ESIC-2.0

ESIC–2.0 refers to the second-generation reforms launched under the Employees’ State Insurance Corporation (ESIC) to modernise, expand, and improve the Employees’ State Insurance (ESI) Scheme in India. Introduced in 2015, this initiative sought to make ESI more inclusive, technology-driven, and citizen-centric. It emphasises enhanced medical services, digitalisation of records, expanded coverage, and improved governance to ensure effective social security for the working population.

Background and Need for Reforms

The Employees’ State Insurance Act, 1948 established a social security framework for providing medical care and cash benefits to workers in cases of sickness, maternity, employment injury, and other contingencies. Over time, the scheme expanded but faced challenges such as limited outreach, outdated infrastructure, and administrative inefficiencies.
To address these issues and align the scheme with the evolving labour market and technological advancements, the government launched ESIC–2.0, marking a comprehensive reform programme to transform ESI into a modern, accessible, and efficient system.

Objectives of ESIC–2.0

The key objectives of ESIC–2.0 include:

• Universalisation of ESI coverage across all states and districts.
• Improvement of healthcare services and infrastructure in ESIC hospitals and dispensaries.
• Digital transformation through electronic health records and online services.
• Inclusion of unorganised and construction sector workers within ESI benefits.
• Administrative decentralisation for faster and more efficient decision-making.
• Enhanced transparency and governance through technology-enabled systems.

Major Components of ESIC–2.0

The reforms introduced under ESIC–2.0 are broadly classified into three core areas:

1. Expansion of Coverage

• The ESI Scheme was to be extended to all states and union territories, including areas where it was partially implemented.
• Coverage was proposed for all districts in a phased manner, ensuring that every eligible worker could access ESI benefits.
• The reforms sought to include workers from construction, transport, and unorganised sectors, thereby expanding the social security net.
• Efforts were made to register smaller establishments and promote employer compliance through awareness and simplified digital registration systems.

2. Health Service Reforms

A central feature of ESIC–2.0 was the improvement of medical services and healthcare delivery systems. Key measures included:

• Electronic Health Records (EHRs): Introduction of digital health records for insured persons and their dependants to ensure continuity of care and portability of medical data across India.
• Upgradation of Dispensaries and Hospitals: Conversion of dispensaries into six-bed hospitals in phased stages and renovation of existing ESI hospitals to improve facilities.
• Enhanced Patient Care: Focus on cleanliness, sanitation, and better hospital management, including daily change of bed linens following a colour-coded system (VIBGYOR pattern).
• Extended Medical Services: Introduction of 24×7 medical helplines, evening outpatient services for senior citizens and differently-abled persons, and improved diagnostic and speciality care.
• Community Health Outreach: Greater emphasis on preventive healthcare and awareness campaigns for insured workers and their families.

3. Administrative and Governance Reforms

To make ESI administration more efficient and responsive, several governance and technology-based reforms were undertaken:

• Project Panchdeep: Comprehensive computerisation of ESIC operations covering registration, contribution, benefits, and medical services.
• Decentralisation: Establishment of state-level ESIC societies for faster decision-making and effective coordination between central and state authorities.
• Digital Services: Online claim processing, contribution tracking, and grievance redressal systems for employers and employees.
• Transparency and Accountability: Real-time monitoring of hospital performance, expenditure tracking, and public reporting mechanisms.

Key Features and Initiatives

The ESIC–2.0 framework introduced several innovative measures:

• Creation of a national database of insured persons with linked health records.
• Integration of digital platforms for service delivery, including telemedicine and electronic medical records.
• Establishment of new hospitals in uncovered districts and upgradation of dispensaries to meet growing healthcare demands.
• Expansion of ESI coverage in the North-Eastern states and remote districts to ensure universal social protection.
• Toll-free medical helpline (1800-11-3839) for assistance in emergencies.

Impact of ESIC–2.0

The implementation of ESIC–2.0 led to several measurable outcomes:

• Increased geographical coverage, bringing more districts and states under the ESI umbrella.
• Improved access to healthcare through modernised hospitals and dispensaries.
• Digital transformation of medical and administrative systems, enabling online access to health and insurance records.
• Enhanced satisfaction levels among insured workers due to improved facilities and responsiveness.
• Expansion of beneficiary base, including informal sector workers in pilot areas.

Challenges and Limitations

Despite notable progress, ESIC–2.0 has faced several operational and structural challenges:

• Infrastructure Gaps: Shortage of trained medical personnel and facilities in certain regions.
• Uneven Implementation: Variation in reform progress across states due to administrative constraints.
• Digital Accessibility Issues: Limited digital literacy among workers in rural or unorganised sectors.
• Coordination Difficulties: Effective collaboration between central, state, and local authorities remains a challenge.
• Sustainability Concerns: Expanding coverage requires balancing financial sustainability with benefit adequacy.

Future Directions

The ongoing development of ESIC–2.0 continues to focus on strengthening and broadening the reach of social security for workers. The future vision includes:

• Universal coverage of ESI in all districts and states.
• Integration with national health programmes such as Ayushman Bharat for shared infrastructure and resources.
• Enhanced digital governance using artificial intelligence and analytics for predictive healthcare management.
• Capacity building of ESI hospitals and training institutions to ensure quality service delivery.
• Inclusion of gig and platform workers within the ESI framework as part of India’s evolving labour market reforms.

Significance of ESIC–2.0

ESIC–2.0 represents a crucial milestone in India’s social security evolution. It demonstrates the government’s commitment to:

• Extending universal health protection to all workers.
• Promoting digitisation and transparency in welfare delivery.
• Strengthening tripartite collaboration between the state, employers, and employees.
• Ensuring that workers enjoy both economic security and health coverage, vital for national productivity and social stability.