The core responsibility of the Employees State Insurance Corporation is to provide medical benefits to those who cannot either afford to avail of it through established channels or buy insurance cover in the market, and by extending benefits to over 10,000 construction workers, ESIC has shown that it has not lost sight of its beliefs.
Goa has a fairly large construction industry employing workers from different parts of the country. Most of these workers are employed on daily wages and in the normal course they would have been left to fend for themselves as they do not fit into the rules prescribed by the ESIC. The old rules stipulated that any worker earning less than Rs 15,000 in registered establishments would be covered under the ESIC scheme which meant that those working in offices of construction companies could avail of this benefit while those at the site, who were more vulnerable to accidents and illness, were left out. This has now changed with ESIC extending benefits to constructions workers in the field. In Goa alone around 10,000 workers have been brought under the scheme and they will now receive cash and medical benefits.
The idea of providing medical cover to industrial workers was first brought to the table in 1923. B N Adarkar was appointed to give shape to the idea but it was only in 1952 that this facility was established through an Act. It was initially intended for workers in factories and companies but was later extended to any establishment having 10 workers or more. At present, ESIC has a network of 1,403 dispensaries, 1,678 panel clinics, 150 hospitals and 42 hospital annexes with over 22,335 beds. It caters to over seven crore beneficiaries of which seven lakh are in the State.
In the field of healthcare ESIC forms the third arm along with the private and public sector. ESIC serves a purpose in as much as it forces employees and employers to contribute towards healthcare and in that sense it is almost like medical insurance. However, with free medical benefits being extended by government hospitals and state governments embracing universal mediclaim, a question mark hangs over the future of ESIC.
In the last decade or so healthcare has under gone a sea of change. Easy availability of medical insurance and growth of the private sector has increased the number of options available to patients. However, for those earning less than Rs 15,000 per month there is only one option “ ESIC. Having contributed to the scheme beneficiaries have to avail of these services or forfeit money contributed. What goes in favour of the scheme is the number of beneficiaries. In 2015-16 over 7,000 workers claimed Rs 159 lakh as sickness benefit while Rs 94.74 lakh was claimed by 965 women as maternity benefits. This is just a small part of the total benefits paid out to workers under various categories of claims and this alone would justify the existence of ESIC scheme. However, only a cost-benefit study will give a clear picture of whether the money is being well spent or used to duplicate services already available in the public and private sectors.
The general rule is that services once extended cannot be withdrawn without causing unrest. One does not want to leave workers in the lurch, but a review would throw up suggestions on how to build a cost-effective yet robust system for delivering healthcare for all.
