Independent Research and Policy Advocacy

Employee State Insurance Scheme – Performance and Potential Pathways for Reform

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Employee State Insurance Scheme (ESIS) is the oldest health insurance scheme in India. It is mandatory for blue-collar workers and their employers in the formal sector to contribute to the scheme. In return, registered workers and their dependents can avail benefits from ESIS facilities. (Forgia &Nagpal, 2012). In its conception, it is akin to a Social Health Insurance (SHI) programme along the lines of the Bismarck Model of a health care system. 3 SHI is one approach to raising and pooling funds for financing health services. Other mechanisms include tax financing, commercial health insurance, and community health insurance. This system is not unique to India and variations of the model can be found in European countries such as Germany, Switzerland, and France, and in Asian countries such as Japan (PNHP, not dated).

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