Page 83 - DMGT306_MERCANTILE_LAWS_II

Mercantile Laws – II

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available to an insured person and his family in kind from the date of his entry into
insurable employment. Medical benefit has also been extended to permanently disabled
persons who cease to be in employment due to employment injury. The benefit is also
extended to insured persons after their retirement on the same conditions.
The Scheme provides for comprehensive medical care in the form of medical attendance
and specialist consultations, supply of drugs and injections, free hospitalization care,
outpatient service, specialist and hospital services.

Within the ambit of the program is a drive towards immunisation of young children, of
insured persons against diseases like diphtheria, polio, tetanus, measles and tuberculosis.
It provides family welfare services to the beneficiaries of the Scheme. Insured persons and
members of their families are provided with artificial limbs, hearing aids, cervical collars,
walking calipers, crutches, wheelchairs and pacemakers as part of their medical treatment.
Conceptually, from the point of view of the insured persons, the ESI Scheme can be said to
be one of the best medical insurance schemes in India. But it suffers from several drawbacks:
The Act envisages that the medical benefits will be provided by the State Governments;
the Corporation may enter into agreements with these State Governments to decide the
nature and scale of medical treatment that should be provided and cost sharing thereof.
The Act also provides for the Corporation itself, in consultation with the State government
concerned, undertaking the responsibility of providing medical benefit to insured persons
in a State. Accordingly, medical treatment and attending to insured persons and their
families is being provided by the State Governments everywhere, except in Delhi where
the Corporation has undertaken this responsibility.
The responsibility for creating the necessary infrastructure for providing medical benefits
therefore rests with the State Governments though the cost is met by the Corporation. The
inability or the unwillingness of the State governments to discharge this responsibility
has come in the way of expansion of the ESI Scheme. This is one of the reasons for the slow
growth of the scheme.

The arrangements under which the Corporation provides funds and the State Governments
implement the scheme has come in for criticism on the ground that there is a dichotomy
in the administration of medical benefit which is not conducive to efficiency and has
resulted in dissatisfaction among the insured persons. The committees which reviewed
the workings of the Scheme have recommended that the Corporation take over the
administration of the medical benefit. There has been no decision on this recommendation
but the process of taking over the administration of medical benefit by the Corporation is
reported to have commenced with the Corporation taking charge of a few hospitals to be
run as model ones.

If the Corporation is free from this constraint, it should be possible for it to expand
medical facilities significantly. It can become a major instrument for providing Universal
Health Care and assume responsibility for providing medical care to all workers in the
organised as well as the unorganized sector.
Question

Critically analyse the above case.

Source: http://thealternative.in/content-type/views/rka-subramanya-the-role-of-esic-in-universal-
health-care/

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