations of Carrefour. Each country or main office may employ full-time a team of doctors or nurses that work together to diagnose and asses prior to a major medical expenditure.

Likewise, provision of first aide and over-the-counter drugs to immediately address emergencies that could be treated within the confines of the company’s medical team will also reduce absences and lack of manpower due to illness or injuries.

This process will make healthcare service accessible to most if not all employees at all levels of operation at the same time reduces unnecessary expenses or losses incurred in unnecessary leave of absence or sick leaves.

For Carrefour Group, a universal healthcare could cost as much as $500 per anum. This will cover daily over-the-counter drugs dispensed and could include a clinic that disburses OTC drugs for headache, cough or colds tablets or even ibuprofen. This may also include insurance coverage for all. Human resources needed may start from a regular nurse for all branches, as well as a doctor for a particular area who need to round several branches on a regular basis. All 461,260 employees is proposed for coverage to provide a blanket as well as equal protection to all.

Conclusion

This study concludes that Carrefour may adopt a universal healthcare system that adheres to its sustainability mandates and policy. While private healthcare as well as available premium healthcare services may be availed by those who may afford it, basic health service that addresses immediate as well as necessary needs of employees could serve as more practical in the long run with advantages that not only seen amongst the employees but also would extend beyond the confines of internal interactions.

Corporate social responsibility is a trend that is reaching mandatory heights among business and organisational enterprises. Sustainability extends not only within the confines of profits and good corporate image but a blameless one internally and externally. A universal healthcare system provided within Carrefour. While there may be other programmes and issues that Carrefour needs to address, it is imperative that its ambassadors or employees be a priority, in developed or underdeveloped countries.

Recommendation

As Carrefour Group maintains a trailblazing trend in corporate global management, it is appropriately recommended that this image be maintained in all aspects of the organisation’s dealings: to its customers, the environment, the community, and most especially, the people behind its global presence.

It is therefore recommended that quality healthcare — a universal healthcare — be adopted by the organisation for its employees to sustain its ideal employee relations and maintain transparency in their global management.

Works Cited

Carrefour (2008). Web.

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Paul Krugman and Robin Wells, The Health Care Crisis and What to Do About It, New York Review of Books, 2006.

Physicians for a National Health Program (2008). “International Health Systems.” Web.

Public Citizen (2004). “Study Shows National Health Insurance Could Save $286 Billion on Health Care Paperwork: Authors Say Medicare Drug Bill Will Increase Bureaucratic Costs, Reward Insurers and the AARP.” Web.

Uninsured Americans with Chronic Health Conditions (2005). “CDC Data Shows that Millions of Uninsured Adults Forgo Needed Treatment for Chronic Health Conditions”. Web.

Sherry A. Glied, “Health Care Financing, Efficiency, and Equity,” National Bureau of Economic Research Working Paper No. 13881.