Many families under the Employees State Insurance Corporation (ESIC) are not reaping the benefits of the medical cover.
Beneficiaries instead pay considerable amounts in private hospitals. Many of them said a new series of norms, associated with the ‘pehchan card’ that is required for accessing services, which came into effect last year, are very cumbersome. There also seems to be very little awareness of the reach of the ESIC scheme.
Under the ESIC, those with a basic salary of less than Rs. 15,000 are eligible for treatment. In Tamil Nadu, 24 lakh people are insured, 95 lakh are listed as beneficiaries and ESIC operates in around 200 centres. In Chennai, the ESIC runs a hospital in K.K. Nagar. The facility in Ayanavaram is under the jurisdiction of of the State government.
Last week, following a meeting with ESIC officials, an inspection was conducted at the Ayanavaram hospital. It was followed up by a grievance redress meeting at the ESIC office in Nungambakkam. However, the attendance was sparse due to lack of awareness.
A beneficiary said many had opted out since obtaining the ‘pehchan card’ required group photographs and the biometric finger prints of the entire family. “My daughter is studying in another town and I will have to wait until she finishes her studies to get the card done. The ESIC does not accept a group photograph that we had taken,” he said.
A. Prem Kumar, an electrician at L.M. Dadha School in Choolaimedu, said he was unaware of how to get the card. Mr. Kumar was earlier attached to the Ayanavaram hospital.
“Both my children were born in Ayanavaram hospital but ever since I moved to Choolaimedu, I consult a private doctor for my shoulder pain,” he added.
R. Audikesavan, who attended last week’s meeting, said that beneficiaries wanted to be referred to the ESIC hospital in K.K. Nagar. “At present, those who seek advanced treatment at the Ayanavaram facility are referred to State-run government hospitals. If the K.K. Nagar facility is too far, then we should be sent to the private hospitals with which the ESIC has tied up,” he said.
ESIC officials said that given that beneficiaries contribute from their salary for health cover, they can definitely seek treatment at designated hospitals. However, the lack of awareness has led to a lack of utilisation. Also, beneficiaries rarely attend Corporation grievance meetings and hence, officials too are not able to gauge the problems they face.
