Corporate India's health insurance safety net doesn't cover everyone

Majority of staff in key business sectors lack protection, shows data from listed companies

As the Industrial Revolution spread, guilds and unions pushed for workers’ medical insurance in the US and Europe. The Granite Cutters Union, in 1877, and the International Ladies Garment Workers Union, in 1913, were pioneers in ensuring worker protection.

Maharashtra announced universal healthcare for all citizens in June, a heartening measure in a state where many of India’s largest companies are based. Nearly a fifth of those working in major Indian firms do not have health insurance coverage, shows a Business Standard analysis of data covering 1.3 million people working for 25 firms on the S&P BSE 100 index.

The permanent staff of companies has health insurance, but less than half of those not on the rolls are covered for the benefit as seen in chart 1 (click image for interactive chart).

Chart 1

Banks, information technology (IT) and pharmaceutical companies provide health insurance for almost all those working for them. Those with less than 50 per cent coverage include capital goods companies, and infrastructure developers and operators (chart 2).

Chart 2

The private sector provided health insurance to 82.93 per cent of the 1.28 million workers in this analysis’s sample. State-owned firms did so for 99.96 per cent of their staff, found the analysis that studied nearly 20,000 of those working in listed public sector companies.

Types of Health Insurance Coverage in India

In a country where social security is weak, company-provided health insurance is crucial. Government reports have said social security coverage is weak for even those with steady employment. Around 49 per cent of men, and 52 per cent of women among regular wage, and salaried employees were ineligible for social security benefits in 2017-18. Data for 2021-22, a period after Covid-19, shows that among regular workers 52 per cent of men and 56 per cent of women were ineligible for social security like healthcare, maternity care and retirement benefit (chart 3).

Chart 3

Workers who have company health insurance are better off than the population at large. Only 29.8 per cent of Indian women and 33.3 per cent of men have health insurance, according to the National Family Health Survey, 2019-21 data. Overall, 41 per cent of households have at least one member covered by a health insurance or financing scheme.

Indians pay around 52 per cent of health spends from their own pocket, according to data from the National Health Accounts--Estimates for India, 2019-20. The global figure was 18.02 per cent in 2019, according to World Bank data.