The Employees’ State Insurance Corporation’s (ESIC) decision to raise the income cap for coverage under its scheme from basic wage of Rs 15,000 to Rs 21,000 is a significant step in creating a social security net for workers at the lower end of the earning spectrum. As per initial estimates, nearly 50 lakh new workers would come under the ESIC’s health and medical facilities, taking the total number of workers under the scheme to over 3 crore.
An ESIC cover is a gateway to medical facilities for many who cannot otherwise avail treatment at non-governmental hospitals due to the prohibitive costs. The wide range of medical facilities under ESIC makes it a popular option among the lower-income earning working population and their families.
A self-financing scheme, workers covered under ESI contribute just 1.75 per cent of the wages while the employers contribute 4.75 per cent of the employee’s wages. This gives them access to one of the widest network of medical facilities in the country through over 150 hospitals, and thousands of dispensaries, clinics and medical officers spread across the country.
The services offered include OPD, drugs, specialist consultation, treatment and hospitalisation. Super-speciality medical facilities are also available. The benefits under the scheme are wide-ranging, including medical benefits, sickness benefits, maternity benefits, disablement benefits, dependant benefits and also a bit of funeral expenses. To top it all, ESIC places no ceiling on expenditure on individual medical care. Retired people those permanently disabled and their spouses can avail the facilities at a nominal premium payment.
While ESIC medical facilities sound good on paper, the ground realities may not be as desirable at they ought to be. Hospitals and dispensaries across the country lack basic facilities and often are not equipped with proper equipment and medical personnel. Along with widening the coverage by raising the cap and bringing in more workers under the net the government should make substantial investments in improving the medical infrastructure to ensure that those availing the ESI facilities are also provided with the best of medical care.
ESIC remains one of the major social security pillars, along with the Employees’ Provident Fund Organisation (EPFO) which looks after old age income security, and the move to widen its reach is a step that needs to be welcomed.