2. However, so far as the administrative side of providing cash benefits is concerned, the working of the ESIC institutions has shown continued improvements since inception of the said scheme. In the beginning there was contribution stamp system, but the same was abolished about more than 31 years earlier. Now, online system of payment of contributions, submission of returns and payments of cash benefits to the insured persons have been introduced and I think, there is hardly any other social security scheme ( excluding medical benefit) which has improved to the satisfaction of its customers.
3. Your observations regarding short-comings in delivery of medical benefit under ESIS are correct. But the position is that there is no alternative for its improvements. Initially ESIS was drafted by Prof. B.P.Adarkar, who was an eminent social security expert and in his report he submitted to the Government of India in the year 1944, he recommended for unification of administrative as well as medical scheme under one authority. But, the Govt. of India allowed dual system i.e. the medical system was made separate and was given to the State Governments. So accordingly, the State Govts., run their ESIS hospitals and ESI dispensaries on the same standard as they are running their civil hospitals and civil dispensaries. Hardlly State Govts. realize that in respect of this scheme, the contributors i.e. poor workers have contributed from their pockets. A majority of State Govts. do not maintain separate accounts in respect of funds received from ESIC for medical facilities and there is hardly any separate system of accountability towards satisfaction of workers in respect of medical benefit (facilities). However, as you may have observed, the ESIC is running ESIS medical scheme in Delhi under its own control and perhaps in Delhi ESIS medical services are more better than other States. In order to improve the medical benefit under ESIS, it is necessary as suggested by Prof. Adarkar, the entire medical benefit should also be under the control and supervision of ESIC. ESIC had started to improve medical services by opening at least one Model Hospital in every State since the year 2002, but such improvements appear to be very minor considering vast infrastructure of ESI Hospitals and Dispensaries in a State.
4. You have also stated that "the Govt. has ambitious plans to extend its benefits to unorganized sector also" and to submit that such like contributory social security scheme are not meant for unorganised sector. In social security scheme like ESIS, there is concept of pooling of resources and risks, which is not possible in vast majority of unorganised sector. There is separate Act titled as "Unorganised Workers Social Security Act, 2008" under which the Central Govt. had made elaborate provisions for welfare of workers of unorganised sector. But since there is hardly any effect of this legislation on welfare of poor workers, the Govt. is now attempting to burden financially sound social security schemes like ESIS. If Govt. is so concerned about welfare of the working class in unorganised sector it must provide social security out of general taxation i.e. from Consolidated Fund of India. Burdening of Social Security Schemes like ESIS to provide benefits to unorganised sector will definitely make this scheme financially unsound in the long run.
5. I may further submit that you may be aware that 2nd National Commission on Labour in its Report, which was submitted to the Central Govt.in the year 2002 had made very good suggestions for improvements in the social security schemes for workers like ESIS & EPF, as well as suggested for consolidation of various labour laws, but I think, the Government has not been in a position to so far make changes / amendments etc. as suggested by said Commission. Therefore, despite of all the recommendations of the Commissions and Experts like Prof. Adarkar, as mentioned by me as above, the scheme is being run half-heartedly and perhaps the Govt. is satisfied with the present situation as mentioned by you. Now, the Central Govt. has come-up with another bill called "Small-Factories Bill" vide which it is suggested to make ESIS and EPF optional in factories employing less than 40 workers. Perhaps, as I understand this is being done to adopt hire and fire policies in factories / labour services and also to adopt a model on the basis of laissez faire policies presently being followed in developed economies like USA.
2nd November 2016 From India, Noida