Arvind Kumar
Certain observations were made by the Finance Minister in his budget speech on 28 February 2015 regarding two premier social security schemes of the country, namely Employees’ State Insurance Scheme (ESI) and Employees’ Provident Fund Scheme (EPF). He quoted the observations that these schemes had ‘hostages’ rather than clients. In Paragraph 62 of the speech he intended to provide alternative options to the employees served by these schemes- in the form of health insurance through commercial insurance providers approved by Insurance Regulatory and Development Authority (IRDA) alongside ESI Scheme and provident fund and pension scheme through New Pension Schemes (NPS) by the side of EPF Scheme, as alternatives. This has stirred the intense debates inside these organizations. Employees of these organisations are obviously anxious on several counts, including fear of loss of their jobs, though such anxieties may not be well founded. But the natural sessions of brainstorming among the employees in these organisations are going on about the expected formulations to translate these intentions of the government into reality and what if scenario post placement of alternatives in place these social security schemes. The fruit of such labour would take time to appear on the horizon and can be critically examined only after that. But on the positive side, lot of discussions are taking place as to what factors would have led to such move of the Government, where the organisations would have lacked in their ‘ought to have done’ areas, and so on, which is likely to bring forth the deficiencies as also the remedial measures required. The situation that might have led to such propositions can be roughly gathered from certain obvious indicators provided by these organisations at macro level.
But before that there is a pertinent question about the governance of these schemes. These schemes are statutory and managed and controlled by the government through its leadership and representations in the apex Corporation (or Board) and Standing Committee (Governing Body) of ESI Scheme and Board of Trustee of EPF Scheme. In fact the Union Labour Minister is the ex-officio Chairman in both the apex bodies of both the schemes. Besides the Chief Executive Officers (CEO) of these schemes are also appointed by the government, as per provisions of the respective statutes, from amongst very senior administrators. So as a matter of corollary the standard and degree of success or otherwise of these schemes will reflect the standard and degree or otherwise of the government of the day. Of course, the present government at the Centre is very new and hence the status obtaining till quite some time qua these schemes cannot be attributed to it. Still, it is the primary objective and prerogative of the government of the day what ‘ought to have been done’ but not done by the predecessor governments; not to move away from its statutory responsibility by creating ‘options’ on which is will not have direct control but its agencies will have the control instead. The question logically involved, then, would be that if the government cannot improve things itself how can its agencies? Will the agency be more effective than the government?
Now, two factors probably being touted as primary reasons for putting alternatives or options in place are undistributed EPF of nearly Rs. 27,000 crore and accumulated ESI reserve funds of around Rs.30,000 crores. Prime Minister spoke of the undistributed EPF of the members lying with the department and assured to get it to them in his speech last year during ‘Shram Ev Jayate’ function at Vigyan Bhavan. No one would disagree that such accumulations should not have happened. But it happened, is the reality. Then the questions would be why these funds accumulated and who are responsible? Of the further questions, fairly, it could be as to where these could have been spent and so on? The answer to first part would be simple non-distribution of employees’ money by EPF due to issues with identification and tracking mechanism and other factors. In case of EPF it might also be due to few other important factors, chief of these being lack of portability of account on inter-state migration of the employees, insufficiency of computerized database and mechanism for tracking, etc., at component levels, leading to locking up of collected funds. If serious concerted efforts can be made to find out the owners of these funds, this is not impossible. Only the government will need to enforce its will of the machinery. In case of ESI Scheme the issues are different. Some of these have long been reiterated such as non-improvement of basic infrastructure like ESI dispensaries and hospitals and other administrative offices, full reimbursements of expenses incurred by the covered employees on the medical treatments, etc. In fact of around 1450 dispensaries and 150 hospitals of ESI scheme, large number are in conditions requiring urgent improvements and modernisation with basic and advanced facilities for better treatment, convenience and comfort of the visiting beneficiaries. Other reasons are lower spend or reimbursement on medical care by limiting the reimbursement entitlements, linking the eligibility of beneficiaries for super-speciality to larger tenures of service for employee and family members to prevent ‘misuse’, etc. When the answer for reasons is searched, it will point out in larger proportion to lack of in-depth study and research before the decision might have presented to and made by the apex body or personnel. In fact, in case of ESI scheme there is state level governance mechanism where its statutory Regional Board considers the issues within its areas, including the infrastructure and other improvement areas, and makes recommendations to the apex body or officer for implementation. In reality, this too needs to be happening in letter and spirit else it would be adding to accumulations as several projects considered and recommended by Regional Boards may lie for scrutiny for years together or may not be considered at all, and be forgotten and lost. Medical care being fast developing area and closest service need to the human beings, for raising its standard sky is the limit. This can be done anytime onwards if the mechanism is firmed up. This appears to be more crying need of the hour as well since the country is in dire need of more and better healthcare infrastructure, more so in the face of the facts that the Govt. institutions are already in deficit in comparison to the population of the nation. Hence while though not big percentage, but around 9 crore plus people are covered under the social security healthcare facilities of the ESI Scheme, who would otherwise have necessarily fallen on the already inadequate public healthcare facilities or would have to go for unaffordable (for them) costly private or corporate healthcare centre and would have suffered, since these are the people whose employee family member would be earning a maximum salary of upto Rs.15,000 per month only!
(To be continued)
