The Employees’ State Insurance Corporation (ESIC) introduced a slew of reforms to improve social security and healthcare facilities across the country as part of its second generation reforms agenda-‘ESIC – 2.0’. Speaking to Dipta Joshi, Gaur Hari Das, Regional Director, Maharashtra, ESIC, elaborates on the Corporation’s growing reach and its plans for Maharashtra.
How successful has the Employees‘ State Insurance Corporation (ESIC) been in keeping up with the growing demands of employees and employers in the current business environment?
The Employees’ State Insurance (ESI) Scheme is an integrated measure of social insurance as well as health care for employees. It protects employees against impact of incidences like sickness, maternity, disablement and death due to employment related injuries besides providing medical care to insured persons and their dependents. Keeping our beneficiaries in mind, the Corporation has periodically relaxed the eligibility conditions for entitlement of different benefits, augmented the quantum of cash benefits and also introduced new benefits like ‘Unemployment allowance’, ‘Skill up-gradation’ and even ‘Funeral expenses’ for insured persons (IPs) without an increase in the employee or employer’s share of contribution. Since 2008, we have been providing primary, secondary and tertiary medical care i.e. superspeciality treatment for employees and their dependents. Keeping pace with the times, ESIC has introduced technologically advanced facilities like online registration of employers and employees, biometric identification cards, online payments through e-challans etc.
How do the services and schemes offered by ESIC compare to those offered by private insurers?
ESIC is the only social security organization in the country which covers most of the requirements of a worker that are mentioned in the list provided by the International Labour Organisation (ILO). The ESI scheme is based on the Gandhian principle of “Contributions as per their ability and benefits as per the requirement”.
The benefits provided by the ESI Schemes are far more inclusive vis-a-vis the services provided by private insurers. While private insurance schemes cover only one person – the insured, our scheme covers the IP as well as his family unit. Our range of coverage is broad as compared to a private insurer. While private insurers cover only identified diseases, our ‘reasonable health cover’ has been liberally interpreted as to mean ‘total health cover’. In other words with a nominal contribution, ESIC provides plethora of benefits to the existing employees and has no substitute.
What changes have been implemented under the second generation reform agenda – ESIC -2.0?
The second generation reforms agenda – ‘ESIC – 2.0’ was launched by Prime Minister, Narendra Modi during the Labour Conference held on 20 July, 2015. It outlined a clear agenda consisting of reforms in the healthcare facilities and coverage area. Accordingly our dispensaries are being upgraded technologically and specific projects have been launched in hospitals. ESI Scheme coverage will be extended to non-implemented areas in 393 districts by 31 March 2016. We are conducting surveys in districts that weren’t covered so far and have added construction workers to our list of beneficiaries in December, 2015. We also intend to include unorganised workers from certain sectors like rickshaw pullers or auto rickshaw drivers in selected urban or metropolitan areas.
You mentioned initiatives being undertaken regarding healthcare facilities under ESIC 2.0. So what can a person seeking medical help expect from any ESIC centre?
Under ESIC 2.0, we want our healthcare centres to introduce some new facility each month. We have already replaced physical medical records with E-Health Records (EHR) which stores medical records in a chip. This enables IPs and their family members to view e-prescriptions and investigation and test reports online at any ESIC centre.
The Abhiyan Indradhanush (VIBGYOR project) ensures a change of hospital bed sheets according to the VIBGYOR (rainbow colours) pattern during the week. This ensures hospital hygiene is maintained, besides making the hospital stay more colourful for the patient.
We began distribution of biometric cards for the IP and his dependents as early as 2011. The card allows the IP to view his entitlement for different benefits under the ESI Scheme.
Please elaborate on the healthcare facilities offered to workers in Maharashtra?
Keeping in view, that health is a state subject, the ESI Scheme is administered by the Government of Maharashtra. In order to provide reasonable medical care to the IPs and their dependents in Maharashtra state, we have 13 Hospitals running under the ESI Scheme, 58 dispensaries, 524 insurance medical practitioners who provide primary medical care, and one ‘Model’ hospital (total bed strength of 2,123) providing secondary medical care. Apart from that ESIC has tied-up with 35 hospitals for providing secondary medical care and provides tertiary medical care through its tie-ups with 119 hospitals and nursing homes. We also plan to develop a few state government run hospitals into Model or superspeciality hospitals and have put in a request with the government for the same.
With regards to extending the coverage area, is there a specific target for Maharashtra?
Yes, we plan to cover the non-implemented areas in Maharashtra in two phases. The state has 36 districts of which two districts – Mumbai and suburban Mumbai have the ESI scheme implemented in toto. It has also been implemented in a few industrial pockets in 20 other districts. In the first phase of our plan, the non-implemented areas of these 20 districts will be covered by 31 March, 2016 thus benefiting seven lakh employees in these districts. The second phase will cover the remaining 14 districts by December 2016. We have been holding camps in industrial areas to increase awareness about our schemes.
