paper41 many acts

8/8/2019 Paper41 Many Acts

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ASIA PACIFIC REGION HIGH LEVEL

MEETING ON SOCIALLY INCLUSIVESTRATEGIES TO EXTEND SOCIAL

SECURITY COVERAGE

SOCI AL HEALTH I NSURANCE:

STRATEGI ES FOR EXTENSI ON

-Prabhat . C. Chat urvedi ,-DI RECTOR GENERAL,

-Employees Stat e I nsurance Corporat ion, I NDI A


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Genesis of Social Security in India

Social Secur it y provisions existed in I ndia

f rom post -vedic period

Tradit ional Joint Family System provided f irst

line of social defense.

Need for formal social secur it y arose af ter

indust rializat ion, consequent migrat ion fromrural t o urban areas and creat ion of nuclearfamilies.


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Size and composition of the workforce

Total Work force

i) in Organised Sector

ii ) in Un-Organised Sector

Composit ion of Workforce in organisedSector

i) Public Sector

i) Private Sector

NSSO-2004-05/ Economic Survey(2008-09)

459 m il l ion

26 mil l ion

433 m il l ion

18 mil l ion

8.46

mill ion


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Composition of workers in Organised Sector

i) Government & Publ ic sector ent erpr ises, quasigovernment bodies and local authori t ies;

ii) Employees of fact ories and establishment s;

ii i) Employees employed in Mines, Plant at ions andother such sect ors for w hom separate socialsecur it y legislat ions are available.

Having employer-employee relat ionship


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Central Laws regulating Social Securityfor workers in Organised Sector

The Employees State Insurance Act, 1948

The Employees Provident Funds &

Miscellaneous Provisions Act, 1952 The Workmens Compensation Act, 1923

The Maternity Benefit Act, 1961

The Payment of Gratuity Act, 1972


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Social Security for workers

in Organised Sector Social Secur it y for Cent ral and State Govt . employees,

Railw ay employees and t hose in Armed Forces/ Para-Milit ary provided by Govt . from t axrevenue/ cont ribut ion

Employees of factor ies and establishments employing10/ 20 w orkers covered under ESI Act & EPF &

Misc.Prov. Act , Coal Mines PF Act etc.

Smaller factories/ establishment s and w orkers notcovered by ESI Act Workmens Compensat ion .Actand Materni t y Benef it Act .

Beedi w orkers, cine w orkers etc - Welfare Fund Act s

Mines and Plant at ions -Mines Act / Plant at ion LabourAct.


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Constraints in extension of coverage

Threshold l im it s for coverage offactories/ est ablishm ent s

Wage lim it for coverage of employees

Dependence on State Governments for providingmedical care facili t ies for ext ension t o new areas- incase of ESI S

Profession/ Act iv it y w ise coverage under EPF Scheme

Cont ractualisat ion/ casualsat ion of w ork by fact ories/establishments

Exempt ions by St ate Governments in case of ESI S

Non-Coverage of establishment s under t he cont rol ofCent ral Government under ESI S


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Strategies for extension of social security coverag

Lowering of threshold of coverage offact ories/ est ablishment s

Link ing w age ceiling t o cost of liv ing index orremoval of ceiling for coverage

Making arrangements for medical care innew areas direct ly by ESI C w it h t ie-uparrangements w it h privat e providers

Emphasis on registering casual/ cont ractworkers

Convergence of various Social SecurityProvisions for organised sector monitoringand avoidance of duplicat ion of benefit s


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Thanks


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Recent Initiatives by ESIC in increasing

coverage/improving benefits

Scheme extended to 49 new areas covering93,910 employees during 2006-07 and to 37

new areas covering 97,739 employees during2007-08.

No. of insured persons covered under ESI

Scheme touched a new high of 1.01 crores in2006-07, No.of beneficiaries went upto 3.94crores.

Wage ceiling for coverage of employeesenhanced from Rs.7,500/- to Rs.10,000/-w.e.f. 1.10.2006.

contd.


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Daily rate of Sickness Benef it enhanced from about 50% ofaverage daily w age to about 60% of average daily w agew .e.f. 1.12.2007.

Daily rate of disablement and dependant s benef it enhancedfrom about 70% to about 75% of w age w.e.f. 1.12.2007.

Rate of funeral expenses enhanced f rom Rs.2,500/ - t o

Rs.3,000/ - w .e.f. 1.12.2007.

Exempt ion lim it f rom payment of employees share ofcont ribut ion enhanced f rom Rs.50/ - t o Rs.70/ - per dayw .e.f. 1.8.2007.

Basic rates of PDB/ DB enhanced ranging f rom 1% to464% in February, 2008 t o protect against erosion in t hevalue due to inf lat ion w .e.f. 1.8.2005.

contd..


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I nt roduct ion of syst em of self-cert if icat ionby employers w .e.f . 1.4.2008

Amnesty Scheme w it h remission in damagesint roduced to reduce lit igat ion

Process to Modernise/ Upgrade/ Expand allModel Hospitals to bring t hem at par w it hbest Pr ivate Corporate Hospit als ini t iated.

Grading of all ESI C hospit als by reput edGrading Agencies.

I SO Cert if icat ion of all Model Hospit als andRegional Off ices.

contd.


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Decision t o take over ESI Scheme in Madhya Pradesh,Jharkhand and Bihar by ESI C in a phased manner.

I nst allat ion of sophist icated equipment s such asMRI / CT Scan etc. through t hird part y part icipat ion in

ESI C Hospitals.

Decision to set-up a Super-specialt y hospital atHyderabad and thereaf t er other suit able locat ions.

Ceiling on reimbursement of expenses on medical careto st ate governments increased from Rs.900/ - t oRs.1,000/ - per I .P. family unit per annum.

Dialysis Treatment taken out from super-specialt yt reatment and now w ill be provided t o all t hose ESIBenef iciaries w here it is advised if t hey are ent it led formedical benef it .

Contd


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Amendment s in ESI Act t o :

enable provision of medical care t o non I Psagainst payment of user charges-providingmedical care to BPL famil ies under RSBY

facili t ate coverage of smaller factories,st reamline procedure for assessment ofdues, providing Appellate Aut hori t y t o avoidunnecessary lit igat ion, third part y

part icipat ion in running of Hospitals et c.

Contd..


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Recent Initiatives- EPF Scheme

Grant of advance from the fund t o

cover medical care of t he member &his/ her family cover ing:

a) Hospit alizat ion last ing for one month

or more, orb) maj or surgical operat ion in ahospit al, or

c) suf fer ing from T.B. leprosy,paralysis, cancer, ment al derangementor heart ailment and having beengrant ed leave by his employer for

t reatment of t he said il lness and


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For t he t reatment of a member of hisfamily w ho has been hospit alized, orrequires hospit als for one month or

more(a) for a maj or surgical operat ion, or(b) for t he t reatment of T.B. leprosy,

paralysis, cancer, ment al derangementor heart ai lment .

grant of advance t o members w ho arephysically handicapped for purchasingequipment t hat is required tominim ize t he hardship on account of

handicap.


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Introduction of a scheme whereby theemployers share of cont r ibut ion under

t he EPF as w ell as ESI C schemes of anhandicapped employee shall be met bythe Government upto the salary levelof Rs.25,000 per mont h.

Amendment making a member who ispermanently and totally disabled

entitled to pension provided he hasmade one months contribution to thepension fund.

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