Raj Kumar, Director General of Employees’ States Insurance Corporation (ESIC), talks to Sangeeta Yadav about the agenda of ESIC and the challenges that lie ahead
It’s been a few months since you took over as the Director General of Employees’ States Insurance Corporation (ESIC). How is it goingIJ
It has been a great learning exercise so far. Being a social security organisation, ESIC, along with State-run ESI hospitals, aims to deliver quality health services to the working class people surpassing all the challenges that are there on the way with the right management and optimum utilisation of the resources. The challenge is to make easy availability of social security facility, as is the responsibility cast upon us under the law.
What are the recent developments in this sectorIJ
We’ve grown almost 33 per cent in 2017. We are currently present in 503 districts out of 686 in India. There are two reasons for this — we are expanding into new areas where ESIC didn’t exist earlier. Secondly, we had amnesty scheme where all employers, who were earlier not a part of ESIC, were allowed to join the system without any past liability. That raised the number of insured persons from 2 crore to over 3 crore who are a part of the organised sector and earn Rs 21,000 per month or less. Including their family members, we have over 12 crore people under our care. I’m sure, as we start providing better services in term of primary and secondary care, many uncovered workers will willingly join us.
What is the agendaIJ
My beneficiary should take pride in being a member of ESI Scheme and they should get good quality services. Our agenda is to expand from 3 crore to 10 crores IPs in the next five years. We have over 8 lakh establishments ranging from manufacturing unit and outsourcing to service unit. from which the contributions are collected.
How are you planning to increase the number of beneficiariesIJ
I would like the existing beneficiaries to act as brand ambassadors of ESIC. If the beneficiary talks to two more people and encourages them to register under the scheme, it automatically increases the number. Movement in that direction is the key to the success, besides expanding in new geographical areas.
How much is the total collection and funding of ESICIJ
ESIC annually collects Rs 15,000 to Rs 16,000 crores from the employers and the employees. Currently, we spend about Rs 11,000 crore rupees annually. Going forward, we expect that whatever we collect, we should be spending that amount.
What are some of the benefits of ESI schemeIJ
If somebody falls sick and looses the wages, we provide compensatory wage of about 70 per cent of his regular wages for upto 91 days in a year. We have Maternity Benefit that provides 100 percent of the wages for 26 weeks to the Insured Women during their maternity period and they get free treatment too. We provide compensatory wages to the people who get injured due to an employment accident till the period of recovery. We also provide compensation to the people who suffer from permanent disability and are unfit to work. Besides, we provide pension to the dependents who lost their breadwinner due to employment injury.
Are these schemes applicable to people working in unorganised sectorIJ
No, we only consider those who are working in an organised sector or an enterprise in the notified areas. In our country, workforce in organised sector is about 10 percent who are covered under ESI, EPF and other similar schemes. Approximately, 90 per cent of the population is associated with unorganised sector especially people in the rural areas who are working in the field, selling vegetables or working as a help in small shops or other places. To bring them in the organised sector, the size and the productivity of the business needs to be enhanced so that they can meet the statutory requirements to get enrolled under social security schemes.
What is the biggest challengeIJ
Though mandatory, it is not easy to convince the employers and workers to join the ESI Scheme. We have to make them realise that through ESIC Scheme, they can not only insure themselves but their family as well. If a worker who is earning Rs 10,000 to Rs 15,000 per month falls sick due to unforeseen reason, then he incurs debt for the treatment. ESIC provides a pool of money for providing medical care to the worker and their family besides paying them compensatory wages. Moreover, the corporation and efficacy of the State Governments in administering the ESI Scheme matters a lot. Not all States are equally enthusiastic and effective in implementing this scheme. We have suggested them to form the state level ESI Society.
How supportive are the employers in making this scheme mandatory for their employeesIJ
Some are supportive but since it is an additional cost for the employers, quite a few don’t. This is an insignificant cost with significant benefits. The worker is contributing 1.75 per cent whereas the employer contributes 4.75 per cent of the monthly wages. The purpose of this scheme was to provide social security to the worker and his family. This scheme was meant for maintaining the productivity of the worker so that he can continue to work in the factory at the same level of efficiency and doesn't need to get worried about the future of his family.
ESIC has expanded a lot over the years. How has your journey been so farIJ
We started off from State-governed hospitals in remote areas where there was no hospital. In 2010, we decided to tie-up with private hospitals and clinics which were established in those regions to make ESIC facility available. But Private Clinics and Hospitals are not uniformly available across the country. These are only in developed areas where you have got private hospital facility. In remote areas, you will not find good private medical facilities.
Moreover, after collaboration with the private hospitals, we also have to keep a check on the quality of their services and charges. To ensure effective functioning of the tie-up arrangements, we have a whole eco-system of the toll-free number, public grievance portal and employer-employee interaction at the Regional/Branch offices.
Are there any awareness campaign that you are planning to come up withIJ
We are planning to introduce SMS campaign to make people aware about different schemes and initiatives. Along with conducting camps at various places especially at employers’ premises to inform them how they would benefit from ESIC. To have more interaction with the employers and the employees, we are contemplating that every district of the country must have one point contact in terms of Branch-cum-dispensary run by ESIC.
Do you think social security cover should be made mandatory for allIJ
Yes, it should be made compulsory. life is uncertain and with the rising healthcare cost, insurance is a must. In the US, every single person is insured. People think of insurance as an additional expense and believe that nothing can go wrong. Instead of putting the money aside for insurance premium, people prefer to utilise it otherwise. You realise the importance of insurance only when you land in trouble.