EMPLOYEE MEDICAL BENEFITS IN THE CORPORATE SECTOR
Item
- Title
-
EMPLOYEE MEDICAL BENEFITS
IN THE CORPORATE SECTOR - extracted text
-
EMPLOYEE MEDICAL BENEFITS
IN THE CORPORATE SECTOR
Ravi Duggal
November 1993
The Foundation for Research in Community Health
84_Af r.g. Thadani Marg, Worli, Bombay 400 018.
CONTENTS
1
I
«
1.
Acknowledgement
V
2.
Foreword
IX
3.
1ntroduction
1
4.
A Profile of the Companies
11
5.
Type of Medical Benefits
28
6.
Expenditure on Medical Benefits
41
7.
Conclusions and Issues
57
8.
References
62
ACKNOWLEDGEMENT
The present
funded by
study was
Council of Medical
Expenditure Studies’
of
the
’Health
Foundation
for
Research
Research (ICMR) as a part
project
of
(FRCH).
We thank ICMR for
the
the Indian
in
Community Health
support to
their continued
FRCH for
studies in the area of Health Economics and Financing.
The
the
present
researchers
without
whom
undertaken.
Thanks to
data
for
study
the
Sunil Nandraj,
Kiran Kaul for their excellent effort
together all
collected by a team of
were
study
not
would
have
been
Saraswathy Ananthram and
in collecting
and putting
the data from the companies1in the sample.
I would
also like to acknowledge their help in the initial stages of data
analysis.
Thanks
also
to
processing of the data
drafts of
the present
Rao
going
for
Shetty for handling the entire computer
Sahana
Maria Pinto
and to
publication.
the many
A special thanks to Nagmani
manuscript,
the
through
for typing
preparing
it
for
publication and handling the printing of the document.
And most
importantly thanks
to
whose continuous encouragement and
Dr. N.H.
Antia, our Director,
support has
helped us launch
into uncharted areas of health services research.
Finally, we
to
our
would like
questionnaires
to thank all the companies who responded
interviewing
and
possible .
V
and
made
this study
We thank the following companies who have responded to this study:
* Acrow India Ltd., Bombay.
* Air India, Bombay.
* Albright, Morarjee & Pandit Ltd., Bombay.
* Asian Paints (India) Ltd., Bombay.
* Automotive Axles Ltd., Mysore.
* Avery India Ltd., Calcutta.
* Bombay Suburban Electric Supply Ltd., Bombay.
* Bakelite Hylam Ltd., Secunderabad.
* Bengal Chemicals & Pharmaceuticals Ltd., Calcutta.
* Bengal Ferro Alloy & Steel Ltd., Calcutta.
* Bengal Potteries Ltd., Calcutta.
* Bihar Caustic & Chemicals Ltd., Dist. Palaman, Bihar.
* Blue Star Ltd., Bombay.
* Bombay Mercantile Co-op Bank Ltd., Bombay.
* Brooke Bond India Ltd., Bangalore.
* Burn Standard Co. Ltd., Calcutta.
* Cable Corporation of India, Bombay.
* Cadbury India Ltd., Bombay.
* Cemindia Company Ltd., Bombay.
* Central Cottage Industries Corporation,
New Delhi.
* Chemicals & Plastics India Ltd., Madras.
* Cibatul , Dist. Valsad, Gujarat.
* Consolidated Coffee Ltd., Kodagu, Karnataka.
* Coromandel Agro Products & Oils Ltd., Guntur, Andhra Pradesh.
* D&H Secheron Electrodes Ltd., Indore.
* David Brown Greaves Ltd., Bombay.
* Drillco Metal Carbides Ltd., Ahmednagar, Maharashtra.
* Elecon Engineering Co. Ltd., Vallabh Vidyanagar, Gujarat.
* Essel Packaging Ltd., Bombay.
* Gohak Mills, Bombay.
* Grob Tea Co. Ltd., Calcutta.
* Gujarat Alkalies & Chemicals Ltd., Baroda.
* Haryana Petro Chemicals Ltd., New Delhi.
* Hercules Hoists Ltd., Bombay.
* Hindustan Paper Corporation, Calcutta.
* Hindustan Petroleum Corporation Ltd., Bombay.
* Hindustan Times, New Delhi.
* Hindustan Vegetable Oil Corporation, Delhi.
* Howrah Mills Co. Ltd., Calcutta.
* Hyderabad Industries Ltd., Hyderabad.
* ICI India Ltd., Calcutta.
* Indian Express Newspapers (Bom) Pvt. Ltd., Bombay.
* Industrial Credit & Investment Corporation of India Ltd., Bombay.
* Instrumentation Ltd., Kota, Rajasthan.
* ITC Ltd., Calcutta.
* Jessop
Co., Calcutta.
* Kerala Spinners Ltd., Alleppey, Kerala.
* Khaitan (India) Ltd., Calcutta.
* Khatare Spinning Mills Ltd., Solapur, Maharashtra.
* Kinetic Honda, Dist. Dhar, Madhya Pradesh.
* Krishak Bharati Cooperative Ltd., New Delhi.
* Larsen'S Toubro, Bombay.
* Loyal Textile Mills Ltd., Madras.
* Lyka Labs Ltd., Bombay.
* M. M. Rubber Company Ltd., Madras.
* Madhya Pradesh Electricals Ltd., Bhopal.
* Mahalaxmi Fibres & Industries Ltd., Calcutta.
* Maharashtra Electronics Corporation Ltd., Bombay.
VI
* Mahindra 6. Mahindra Ltd., Bombay.
* Malabar Bldg. Products Ltd., Trichur, Kerala.
* Maruti Udyog Ltd., New Delhi.
* May & Baker Ltd., Bombay.
* Mipco Seamless Rings (Gujarat) Ltd., Bombay.
* Mukand Ltd., Bombay.
* Munjal Showa Ltd., Gurgaon, Haryana
* Murugappa Electronics Ltd., Madras.
* Mysore Sales International Ltd., Bangalore.
* National Organic Chemicals Industries Ltd., Bombay.
* National Fertilisers Ltd., Delhi.
* National Textile Corporation (South Maharashtra) Ltd., Bombay.
* Nepa Ltd., Nepa Nagar, Madhya Pradesh.
* New Phaltan Sugar Works Ltd., Dist. Satara, Maharashtra.
* Nirlon Ltd., Bombay.
* Nizam Sugar Factory Ltd., Hyderabad.
* Octavius Steel & Co. Ltd., Calcutta.
* Orissa Cement Ltd., Dist. Sundargarh, Orissa
* Otis Elevators Co. (India) Ltd., Bombay.
* Paharpur Cooling Towers Ltd., Calcutta.
* Parke Davis (India) Ltd., Bombay.
* Parle Products Ltd., Bombay.
* Phoenix Mills Ltd., Bombay.
* Pieco Electronics & Electricals Ltd., Bombay.
* Piramal Spinning
Weaving Mills Ltd., Bombay.
* Polyolefins Industries Ltd., Bombay.
* Priyadarshini Spinning Mills Ltd., Hyderabad.
* Proctor & Gamble India Ltd., Bombay.
* Projects & Developments India Ltd., Dist. Dhanbad, Bihar.
* Quest International India Ltd., Bombay.
* Rallis India Ltd., Bombay.
* Rashtriya Chemicals & Fertilisers Ltd., Bombay.
* Rashtriya Ispat Nigam Ltd., Visakhapattanam.
* Rasoi Ltd., Calcutta.
* Reliance Chemotex Industries Ltd., Bombay.
* Reliance Industries Ltd., Bombay.
* Rhone Poulene, Bombay.
* Roche Products Ltd., Bombay.
* Roplas (India) Ltd., Pune.
* S.N.Sunderson (Minerals) Ltd., Calcutta.
* Saraspur Mills Ltd., Ahmedabad.
* Shri Rajendra Mills Ltd., Salem.
* Silver Cotton Mills, Ahmedabad.
* Sir Shadi Lal Enterprises Ltd., Dist. Muzaffarnagar, U.P.
* Sri Chamundeshwari Sugars Ltd., Bangalore.
* Standard Batteries Ltd., Bombay.
* Standard Chartered, Bombay.
* Synbiotics Ltd., Baroda.
* Tamil Nadu Chromates & Chemicals Ltd., Madras.
* Tata Exports Ltd., Bombay.
* Tata Tea Ltd., Calcutta.
* Tata Yodogawa Ltd., Jamshedpur.
* Telangana Paper, Hyderabad.
* The Associated Cement Companies Ltd., Bombay.
* The Bombay Electric Supply & Transport Undertaking, Bombay.
* The Bombay Oil Industries Ltd., Bombay.
* The Cotton Corporation of India Ltd., Bombay.
* The Dhampur Sugar Mills Ltd., Dist. Bijnor, Uttar Pradesh.
* The East India Hotels Ltd., Calcutta.
* The Fertilisers & Chemicals Travancore Ltd., Kerala.
VII
* The Great Eastern Shipping Co. Ltd., Bombay.
* The Indian Hotels Co. Ltd., Bombay.
* The Morarjee Gokuldas Spinning & Weaving Co. Ltd., Bombay.
* The Mysore Lamp Works Ltd., Bangalore.
* The Tata Electric Companies, Bombay.
* The Travancore-Cochin Chemicals Ltd., Ernakulam, Kerala
* The Zandu Pharmaceutical Works Ltd., Bombay.
* Travancore Electro Chemical Industries Ltd., Kottayam, Kerala.
* Travancore Titanium Products Ltd., Trivandrum, Kerala.
* Universal Paper Mills Ltd., Calcutta.
* Varun Shipping Co. Ltd., Bombay.
* Vijayeshwari Textiles Ltd., Coimbatore Dist., Tamil Nadu.
* Voltas Ltd., Bombay.
* Western India Enterprises Ltd., Pune.
* Weston Components Ltd., New Delhi.
*****
VIII
FOREWORD
Council of Medical Research (ICMR) in 1986 approved a
The Indian
series of studies to be undertaken by the Foundation for Research
in
Community
Financing
studies
Health
and
was
The
Expenditure.
to
fill
the areas of Health Economics,
in
(FRCH)
the
larger
of these
objectives
in knowledge of this important
gaps
subsector of health.
the above ICMR
The present study is the last
of the
supported research
It is an exploratory study looking
into the medical
program.
care
studies in
provided
benefits
by
companies
of the
organized industrial sector to their employees.
The organized
sector, though proportionately small in the Indian
context, is large numerically.
million including
about 110
sector.
have
It
accounts for
a population of
family members of employees of this
Being politically a group that can carry its
gained
substantial
benefits
voice they
from employers through their
struggles.
Medical Care Schemes and Allowances are one such
set of benefits
that give these workers and their families additional resource in
cash or kind to manage their struggle for survival a
comfortably than
little more
the masses, especially the rural poor, who live
at or below the subsistence level.
IX
The present study was restricted in its scope to look at only the
type of medical benefits and the volume of
expenditure on
companies because of constraints of time and resources.
definitely like to go beyond this study and look at
from the
point of
view of
the workers
it by
We would
the benefits
and their unions in the
near future.
However , we are happy that this study has filled an important gap
in the
knowledge of
health expenditure in the country.
that other researchers will get enthused through the
We hope
findings of
this study to take the lead to gather further information in this
important area of health services research.
Dr. N.H. Antia.
X
INTRODUCTION
BACKGROUND AND STUDY DESIGN
The Background
sector work-force in any country is not only vocal
The organised
4
about its needs but is also an important balancing force
players of
power politics.
used by and uses, the
is both,
It
for the
power brokers for gains of each other.
in India
The organised sector as a ratio to the total work-force
may be
a small proportion (only 10%), but in terms of numbers it
is huge, constituting the
,
a
the
is a force in which vests the potential
radical
change
in
political economy.
the
to bring about
But the dominant
trade unions serve less the interest of the workers and
machinations
to the
lower-middle
This work-force, presently numbering about 26.5
middle classes.
million,
from
range
of
leaders.
political
As
more the
a
consequence
is
that,
this
I
potential remains suppressed.
The result of
capitalist
advanced
I
such
a
political
the
countries,
make very major gains in
its
economy
working
unlike the
working class is unable to
conditions
and benefits.
India, unlike the advanced capitalist countries, is not a welfare
state.
It
only
presents
a
facade
of
welfarism
through its
socialistic proclamations and innumerable development programs
1
(that invariably fail) for various sections of the society.
While the historical basis for welfare or social security in the
west
rooted
is
in
Bismarckan
the
model, most underdeveloped
countries have not been able to muster that kind of state inter
vention for workers’ or peopled welfare.
Indian case,
best, like
At
the efforts have been marginal, serving ruling class
interests by providing the minimum appeasement
the class
in the
struggle from
necessary to keep
as well as to hold the
going overboard
existing scheme of things intact.
Our concern in the present
benefits
medical
that
is
study
the
privilege
of
approximately
term it a privilege, not in
to
looking at
sector
(both public and
In India
such benefits are
corporate
private) provides to its employees.
the
restricted
half the organised sector.
terms of
We
any special consideration,
but relative to the fact that the vast majority of the population
has access to a grossly inadequate and a
health system
on the
for-profit health
difficult access public
one hand, and on the other an unaffordable
system
care
whose
reach
is
widespread but
quality highly questionable.
We
view
wages
and
medical
benefits,
salaries)
strictest sense
as
like all other benefits (other than
social
are benefits
wages
(social
in kind).
viewed as something which are the result of
employer.
wages
in
the
Benefits are not to be
the goodness
of the
They are provided for from the value created by labour
2
power
and
the
include
generally
families
workers'
as
beneficiaries also.
In business economics (atleast in India) the term used is “fringe
benefits" .
These include "benefits paid by employers which
materially
add
to
of employees either during the
welfare
the
tenure of their service or after retirement, and
on employees
not form
which do
for
time
not
worked
education, medical,
profit and other bonuses,
(leave),
legally required payments on
social
their normal wages and
benefits include payments
Thus fringe
allowances’ (EFI, 1972).
made
part of
the expenditure
security
schemes, housing,
energy (fuel and light), water, food,
recreation etc. (either subsidised or free of cost).
In India, given the limited bargaining power of the workers, most
of the
benefits provided,
especially by the private sector, are
only those mandated by law.
It is
the public
sector which more
beyond the legal framework and provides benefits that
often goes
are not statutory.
The
first
step
security in
towards
India was
provision
through the
for
health
related social
Factories Act (Amendment) of
1922, which, for the first time, provided parameters
for working
conditions whereby, the employer was fined for an offence causing
injury or death to a
followed
in
1923
The
worker.
as
a
Workmen’s
comprehensive
measure
Compensation Act
to provide for
employment - injury compensation to industrial workers.
3
Similar
exist
legislations
Employees State
industrial
Plantations
for
Insurance Act
workers.
benefits for
maternity related
In 1948 the
health insurance to
provided for
Maternity
The
Mines.
and
of 1961 provides for
Act
in the organised
women employed
sector .
emphasise here that these Acts cover only the organised
One must
sector i.e. those organisations which come either under the
Factories Act or the Shops and
earlier this
is only a small proportion of the total work-force.
and audit machinery
Further , because of an inadequate monitoring
of
the
As indicated
Establishment Act.
only
State,
about
half
of
such workers are actually
covered by these provisions.
Data on medical benefits provided to
come
This
by.
is
collate such data.
obtain
because
all benefits
companies’
balance
benefits and salaries separately.
publish
their
difficult to
because there is no statutory provision to
Data on
the
employees are
accounts
(Annual
are less
sheets
Hence,
for
Reports),
difficult to
have
to
show
companies which
this information is
available.
However it is an exceptional company
its medical
benefits separately,
that would show
except for ESIS contributions,
which are a statutory requirement.
The only data available consistently on employee medical benefits
are
those
published
by
Plantations,
ESIC,
Mines
and
Beedi
Workers’ Welfare Funds etc. i.e. the statutory benefits covered
4
under
various
Labour
across
such
information
Acts.
Ocassionally one would also come
public
from
sector
undertakings and
the Railways, and the Post and Telegraph
departments, especially
Department.
The only comprehensive studies are a
the Employers’
two carried
out by
India, for the years 1960 and 1969
Federation of
(EFI, 1962 and EFI, 1972).
set of
Both
these
studies
at the
looked
entire range of "fringe benefits" as defined earlier (EFI, 1972).
The benefits that these
studies identified
are as
and analysed
follows : (i) Profit and other Bonuses; (ii ) Payment for time not
worked; (iii) Gratuity and pension payments; (iv) ESIS;
(v) EPF;
(vi)
Maternity
Retrenchment
benefit,
workmen’s
statutory] (viii)
(ix) Medical
or
lay
off
compensation;
compensation
etc;
[(iii)
(vii)
(vii)
to
are
"Voluntary" PF, gratuity and pensions;
assistance;
(x)
Workmen’s
compensation
and life
insurance premia;
(xi) Canteen; (xii) Housing; (xiii) Education;
(xiv) Recreation,
culture,
cooperative
societies,
payments in
kind etc .
The 1960 survey showed that all these benefits amounted to 21.30%
of the wage bill.
In the 1969 survey this
had improved slightly
to 27.11%, but as the study points out, most of this increase was
due
to
additions
expenditure by
in
statutory
employers.
benefits
and
not “voluntary"
However, the study noted significant
differences between the mining
and
plantation
hand and the manufacturing sector on the other.
5
industry
The former
on one
recorded a
sharp rise
in "voluntary"
payments/benefits but the
latter’s increase was mostly in statutory payments.
fringe
benefit
in
rupee
value
worked
out
The average
Rs.896.30 per
to
employee in 1969 in comparison to Rs.287.30 per employee in 1960.
We have also identified a study on Health Financing by the Indian
Institute
Management,
of
Development Bank.
sent to
the
for
Asian
As part of this study 2000 questionnaires were
various small, medium and large companies in Maharashtra
and 150 to companies in West
poor -
done
Ahmedabad,
126 from
Bengal , but
Maharashtra and
the response
Bengal.
27 from
was very
For the year
1985-86 their findings showed that for medical benefits the small
companies in
spending Rs.
Maharashtra were
532.30 per employee
and the medium and larger ones Rs. 454.10 per employee (only
employer share).
In Bengal
expenditure
this
was
Rs.
470 per
employee in the same year (IIM, 1987).
The Study and its Methodology
series of
studies on health
financing and expenditure which seek to look at
the entire gamut
country.
In this study we
study is
The present
of
health
care
explore the types
a part
financing
of
of a
in
medical
the
benefits
that
employees
get in
exchange for their labour power.
A preliminary
exploration of a few companies regarding provision
of medical benefits to their employees showed four major types of
i
non-ESI
benefit
(i)
schemes
against
claims
bills with upper
limits, (ii) fixed lumpsum payments ( iii ) group health insurances
and
facilities.
earning
or
in-house
(iv)
ESI
scheme
Rs.1600
per
The
upto
retained
is
hospital or other medical care
compulsory
for
all employees
month (presently this limit is being
raised to Rs.2500) wherever it has been made applicable.
We will
discuss the details in a later section.
We began
very ambitious
on a
this study
sample we decided to
companies listed
use the
To select our
plane.
in the
May 1989
volume of the Centre for Monitoring Indian Economy’s (CMIE) 'Data
The CMIE report covers companies with
on Larger Business Units’.
a sales turnover of Rs.50 million and above.
For each company it
provides information from its balance sheet
and profit
account, that
reports.
we
is, most
data published in company annual
of the
The May 1989 volume lists 1872
selected
775
for
randomly
questionnaire to 641 of these
and loss
companies out
our
study.
companies
and
We
the
of which
the
mailed
remaining 134
sub-sample was selected on a stratified random basis for personal
contact by us because
we anticipated
a high
non-response rate.
The stratification
was done to give proportionate representation
to broad
groups,
industry
regional
distribution
and
type of
ownership.
The initial
reminder
response to
did
significantly.
not
help
the mailed questionnaire was dismal.
in
improving
the
response
Finally, by our final deadline, only 75
7
A
very
adequately completed questionnaires reached us in response to the
mailed questionnaire, making the response rate
personal visits
to the
134 companies
out
of
134
companies
44%.
or
of
the
sector
public
was
Our
better response :
This helped us achieve a
17.29%.
disappointing total response rate of only
rate
12%.
located in Bombay, Thane,
Calcutta and the Delhi region yielded a little
59
a mere
twice
The response
as much as that of the
private sector (see Table A-l).
Table A-l = Response Profile of the Sample
Universe = 1872 companies; sample selected = 775Mailed
Questionnaire
All
Public
Companies
Total
Sample
All
Public
Companies Sector
Companies Sector
All
Public
Sample Size
641
76
134
22
775
98
Responses
75
15
59
16
134
31
11-70
19-74
44-03
72-73
17-29
31-63
Response Rate %
The data collection
frustrating as
in a
Personally
Canvassed
full
personally
experience
of
the
researchers
was fairly
the vast travelling and time spent did not result
response
contacted.
from
even
rate
Companies,
sector, either did not want to
to be a sheer waste of time.
the
companies
especially
reveal information
in
that were
the private
or thought it
Persuasion was rewarded a little
8
better
public
in
sector
executives in the public sector units
and
other
of the usually
were proud
benefit schemes
egalitarian medical
Personnel
companies.
they provided to employees,
and were most willing to share this information with us.
Almost as a contrast,
sense of
showed no
sector executives
most private
pride in their medical benefit schemes.
achievement or
On the whole, with few exceptions, private sector
companies were
to part with information required as answers to our
less willing
questions.
In our initial ambitious enthusiasm we
study
the
role
trade
of
had also
ventured out to
unions in this context.
attempt was abandoned because of a
lack
of
time,
Later, this
and
a quick
glance at a few trade union agreements showed the relatively less
importance paid
benefits, except
to medical
annual payments to monthly payments.
changing them from
We hope to pursue this part
of the study in the near future.
The
study
present
expenditures on
of industry,
seeks
to
analyse
the
volume
of
medical benefits in terms of variables like type
profitability, sales
added, capital
the context
then,
employed etc.
of public
considerations the
All these variables are viewed in
/ private
study was
turnover, productivity, value
ownership.
To examine equity
also to disaggregate variations in
medical benefits between management, staff and workers.
9
Unfortunately this
entire range
been possible because of
especially
from
the
the
private
of analysis
severe
sector,
we planned has not
limitations
and
of
also because of the
reduced sample size due to the high non-response rate.
IO
the data,
A PROFILE OF THE COMPANIES
The
companies
in
the
the
represent
sample
upper
crust
of
corporate enterprise in India, as they represent those which have
turnover of over Rs. 50 million in the 1987-1989 period.
a sales
As mentioned earlier, this list included 1872 companies, of which
public
sector.
turnover of Rs. 1,632,736
million
263
were
the
in
public sector),
These companies had a sales
(52.2%
of
872 million
averaging Rs.
this
was
in the
per company, and net
assets worth Rs. 1,921,540 million (64.5% in the
public sector),
averaging Rs. 1026 million per company (CMIE, 1989).
It has been
estimated by CMIE that
these
60%
of the
gross value
the factory sector in India (ibid).
Also,
added of
companies
constitute
the total sales and assets of these companies amounted to 50% and
60% of the GDP, respectively.
In the
original sample of 775 companies selected randomly by us,
the sales turnover was Rs. 490,498 million or an average of
Rs. 632.90
million per
was 36%).
Out of these 775 companies, 134 which responded, had a
sales turnover
(the share of the public sector
company
of Rs. 270,603 million or Rs. 2097.70 per company
(the public sector’s share being 46%).
of our
final sample
is three
Thus
the average company
times larger in terms of sales as
compared to the original sample and over twice as larger than the
average of the universe from which the sample was selected.
is because of two reasons.
Firstly, the much higher propor-
11
This
tionate
of
the
public sector companies, which on any
larger,
on
the
response
count is much
comparison
in
the fact
relatively smaller companies, perhaps due to
do not
have very
significant benefits to show.
that they
While the first
reason holds true, the second is only a conjecture, and
there is
way of proving it for the non-responders.
no significant
to the
secondly, the higher non-response from the
And
private sector.
average,
In the
case of the responders there is a positive correlation (Pearson’s
r =
.32 with
.001 level)
significance at
between per employee
sales turnover and medical expenditure).
our final
The 134 companies in
sample (31
of which
are in the
constitute 7.16% of the universe and 17.3% of the
public sector)
original sample, which was
randomly selected
from the universe.
While the sample appears to be small in terms of our expectation,
it
is
fairly
consider the
adequate
for
an
public sector).
work-force
analysis
when we
fact that we have covered a large work-force of the
organised sector - as many as
in the
exploratory
per
453,725 employees
(186,740 or 41%
works out
to an
average of 3396
the
public
sector), hence,
This
company
in
(6024
clearly representative
of upper crust of the larger companies in
the organised sector .
The management constituted 9% of the total
employees
(13%
in
the
public
annualised and mostly refers
sector).
to the
The data presented is
fiscal year 1988-89/1989-90
(98.5% of companies gave data for 1988-89/1989-90).
12
General Profile (Table B.l)
Location of
sample are from western India and
Bombay itself.
for
the
original
the
of
80%
are from
latter
true for both the public
concentration is
This
sector and private sector.
good
half of the companies in the
More than
Companies:
The same pattern, more or less, holds
of 775 companies wherein 42% of
sample
companies are in western India.
that we
This is due to the fact
are covering the larger companies of the organised sector, a very
substantial chunk of which is in and around Bombay.
Incorporation Year :
sample may
majority of
A large
be regarded
prior
in the
the companies
Seventy—nine percent of the
as "old".
companies were established
,
to
Exactly
1975.
the same
percentage distribution is true for the original sample.
Industry
Group
reported
sample
The
:
is
largest group of industry in the
single
the
chemicals
engineering and durable goods group.
like food
products,
petroleum)
and
textiles,
services
group,
little from
the
However, other major groups
minerals
(including
represented in relatively large numbers.
vary a
by
followed
and
metals (including
financial)
are
also
This distribution does
the original sample of 775 companies.
Table
B.2 shows that the difference in the two distributions has arisen
due to
a very
good response by the minerals and metals group as
also the chemicals
group
of
industries,
whereas
that
of the
textiles, engineering and durable goods, and services sector was
13
Table B.l: Soae Characteristics of Saaple Coapanies
(figures are nuaber of coapanies)
Public Sector
Private Sector
All Sectors
Location
Boabay
10
33.3*
45
43.7*
55
North India
7
23.3*
12
11.7*
19
14.3*
Calcutta 4 East
4
13.3*
17
16.5*
21
15.8*
West India
2
6.7*
12
11.7*
14
10.5*
South India
7
23.3*
17
16.5*
24
18.0*
21
70.0*
80
81.6*
101
78.9*
9
30.0*
18
18.4*
27
21.1*
Non-MRTP/non-FERA
27
87.1*
57
55.3*
84
62.7*
FERA 4 HRTP
1
3.2*
14
13.6*
15
11.2*
HRTP only
3
9.7*
32
31.1*
35
26.1*
41.4*
Incorporation
pre-1975
1975 i later
Type of Coapany
Industry group
Food Products
2
6.5*
14
13.6*
16
11.9*
Textiles
2
6.5*
16
15.5*
18
13.4*
Minerals 4 Metals
2
6.5*
16
15.5*
18
13.4*
Cheaicals
7
22.6*
17
16.5*
24
17.9*
Engineering 4 Durables
5
16.1*
16
15.5*
21
15.7*
Services
6
19.4*
12
11.7*
18
13.4*
Diversified
2
6.5*
7
6.8*
9
6.7*
Others
5
16.1*
5
4.9*
10
7.5*
Profitability Group
Negative
6
20.0*
16
16.5*
22
17.3*
Low
12
40.0*
29
29.9*
41
32.3*
Average
High
9
30.0*
43
44.3*
52
40.9*
3
10.0*
9
9.3*
12
9.4*
Returnability Group
Negative
5
17.9*
13
14.0*
18
14.9*
Low
12
42.9*
28
30.1*
40
33.1*
Average
4
14.3*
34
36.6*
38
31.4*
High
7
25.0*
18
19.4*
25
20.7*
Poor
7
25.0*
18
21.2*
25
22.1*
Low
10
35.7*
35
41.2*
45
39.8*
Average
7
25.0*
26
30.6*
33
29.2*
High
4
14.3*
6
7.1*
10
8.8*
Vai.Add. Group
14
relatively poor.
: In
MRTP/FERA Companies
the public sector there is no question
of either MRTP or FERA companies but since we have put the joint
sector companies under public sector there are 4 companies out of
31 which fall under this category.
In the private sector 31% are
Being MRTP and FERA
MRTP and another 14% are both FERA and MRTP.
is important from the present
generally
that
believed
study’s
these
viewpoint
are
companies
because
it is
not
good
only
performers but they also take good care of their employees.
Profitability and Productivity :
variables
that
have been
the
basis
of
their
performance are: (i) Profitability (Profit Before Tax (PBT)
as %
used
to
of Sales
the
categorise
Turnover)
The
companies
(ii) Return
on
(PBT as
% of Gross Block) and
(iii) value added group (value added as % of Gross Block).
As expected, the public
sector has
a higher
proportion of loss
makers, and low productivity and low profitability companies.
the same time, in the high profit group, the public
sector has a
larger proportion
of companies than the private sector.
the private sector
companies
productivity and
are
concentrated
profitability range,
is mostly in the low or very high range.
15
in
At
Hence,
the average
whereas the public sector
of Industry Group Ole-trlbutlon
in reported and original eanple.
( Percentages )
Industry Group
Reported Sanple
C134 companies )
Original Sample
< 775 companies )
11-9
13-4
13-4
18-0
15-7
10.6
17-8
3.9
14-7
21.3
13.4
20.9
6.7
7-5
5.6
5-2
Food
Textiles
Minerals & Metals
Chemicals
Engineering and
Durable goods
Services
Diversified
Other
Financial Profile (Table$B.3 and B.4)
In this
present an overall financial analysis of the
section we
B.4 give
results as averages
and per employee, respectively.
This brief analysis
sample companies.
per company
Tables
will form the context
medical benefits
B.3 and
against which
we will
be looking
provided by the various companies.
at the
We will not
go into the minute details of Table B.4.
The
results are self —
revealing
not
necessary.
The
sample
companies
is Rs.
and
therefore
aggregate sales turnover
270,603 million
(for 129
per company. As mentioned
amongst companies
comments
of
all
the
are
companies), averaging Rs. 2098 million
earlier our
which had
annum and our sample is more
a sales
sample was
of over Rs. 50 million per
representative of
this group of companies.
16
selected from
the larger among
Table B.3: Financial Profile of Saiple Companies
(figures in rupees Billion total 4 per coapany)
Sector
All Sectors
Public
Private
Sector
Sector
Total
123966.74
146636.10
270602.83
Mean
3998.93
1496.29
2097.70
Total
116002.68
101563.53
217566.21
Mean
4142.95
1092.08
1798.07
Total
5883.93
24525.80
30409.72
Mean
189.80
242.83
230.38
Total
643.85
2949.53
3593.38
Mean
20.77
28.64
26.82
Total
7260.07
9738.44
16998.51
Mean
234.20
96.42
128.78
Total
1471.21
1626.48
3097.69
Mean
47.46
16.10
23.47
Total
420.37
335.16
755.53
Hean
13.56
3.25
5.64
Total
21631.95
42952.56
64584.51
Mean
721.07
482.61
542.73
Total
186740
266985
453725
Mean
6024
2643
3437
Sales Turnover
Gross Block
Profit Before Tax
Dividend Paid
Salary t Benefits
Total Benefits
All Medical Benefits
Value Added
Nuober of Euployees
17
Table 8.4= Per Employee Financial Profile of Saaple Cospanies
(figures in rupees per Eiployee)
Gross Block per Eip.
Sales per E»p.
All Sectors
Sector
PBT per Eup.
All Sectors
Sector
All Sectors
Sector
Public
Private
Public
Private
Public
Private
Sector
Sector
Sector
Sector
Sector
Sector
Boabay
North India
Calcutta I East
986156.83
860325.71
727932.22
947424.96
840472.96
881843.35
486203.82
742387.43
589041.54
89220.54
345794.03
287060.02
West India
564603.81
186853.51
283982.13
323035.39
327141.38
233517.85
326058.52
650821.95
452591.65
726028.07
Non-MRTP/non-FERA
672801.39
FERA 1 MRTP
MRTP only
184800.00
Location
543833.69
930933.85
125872.67
48734.17
29591.25
159790.92
148350.34
111389.62
66193.45
149389.72
1505586.9
119743.55
65.34
125440.22
242400.75
1791763.7
171275.13
1175181.8
38856.57
16512.15
23818.50
10138.79
18381.00
1862767.7
517728.26
377924.31
445055.12
418523.63
16718.57
512362.98
1337543.7
921319.18
1246555.8
26986.92
112872.25
109154.47
442925.63
609390.56
672261.23
362564.96
585958.18
31017.52
40384.84
33669.85
648408.35
616165.05
53087.50
379491.45
356790.52
23081.25
33102.01
32405.08
628881.39
552271.87
553526.07
709440.03
393884.47
399062.50
77527.14
131636.15
130750.32
Industry group
Food Products
Textiles
442772.58
53344.94
143541.09
540465.84
172570.40
156840.00
24044.49
29446.02
345290.30
767657.23
33309.15
477409.46
17303.40
-13546.18
18563.64
400209.47
18443.58
234429.31
Minerals A Metals
2675964.7
569828.26
1553852.1
2390606.4
340559.69
1298377.4
109106.95
727934.39
890973.15
803160.70
1234556.5
830876.92
1050715.8
64279.32
53498.00
122319.99
79159.57
CheaicaIs
Engineering A
Durables
910617.09
440706.85
616362.64
255452.31
144699.97
186099.99
35431.17
9136.54
18888.49
Services
450029.98
889144.95
582993.30
397969.08
844260.03
533105.29
29520.93
71982.61
42378.26
Diversified
109213.68
937765.86
664776.24
41212.99
392481.19
276746.09
-1310.53
38222.13
25196.99
Others
81953.11
342647.49
138887.95
376195.77
309182.54
359130.96
-2900.28
32347.68
4797.76
Negative
94449.27
317294.91
141386.48
67332.20
148339.38
83640.19
-8379.36
-15282.63
-9833.37
Low
Average
High
1425155.2
900556.24
564256.79
1008947.4
808703.72
203809.25
490777.68
53814.06
15656.80
35366.65
697763.04
735954.34
959740.44
374720.62
486783.20
110686.75
60264.05
69759.97
340689.10
352003.64
351619.80
193729.23
602126.87
588271.93
107255.78
242547.83
237958.03
Negative
94214.72
326659.88
141009.50
67332.20
148339.38
83640.19
-8355.40
-16053.37
Low
456100.78
531951.75
495749.20
1305282.9
520785.63
27013.55
32072.37
-9905.12
29657.87
Average
High
4584470.5
1271535.1
657846.11
504119.87
1359037.2
581478.91
999894.87
358096.35
366669.70
333069.57
895214.61
479746.94
335592.39
183271.25
178362.99
65921.14
188538.54
86876.76
187512.79
384639.08
798521.42
541959.35
1661471.7
1181174.0
1478906.4
26222.87
76066.33
45168.80
267252.00
396244.01
65578.67
43813.48
52999.03
South India
16552.16
14555.55
16525.86
Incorporation
pre-1975
1975 1 later
73740.25
45254.03
Type of Coapany
91059.36
Profitability Group
Returnability Group
Vai.Add. Group
Poor
Low
1377654.5
636988.67
949571.34
572899.05
Average
High
153798.68
387105.25
307436.30
44637.03
297355.95
211058.12
-1181.14
152080.94
99745.38
500650.85
528347.59
518959.25
47632.31
48205.35
48011.11
43709.58
50308.53
48071.69
All Sectors
663846.72
539254.13
590980.85
661496.54
383591.32
495716.06
31508.66
91188.47
66550.79
(continued)
18
Table 8.4: Per Enployee Financial Profile of Saiple Companies
(figures in rupees per Employee)
Dividend per Enp.
All Sectors
Sector
Vai.Add per Eip.
Sal t Ben per Eip.
Sector
Sector
All Sectors
All Sectors
Public
Private
Public
Private
Public
Private
Sector
Sector
Sector
Sector
Sector
Sector
location
Bonbay
3717.11
12995.15
8976.71
158743.46
292067.56
230435.67
46022.68
51740.57
49264.08
North India
10058.13
38363.19
131558.87
379974.01
57605.61
192929.18
55724.10
40542.07
26655.25
30355.18
20707.40
23355.07
640.03
6973.17
10497.31
3817.55
18781.90
5376.89
63794.39
74287.75
83085.12
59855.21
37121.36
27958.52
26354.57
28885.70
37402.42
22068.96
28010.49
219253.77
236788.07
166243.40
42035.24
27879.10
43923.80
43158.43
24436.50
27113.76
Calcutta i East
West India
South India
12474.82
1728.85
48969.75
185817.45
52331.71
28276.23
Incorporation
pre-1975
1975 4 later
2977.71
3822.67
11276.70
37876.04
7913.42
11393.25
95724.02
108009.41
136159.54
Type of Coopany
Non-MRTP/non-FERA
3271.09
10572.77
5367.09
117031.21
132030.76
120760.42
38434.41
31385.53
36410.98
FERA 4 HRTP
HRTP only
1584.38
11691.47
10988.53
90462.50
135224.46
132111.33
62534.38
45854.06
47014.15
18521.31
10828.06
10954.01
236183.48
207260.94
207765.08
40702.94
36273.96
36346.47
Industry group
Food Products
16924.29
4141.47
20084.78
5353.83
47626.84
23580.05
16534.59
17202.80
16008.83
38629.03
735222.57
39520.48
12037.38
378661.99
19500.75
30987.22
26384.92
Textiles
Minerals 4 Metals
3501.65
5712.54
4692.30
211852.26
157252.86
183175.54
32619.63
48700.63
41279.81
Chemicals
7214.91
28896.53
17218.84
204661.45
284736.85
241608.35
35396.66
59039.57
46305.53
Engineering 4
Durables
Services
5720.82
2689.42
7169.38
3813.68
139106.48
45949.42
49058.62
47905.51
139493.41
101284.60
143104.75
115422.68
4277.49
140461.52
59928.23
48138.72
56258.81
17162.55
11507.87
69181.33
32454.78
21591.27
48257.50
192.73
128153.18
105113.39
97822.06
882.50
36095.05
60302.24
29134.43
43050.85
23238.67 '
2970.66
Diversified
Others
Profitability Group
Negative
1104.57
232.65
24405.84
68546.84
33219.35
24560.26
42663.72
28373.33
Low
4615.78
8434.98
202402.19
84750.72
143954.25
62074.70
45082.01
53859.45
Average
13465.39
10311.01
6462.20
10905.06
256943.62
147829.77
171544.17
32338.42
40241.94
38753.50
High
1430.89
17791.71
17236.67
180676.94
319393.42
314687.45
43708.96
21874.25
22615.00
1188.03
239.17
24579.29
71817.35
33550.35
24664.66
44680.46
28694.14
Low
2652.02
7664.81
5272.28
151780.27
120199.62
48561.35
8998.70
14016.79
13120.70
385439.97
167438.18
55828.08
43583.39
41926.17
Average
High
136368.77
209071.17
43339.92
43383.39
31105.26
14237.48
15937.84
284794.35
248838.56
252490.81
50957.12
26490.93
28957.23
Poor
Low
Average
High
2737.40
5124.06
2958.35
24659.42
9661.60
10330.44
11070.15
7746.63
7813.04
115750.63
193686.24
36115.21
232882.43
123793.34
218856.01
160273.44
153290.19
156454.14
28173.51
56913.42
28475.16
32566.55
41531.04
34896.41
29843.35
48022.86
32703.70
1139.69
14177.07
9757.80
154233.34
111136.34
125744.89
50214.58
47042.19
48117.53
All Sectors
3447.82
10896.81
7831.03
118206.09
176461.05
151460.00
38877.98
36475.60
37464.35
Returnability Group
Negative
Vai.Add. Group
(continue'
19
Table B.4: Per Employee Financial Profile of Saiple Coapanies
(figures in rupees per Eiployee)
Benefits per Eip.
Medical Ben. per Eap.
Sector
Sector
All Sectors
All Sectors
Public
Private
Public
Private
Sector
Sector
Sector
Sector
Boabay
11437.28
9956.01
10597.57
2051.17
1844.04
1933.75
North India
7895.37
1847.38
6031.34
5756.14
929.90
4268.66
Calcutta & East
4024.37
2301.63
2695.99
704.00
548.15
583.83
Uest India
9172.53
3553.01
4417.28
1008.02
837.30
863.56
South India
1118.96
4466.74
2266.12
1940.84
1161.90
1673.92
pre-1975
8794.15
8132.61
8400.71
2347.42
1450.89
1814.22
1975 4 later
3285.85
1883.48
2974.08
1777.01
803.31
1560.54
Location
Incorporation
Type of Coapany
Non-MRTP/non-FERA
7851.70
4204.52
6804.75
2269.23
1104.14
1934.78
FERA 4 MRTP
6903.12
11430.72
11115.83'
■1318.75
1473.45
1462.69
MRTP only
11036.54
5490.66
5581.45
2132.64
1213.73
1228.78
544.42
554.96
Industry group
Food Products
2358.13
1037.77
1163.00
Textiles
3099.16
4765.85
4098.06
655.53
582.66
Minerals 4 Metals
6751.92
7374.35
7087.12
Chemicals
5033.50
10403.68
’
884.90
763.80
2226.68
1167.56
1656.31
7511.31
5675.89
2065.96
4010.27
Engineering 4
Durables
7382.86
8302.02
7961.13
2382.46
971.68
1494.90
15360.06
6163.26
12497.61
2480.06
3999.72
2953.05
Diversified
4825.33
12965.40
10283.43
630.34
1113.11
954.05
Others
3051.62
396.54
2471.76
1878.80
169.25
1505.44
Services
Profitability Group
Negative
2128.57
6730.35
3097.83
1609.75
1208.92
1525.32
Low
18078.63
7330.77
12882.49
3046.44
1333.98
2218.54
Average
High
3955.48
8232.61
7427.11
2493.17
1124.86
1382.55
9169.03
1604.66
1861.29
3186.06
1295.95
1360.07
Returnability Group
Negative
2162.69
7238.90
3184.61
1620.47
1241.92
1544.26
Low
14484.46
9840.94
12057.23
3194.20
2071.21
2607.20
Average
12294.58
6081.26
7190.80
2735.89
1234.25
1502.40
High
9127.68
3214.90
3810.94
1793.37
539.50
665.90
Vai .Add. Group
Poor
2647.07
11732.90
6100.67
4001.30
3000.89
3621.04
Low
15605.02
6488.06
10335.69
2655.96
1223.68
1828.14
Average
4582.27
4757.24
4697.49
772.42
856.28
827.64
High
4889.88
6943.10
6247.12
1564.59
800.12
1059.25
All Sectors
7878.39
6092.04
6827.25
2251.10
1225.46
1647.58
20
Of all companies those situated in Bombay and North India (mainly
around Delhi) had the highest average sales turnover
sales.
per employee
in terms of
The pattern is more or less similar between
the public and private sector companies, where sales
by location
is concerned.
However overall, the public sector’s average sales turnover (both
the private sector.
per company and per employee) is higher than
Infact the
public sector’s
their proportion
46%, twice that of
mean
the
that
share of the total sales turnover is
public
sector’s
in the
Does this
sample.
performance in marketing their
products is far better than that of the private sector?
look at
When we
the sales turnover per employee this proposition is well
substantiated - the public
contributes a higher
sector employee
value of sales in comparison to the private sector employee.
However,
above
the
strength is reduced substan
proposition ’s
tially when
we consider
generate that
volume of
of gross
block employed to
The public
sector uses nearly
the volume
sales.
twice the amount of capital per employee to arrive at
the higher
sales turnover.
Hence if we take the ratio of sales turnover to
gross block
then
the
employed is
much better
sales
performance
in the
terms
of capital
for the private sector - for every unit
of capital per employee the sales
sector whereas
in
is 1.44
times in
the private
public sector it is nearly equal to unity
at 1.06 times .
21
in profits and value added.
gets reflected
This also
The total
profits (before tax) of the sample companies (132 reported) is
Rs. 30,410
The public
million.
sector’s share in this case is
only 19%; as a consequence profitability (PBT as
lower
much
that
than
terms the profits in
that
sector are
the private
public
capital
and
sector
employed
On per employee
the private sector.
3 1/2 times than that of
nearly
on
the
of
of
as
(PBT
sales) is
% of
nearly three times
the former’s profitability is
Similarly, return
the latter.
% of gross block) is nearly five
times higher in the private sector.
The above pattern is
added
value
significantly
(interest
+
PBT
Though
the
public
company
per
disaggregated in
added is
than
the
private
larger
per employee
one and
terms as a ratio to
private sector
is
a half
capital
works out
of the
the
employed
to two
and a
Depreciation
+
sector’s value
sector , when
private sector’s value
terms the
times that
+
look at
we
when
payments
Remuneration to employees).
added
supported
public sector.
value
added
In
in the
that in the
half times
public sector .
Can one really conclude from the above that the private sector is
generating a
higher value
of goods
more efficient and cost-effective?
when one
looks at
and services
or that it is
On the face of it,
yes.
But
the political economy of this entire business
the conclusions cannot be so simple!
22
A fair
chunk of
the public
sector operates in an area which is
the state sector’s monopoly, and a large proportion of the public
is in what one would call basic industry and
sector’s investment
infrastructure, where the volume
needed is really
of investment
This is one factor which explains a higher sales turnover
huge.
and gross block in the public sector.
sample there
is only
(Please note
that in the
company which is matched in
one petroleum
size and assets by a few private sector companies, hence there is
no question of a single petroleum company skewing the results).
very
This
factor
explains
also
the
productivity
lower
The nature
profitability of the public sector.
and
of investment of
the public sector is such that it is directed at producing mostly
intermediate
products
enterprises
to
produce
policies
the
pricing
are
that
finished
consumed
largely
goods.
As a consequence of
of
value
output
by
private
enterprise
public
is
deliberately kept low (amounting to subsidisation) so that inputs
to the private sector are kept cheap.
This argument is substantiated
value added
when we
the profits and
It is clear from this disaggre
group.
by industry
look at
gation that the public sector’s productivity and profitability is
much better in the "foods" and "engineering and durables" groups,
as
in
these
subsidisation
product.
In
industries
there
is
very
little,
because
most
cases
the
product
is an end
group
the
the
in
“minerals
and
metals"
if
any,
better
performance of the public sector is due to its statutory monopoly
position in most cases.
23
In
the
“chemicals"
and
"services"
sector *s stake is largely
to
group,
manufacture
the
where
public
intermediate products
consumers)
and infrastructure
provision, the public sector’s performance is
relatively poorer.
(where
In
manufacturing
the
case
units
"textiles”
of
public sector textile mills
units
had
that
become
are
there
is an exception because the
are mostly
and
"sick"
erstwhile private sector
taken
were
over
by
the
gover nment.
Thus,
private
sector’s performance,
the
public
sector’s
and
efficiency,
etc.
cannot
compared on the same plane because
be
making a loss or having a lower value of production in the public
sector is
not due
to poor
productivity or inefficiency; on the
contrary, it is for reasons embedded in political
in
most
cases,
that
the
economy alone,
value of labour in the public sector
appears lower than in the private sector.
Out of this value added through labour power, what accrues to the
contributors of
labour?
Under capitalism,
for the market, the total value
accrue
to
subsistence.
share.
the
producer.
The providers
added by
Labour
of
where production is
labour power
does not
gets a share enough for its
capital
appropriate
the larger
From among the components of value added labour gets only
remuneration (wages + benefits, part of
whereas the
capitalists get
which are
social wages)
interest, profits and depreciation.
The state gets taxes, most of which, in India, are
ploughed back
for the development of capitalism and very little for social
24
capital
social
and
appropriate,
capitalists
lavish
The
surplus
labour
besides
providing
for
the
latter’s
the
source
for
further
wages.
life-style,
becomes
also
that
value
expropriation of surplus value.
In our sample companies the total remuneration that employees get
staff + management, excluding directors) is Rs.16,998
(workers +
million.
This is only 6.3% of sales turnover and
In the public sector the proportion
added on per employee basis.
only
21%
in
private
the
employees in the public
value of
added is
to value
of salaries + benefits
sector get
than in
33% in
a much
larger share
of the
sector .
In the
the private
public sector the average annual remuneration
employee, whereas
comparison to
This clearly shows that the
sector.
their production
24.7% of value
is Rs.
38,878 per
private sector it is a little lower at
in the
Rs. 36,476 per employee (all companies Rs. 37,464
per employee).
It is interesting to note that in the private sector remuneration
to employees declines with rise in profits (Pearson’s
and
in
higher
the
profit
-
group
companies the average
of
remuneration is twice higher in the public sector,
value added
for this
public sector.
r = -0.58)
even when the
same set of companies is much lower in the
On the basis of location and type
of company the
Bombay based and the FERA group of companies have a significantly
higher pay-packet as compared
to others.
the
we
data
by
Industry
“engineering" group in
group
the
public
find
When
we disaggregate
that the -services" and
sector
and
the "chemicals"
group in the private sector give the highest remuneration to
25
The worst in each of the sectors is “textiles"
their employees.
and "Food Products", respectively.
When we look at the benefit or social wage component
specially
benefits,
public
the
performance
sector’s
The public sector employees get much
better.
private sector
comparison to
(of Rs.
3098 million)
per
employee
private sector.
the board.
is 48% and of medical benefits 56%.
annually,
in
contrast
The
total benefits
companies of
works out
the total benefit package in the public sector
7878
is even
higher benefits in
employees, across
public sector’s share in the sample
and medical
Thus
to Rs.
Rs. 6092 in the
to
This amount is 20% and 16%, respectively, of the
The
total remuneration.
gap is
benefits wherein public sector
much wider
employees
in case of medical
average
Rs.
2251 per
year against Rs. 1225 in the private sector.
This finding
wages are
follows
It is well established that social
is as expected.
much better
statutory
and
because the latter
in the
public sector
other
legal provisions more stringently
than the private sector.
Infact,
the public
sector often goes
beyond the legal provisions and extends a wider variety of social
wages or benefits to its employees than does
the private sector.
The salary component is adequate only for the employees ’ family’s
wage
makes
his/her life
subsistence but the
social
qualitatively better
because they include benefits (like medical
care,
housing,
education,
component
recreation, etc.)
that
would
eat
substantially into cash incomes of employees if the latter had to
26
provide for it on their own, especially considering the fact that
prices of most of these needs are dependent
on the
market forces and are prone to high inflation.
27
whims of the
TYPE OF MEDICAL BENEFITS
We have
seen in
discussion that the organised sector
the above
employees, besides getting their
certain social
fringe benefits.
wages or
one prominent benefit.
and
salaries
wages,
also get
Medical Benefits are
In the present study this is
our central
concern, hence we will not look at other social wages.
We
have
also
otherwise, are
there are
seen
that
statutory
some
or
of
benefits,
the
mandated
by
medical
or
legislation, whereas
others which the Employers Federation of India prefers
to term "voluntary".
However, while one does not deny that there
are a few exceptions, most of such "voluntary" benefits have been
obtained after workers’ struggles and negotiations.
As discussed earlier the study’s
many
details
about
scope
was
while
available through
available
for
some
data
official
the
for
As regards statutory
the entire organised sector are
documents,
non-statutory
no
medical
therefore in the latter that our efforts were
success.
limited and
various statutory and non-statutory medical
benefits have not been possible to collect.
benefits
fairly
such
information is
benefits.
It
is
directed with some
We have also gathered information on ESI benefits - the
employer’s and employees contributions.
28
Before
we
go
the
into
details
our findings some data on
of
statutory benefits need to be highlighted.
(Labour
Bureau 1986
and 1990 ) .
a)
Under
the
Compensation
Workmen’s
Act, which provides for
compensation due to death or injury,
injuries
and
were
with Rs. 15.92 million, in
compensated
1976 43,088 with Rs. 13.43 million, in 1981
34.26
and
million
57,346 deaths
in 1971
33,031 with Rs.
1986 24,990 with Rs. 38.80 million.
in
This worked out to a mere
Rs. 278,
Rs. 1,037 and
Rs. 312,
Rs. 1553 per death or injury in the respective years.
b)
Under the
Maternity Benefit Act in 1982 42,502 confinements
were covered for women working in factories, plantations and
mines.
The total amount paid to them was Rs. 32.61 million
or
767.26
Rs.
confinements,
per
confinement.
40.6
Rs.
In
for
1987
26,832
was spent under this Act,
million
making for Rs. 1513.12 per confinement.
c)
Under the various Mine
Iron, Manganese,
Labour
Welfare
Chrome, Limestone
expenditure was
spent on
maternity benefits
are covered
29
medical care.
Rs. 42.99 million .
Rs. 9.93 million was
Act.
(Coal, Mica,
and Dolomite) in 1986 a
total of Rs. 46.81 million was spent for
1989 this
Funds
water supply
In
In addition
in 1986.
The
under the Maternity Benefit
d)
Under
the
Beedi
Welfare
Workers
in 1986 Rs. 15.59
Fund
million were spent on medical care of the Beedi workers.
e)
Under the Plantation Act
in 1982
27.46 million
were paid
for 5,92,280 employees (Rs. 46 per
employee) and
maternity benefit
for
confinements
21,194
sickness benefits
of Rs.
(Rs.
of Rs.
12.11 million paid
confinement).
per
571
Information on medical care is not available.
f)
The Employees State Insurance Act provides
benefits.
There are
cash benefits
sickness,
maternity
and
temporary), on
the one
medical care
provided for
In 1989
families.
range of
a wide
for sickness, extended
disablement
(permanent
and
hand, and on the other there is the
employees and their
the insured
6.8 million insured workers
there were
with beneficiaries (their families included) totalling 26.41
million.
The total number of cases treated during that year
was 36.55 million (0.32 million hospitalisation) or 5375 per
1000
The
insured.
Corporation
for
was
Rs.
benefits Rs. 404.10 million;
36.52
million;
these
providing
costs)
administrative
expenditure
million;
maternity
depreciation
other
provision
of
benefits
2972.14
benefit
million;
the
ESI
(including
million (sickness
benefit Rs.
31.27
million;
medical
care Rs.
3.38
million;
Rs.
benefits
Rs.
Rs.
231.63
administration costs Rs. 427.15 million).
30
by
extended sickness
disablement benefits Rs. 455.39
1382.70
incurred
million
and
This expenditure
beneficiary.
was Rs.
per
insured
employee
The income
of the
ESIC during
437
Rs.
averaged
from
dividends
113 per
the same year
and of this the contribution from
4212.68 million,
employers and employees was Rs. 3313.37
that
Rs.
or
and
million (78.6%) and
a fantastic Rs. 642.29
interest
million (mostly invested in securities)
g)
Those in
government
in
services,
various
ministries and
get statutory medical benefits.
About 3.5
million beneficiaries (0.77 million employees) in
1988 were
departments also
the Central
covered under
Government Health Scheme (CGHS ) .
The CGHS hospitals and dispensaries in the same year treated
cases, that
15.32 million
times that of ESIS
is 19,896 per 1000 employees. (3
through its
The CGHS,
beneficiaries).
262 dispensaries, spent Rs. 295.70 million in 1984-85, which
worked out
to Rs.
93.28 per
beneficiary or
Rs. 18.69 per
Similarly, employees in the Railways, Post &
case treated.
Telecommunications, Defense services
special medical
schemes.
In 1987-88
and
many
others have
the Railways covered
8.61 million beneficiaries with an expenditure of
Rs. 1271.71
million or
Dept, spent Rs.
243.40
Rs. 148
per beneficiary.
The P&T
million
on
medical
for its
care
employees in 1989-90. (CBHI, 1989).
h)
Under
group
health
insurance plans (non-statutory) of the
four General Insurance Companies,
corporate enterprises can
insure their employees for benefits with specified upper
limits.
insurance companies do not publish such
Since the
data (because this is
an insignificant
insurance
nor
business)
difficult to get
compile
information
any
proportion of their
them
centrally, it is
an
All-India basis.
on
However, the IIM Study referred to earlier has compiled this
250
information from Maharashtra for
the
New
Assurance
India
covered by
companies
Company.
1986, for 57,521
In
insured employees the companies paid Rs. 10.3 million during
the year
i.e. Rs. 179 per employee. During the
as premium,
same year the insurance
or an
company reimbursed
Rs. 160
average of
Rs. 9.2 million
per employee as claims, both for
hospitalization and domiciliary benefits. (IIM, 1987).
In the present study,
mainly
to
medical
broken
the
down
expenditure
care
because
benefits, especially the statutory ones, were
majority of
the companies.
medical benefits.
benefits refer
medical
details of other
not provided
These are however included in total
The ESI benefits refer only
to the employer’s
contributions towards the ESI scheme paid to the ESIC.
benefits, compensation for injuries
“other" and
included in
by a
/ deaths
Maternity
etc. are
shown as
the total, as details were not provided
by most companies.
As mentioned earlier, besides the ESI
there
are
other
company to another.
schemes
benefits for
medical care
offered to employees varying from one
Usually, in each company it is a mix
to three schemes offered to employees.
32
of two
Table C.l gives a count
of
the
companies
providing
Though ESIS is
employees.
medical benefits to their
various
statutory
a
scheme
it
is
not the
single largest group because of the fact that it is restricted to
employees drawing salaries less than Rs. 1600 per
for the
month, whereas
the mean monthly salary is much higher
sample companies
at Rs. 2445 per month; hence there are many companies that do not
earning less than Rs. 1600 per month.
have employees
of the companies had atleast one type of
ESIS; of
Infact 91%
medical benefit besides
9% (12 companies), all had only the ESIS
the remaining
scheme .
The single largest group of
public
sector
and
private
bills with upper limits0
medical benefit
47% of
the companies
public sector).
care for
this case 37% companies
public
sector).
health insurance
short).
important provision
had
the
such
important
form
private
sector,
of
is
In
in
case of
giving
medical
through group
the General Insurance Corporations.
covered
but in
the private
the
companies.
of
(52%
facilities
through such
32%
for medical
through owned hospitals and clinics.
the
by
type of
the sample companies (77% in
Twenty-seven percent of
were opted for
This
had employees enrolled (45% in case of the
schemes of
a scheme,
by'both
This was followed by ESIS, in whose case
Another
benefits, especially in
for
61% of
The third most
employees was
provided
benefits
sector companies is “claims against
(claims,
existed in
case of public sector).
medical
companies
their employees
sector such schemes
Giving
a lumpsum
(allowance) amount as medical benefit is more popular in the
33
Table C-l - Employees Covered under each Health Scheme of Companies by SectorPRIVATE SECTOR
PUBLIC SECTOR
ALL SECTORS
Co’s
Workers
Mgt.
Total
Co’s
Workers
Mgt.
Total
All
Co’s
ESIS
14
38381
8
38389
49
41735
0
41735
63
80124
Insurance
4
6864
3202
10056
33
27311
12187
39498
37
49564
24
69773
11371
81144
58
69393
9785
79178
82
16032?
Lumpsum
4
8936
2752
11688
16
30684
1729
32413
20
44101
Owned Hosp.
16
53884
11893
65777
33
137473
8288
145671
49
211448
4
-
-
-
8
-
-
-
12
-
2
-
-
16
9
-
-
2717
11
2733
31
161708
25032
186740
101
24SO91
21894
266985
132
453725
All
Emp-
& Clinics
Retained
Facility
No facility
for section
of employees
No of companies
& employees in
the sample
Note = Please note that the sum of all companies or employees will always be greater than
the actual number (last row) because of multiple benefits provided-
34
than in
private sector
sector; but
the public
medical care.
companies used such a method of payment for
9% of
only 15% of the
Only
the companies had a retained facility i.e. hired against a
capitation fee or reserved for a fee.
single
largest
type
coverage was through "owned
in
terms
of
hospitals and
clinics" , even though
such facilities it was only the
third largest category of benefit (Table
for such
The
in terms of employee
having
companies
?
benefit
medical
of
employees
amongst
distributed
How were these benefits
C.l).
The main reason
a distribution is that when a hospital or clinic of the
company exists it is generally accessible to all employees of the
company;
ofcourse
discrimination does exist as to how different
In contrast
employees are treated.
other schemes are
to this,
more discriminatory between workers, staff and management.
For
the
workers
in
both
the
pattern in the provision of
similar.
Besides access
public
medical
and private sector, the
is
benefits
more
or less
to own facility of the company, claims
cover the largest number of workers in both the sectors
- 43% of
workers in the public sector and 28% in the private sector.
This
is followed by ESIS - 24% of all
employees in
and 17%
In case of the lumpsum scheme 6%
in the private sector.
the public sector
of the public sector and 12% of the private sector
covered.
Similarly, a
public sector is
also
employees are
major difference between the private and
noted
in
the
case
of
group insurance
medical scheme which covers only 4% of workers in the public
35
sector but
in the private sector accounts for benefits to 11% of
the workers.
In case of the managerial employees the pattern is very different
in the
public and
private sectors
workers of the
respective
covered under
ESI which
sectors.
Management
In the public sector 47%
covered through
owned facilities
45% are entitled to claims against bills.
in
contrast,
56%
of
the
through
contrast are
public
available to
covered
and
sector
managers.
For private
and
important scheme
medical
lumpsum
for medical
through claims and
insurance
benefits in
of management
staff in the
Group
only 13%
of management
In the private sector,
is
management
facilities.
owned
is not
of the companies and
benefits through group insurance schemes, 45%
38%
staff
of the major statutory benefits
is one
accruing to the workers.
staff is
as also in comparison to the
allowance
sector managers’
11%
to
lumpsum is
covers only 8% of them.
of the
a much less
The coverage for
retained facilities was not made available by most
companies but
it was clearly indicated that it was generally for the management
and senior staff.
Two important sets of findings come out of
distribution.
In
pattern of
Firstly, the majority of workers are covered only
scheme, especially
by one type of medical benefit
sector.
the above
the
entitled to two or
case
of
management
more different
staff
in the public
the majority are
medical benefits.
Secondly,
the differences between the benefits that accrue to workers and
36
Table C.2: Coibination of Type of Medical Benefits
Provided to Eiployees
(figures are nuiber of companies)
Insurance
ESIS
Claiis
Luipsui
Own
Hospital 1
Retained
Facility
Clinic
Public Sector
2
ESIS
14
2
12
2
5
Insurance
2
3
2
1
1
Claiis
12
'2
24
4
11
Luipsui
2
1
4
4
1
Own Hospital $ Clinic
5
1
11
1
16
3
Retained Facility
2
3
4
3
3
Private Sector
ESIS
49
12
31
3
12
1
Insurance
12
32
16
5
9
5
Claiis
31
16
55
7
14
7
Luipsui
3
5
7
15
6
1
Own Hospital 4 Clinic
12
9
14
6
32
5
Retained Facility
1
5
7
1
5
8
37
Table C.3: Type of Medical Benefits Provided to Employees
by Selected Characteristics of Companies
(figures ara number of companies)
ESIS
Insurance
Claims
Luipsui
Own
Retained
Hospital 4
Facility
Clinic
Public Sector
14
3
24
4
16
4
Private Sector
49
32
55
15
32
8
All Sectors
63
35
79
19
48
12
Boabay
20
23
37
10
20
9
North India
6
8
2
11
Calcutta 1 East
12
4
12
2
7
West India
5
3
6
4
3
South India
20
5
16
1
6
16
50
12
28
4
7
9
1
5
4
Location
3
Type of Company
Non-MRTP/non-FERA
45
FERA 1 MRTP
6
MRTP only
12
• 12
20
6
15
4
pre-1975
47
29
58
18
36
10
1975 4 later
13
5
15
1
9
2
Food Products
6
4
6
4 .
11
2
Textiles
15
3
12
2
5
2
Minerals 4 Metals
8
4
9
2
6
,
Incorporation
Industry group
Chemicals
9
5
20
5
7
2
Engineering 4 Durables
10
10
9
2
7
2
Services
6
7
15
3
4
2
Diversified
5
2
4
1
3
2
Others
4
5
4
Profitability Group
Negative
13
6
6
3
Low
25
8
29
7
9
2
Average
22
17
34
8
23
9
High
2
2
7
1
7
1
8
Returnability Group
Negative
11
6
4
2
6
Low
21
10
26
6
15
Average
High
18
12
24
7
13
3
8'
5
19
3
10
4
5
Vai.Add. Group
Poor
11
5
10
2
10
3
Low
21
13
30
9
19
3
Average
17
10
21
3
7
4
High
4
2
8
2
3
1
38
management
personnel
is
sharp
less
in
the
public sector as
compared to the private sector.
As regards combinations of types of medical benefits
employees in
the public
and claims, and hospital/
sector, ESIS
clinic and claims are the
main
combinations.
claims
is
the
sector ,
ESIS
and
most
In
the private
important
combination
followed by group insurance and claims and hospital
claims.
(see Table C.2).
When we
disaggregate the
various schemes
get the following scenario.
i)
like claims
Calcutta,
medical benefit
is the least important
- clinic and
by other variables we
(Table C.3)
South India, followed by
most important
provided to
have
ESIS
provided, whereas this
where other schemes
in Bombay,
are more important.
and Insurance
as the
In the
the single most
north, owned hospitals and clinics are
important medical benefit provided, followed by claims.
ii)
For the
non-MRTP / non-FERA group of companies as well
as the FERA and
MRTP companies,
important type
of benefit provided but the second most
claims form
important type of medical benefit is
3 groups.
the most
different for the
For the first group it is ESIS, for the FERA
and MRTP group it
is insurance
and for
group, it is owned Hospitals and clinics.
39
the MRTP-only
the single-largest type of benefit provided in
iii) ESIS is
the textile group
of
industries
and
the diversified
group.
In both these groups it is closely followed by
claims.
In the
metals group
are
claims form
the largest
In the engineering group
provided.
equally
important,
whereas
owned
hospitals
and
group
and minerals and
chemicals, services
type of benefit
ESIS and Insurance
in the Food products
clinics
are
the
most
important.
iv)
With regard
to Profitability and Return on capital the
average and high profit making and productive companies
tend to
have a
much higher
medical benefits, whereas the
groups
have
a
tendency
proportion of the non-ESI
negative and
towards
statutory benefits.
40
providing
low profit
only the
EXPENDITURE ON MEDICAL BENEFITS
In the
preceding discussion
we have overviewed both the general
profile of the companies covered in the study as well as explored
the
types
various
of
medical
benefits which employees get in
different companies.
In this concluding section we will make a
brief analysis
of the
cost of these benefits provided to employees.
Though medical
benefits are
an important item of expenditure in
many companies, the information
not
available
in
any
on this
published source.
reports and accounts do not show
separate one.
ESIS
expenditure is
The companies* annual
this item
of expenditure
as a
It is clubbed along with all "benefits* which are
required by law to be shown
Only
item of
expenditure
is
separately from
shown
separately
salaries and wages.
because
it
is a
gratuity and
statutory requirement.
Sometimes, provident funds,
bonus
given separately, but other benefits like
paid
are
also
medical, housing, education etc.
are
rarely
listed separately.
The public sector gives the latter figures separately to a larger
extent.
As mentioned in a preceding section there is no significant study
available on
corporate sector’s
expenditure on medical benefits
for their employees, except for the EFI and IIM studies referred
41
The EFI study of 1969 showed that the expenditure on
to earlier.
medical care (including statutory benefits like
workmen’s
compensation
for
employee remuneration and 12.58%
out to
Rs. 112.72
of all
530
per
(IIM,1987).
This worked
benefits.
In the IIM
per employee in 1969 (EFI, 1972).
study in 1985-86 medical expenditure varied
Rs.
was 3.41% of total
etc.)
injuries
ESIS, maternity,
employee
small,
for
450 and
between Rs.
medium
and large companies
The study has also reported information for selected
companies as case studies (Ibid).
The only
other data
on medical care and related expenditure for
the organized sector employees available in a published
form are
about the statutory expenditure under the various Labour Acts and
those by some public sector undertakings.
These are published in
the annual reports of the agencies responsible for implementation
of these Acts, as well as in a compiled form
of the
in the publications
Labour Bureau of the Ministry of Labour Welfare.
This we
have already discussed in the preceding section.
In the
sample
companies
expenditure works
out to
the
Rs. 755.53
works out to Rs. 5.64 million
1647.58 per
employee per
total
per
medical
and related
care
million (Table D.l).
This
(Table
or Rs.
company
year (Table
B.3)
we assume an
D.2(a)). If
average family size of 4.5 persons for the organized sector, then
the medical
expenditure by the corporate sector works out to
Rs. 366 per capita per year
(at
1990
prices).
If
we exclude
“other medical benefits" (Which is mostly maternity benefits,
42
Table 0.1
Expenditure on Various Medical Benefits in Public and Private Sector Companies
PUBLIC SECTOR
Type of Benefit
PRIVATE SECTOR
ALL SECTORS
Expenditure
Percent
Expenditure
Percent
Expenditure
Percent
(Rs.million)
Share
(Rs.million)
Share
(Rs.million)
Share
1.
ESI (Employer Contribution)
26.13
6-22
27.10
8.09
53-23
7.04
2-
Group Insurance Scheme
13.07
3-30
22-57
6.73
36.44
4.82
3.
Claims / Reimbursements
151-65
36-08
141-47
42-21
293-12
38.80
4-
Lumpsum Allowance
26-15
6-22
14.94
4-46
41.09
5.44
5-
Own Hospital / Clinic
69-74
16-59
59.29
17-69
129.03
17.08
6.
Retained Facility
0-51
0-12
0.97
0-29
1-48
0.20
7.
Other Medical Benefits *
132.32
31.47
68.82
20.53
201.14
26.62
335-16
100-00
755-53
100.00
ALL MEDICAL BENEFITS
420-37
100-00
Note : * This includes special medical benefits for c:atastrophic illness and other statutory
CAjnv'viicni etctin iiw
were
LM?I Rf 1 1 CVi 1 1 KV Illd l_e Fill t-X UJf 1 Rf 1 1 W « aCC ILWHCS aiiu
not available separately for most companies hence we have had to club them asi “others"-
43
etc.) and
injury/death compensation
the
care
medical
expenditure
the ESIS contribution, then
works
to
out
Rs.
1086.96 per
employee per year or Rs. 241.55 per capita per year.
There is
a wide difference between the public sector and private
expenditure
sector in medical care
average,
public
each
by
company
sector
the
companies.
On an
in the sample spends Rs.
13.56 million per year (1.88% of value added) in contrast to only
million per
Rs. 3.25
year (0.67% of value added) in the case of
the private sector company.
For the public sector employee this medical expenditure works out
to Rs.
2251.10 per
employee annually (Table D.2(b)) whereas for
private sector employees it is much lower at
Rs. 1225.46 yearly,
per such employee (Table D.2(c)).
How is
distributed amongst the various medical
this expenditure
schemes we discussed in the last section ?
Table
account
D.l
shows
for
the
single
expenditure in both the
’other
medical
as
that,
expected,
largest
public and
benefits’,
claims
category
/ reimbursements
of
medical
private sectors.
care
Excluding
next major type of medical care
the
expenditure is ’owned hospital and clinic’, which, in proportion,
is half
that of
claims.
’Claims’ and ’owned hospitals’ account
for 56% of the medical expenditure of the
companies (60%
in the
private sector) and ’other medical benefits’ for over one-fourth
44
of total medical expenditure.
The
differences
same as
between
discussed in
Thus, group
the
twice
on type
the section
insurance medical
costs are both
private and public sector are the
higher
of medical benefits.
expenditure and retained facility
as
a
proportion
in
the private
sector .
Tables D.2 (a),(b),(c) give the broken down cost for each benefit
as an average per employee, across selected differentials and for
each sector
separately.
cost per recipient of
gives the
And Table D.3 gives the actual average
the said
medical benefit
scheme; it also
proportion that this benefit is of total emoluments of
employees receiving the respective medical benefits.
DISAGGREGATED MEDICAL EXPENDITURE
Overall Medical Expenditures
The foregoing analysis shows that the public sector spends nearly
twice the amount on an average, for medical care of its employees
in comparison to the
expenditure
across
also confirms this.
MRTP /
private
other
sector.
variables
Thus, North
Disaggregation
of this
(Table D.2 (a)(b ) and (c))
Indian companies
and the non-
non-FERA group of companies, which have a high proportion
of public sector companies, have significantly higher average
45
Table 0.2(a): Expenditure on Medical Benefits - All Sectors
by Selected Characteristics of Companies
(figures are rupees per eiployee)
ESI per
Eip.
All Sectors
Insur.
Cialis
Luipsui
per Eip. per Eip. per Eip.
117.31
80.33
8o*bay
125.00
139.17
North India
17.98
628.43
90.56
Own
Retain
Other
Medical
per Eip. Medical Ben. per
Benefits
per Eip.
Eip.
Hosp.
284.37
3.27
2.72
443.31
1647.58
Location
784.63
49.52
194.74
2041.72
766.28
610.36
637.98
1933.75
832.32
4268.66
Calcutta A East
102.66
13.39
86.42
28.79
206.85
139.14
583.83
West India
274.57
83.61
221.88
71.73
161.20
50.56
863.56
South India
151.53
52.19
643.87
25.66
596.73
203.94
1673.92
6.58
Type of Coipany
Non-MRTP/non-FE
RA
152.99
83.80
665.61
105.43
294.44
1.69
630.82
1934.78
FERA A MRTP
72.38
38.31
642.74
82.59
133.88
3.26
489.53
1462.69
MRTP only
71.86
87.17
562.77
68.40
312.78
5.88
119.92
1228.78
137.01
67.59
747.08
124.28
205.80
3.56
528.90
1814.22
122.57
6.54
495.85
2.14
621.12
5.53
306.80
1560.54
Incorporation
pre-1975
1975 4 later
Industry group
Food Products
4.94
8.56
26.47
45.37
366.47
8.77
94.36
554.96
505.65
35.78
30.66
3.89
73.99
1.57
112.26
763.80
Metals
60.57
321.55
423.10
2.65
560.68
287.76
1656.31
Cheiicals
56.17
62.38
2132.31
564.20
629.18
6.74
559.29
4010.27
Textiles
Minerals &
Engineering A
Durables
54.81
92.37
404.43
39.11
351.09
3.18
549.91
1494.90
Services
68.75
75.61
1495.60
57.82
54.82
.75
1199.70
2953.05
Diversified
114.64
79.13
364.11
64.70
87.07
1.27
243.13
954.05
Others
30.63
728.17
1505.44
152.60
594.04
Profitability
Group
Negative
247.21
20.10
87.07
7.13
117.85
1045.96
1525.32
Low
88.70
191.13
1070.12
259.74
181.94
6.82
420.08
2218.54
Average
High
122.50
64.78
544.35
56.03
386.10
4.16
204.62
1382.55
2.61
15.04
818.58
1.65
428.04
.92
93.23
1360.07
Returnability
Group
Negative
243.35
20.66
87.10
6.43
114.72
Low
127.54
66.60
1403.38
215.00
453.55
Average
High
87.04
259.09
576.48
50.29
12.47
14.67
176.27
43.43
1071.99
1544.26
8.23
332.91
2607.20
178.55
.58
350.38
1502.40
283.91
2.21
132.94
665.90
Vai.Add. Group
Poor
63.97
26.06
1760.41
337.68
794.18
15.70
623.04
3621.04
Low
82.68
120.36
648.53
58.29
138.88
.50
778.91
1828.14
Average
147.92
60.60
249.82
4.61
233.17
.89
130.63
827.64
High
66.10
10.12
450.15
224.47
5.30
4.82
298.30
1059.25
46
Table 0.2(b): Expenditure on Medical Benefits - Public Sector
by Selected Characteristics of Cospanies
(figures are rupees per employee)
ESI per
Emp.
Lumpsum
Own
Retain
Other
Medical
per Emp. per Emp. per Emp.
Hosp.
per Emp. Medical
Ben. per
Insur.
Claims
per Emp.
Public Sector
139.92
74.29
173.06
143.38
812.09
140.03
373.44
2.73
4.67
Benefits
Emp.
708.59
2251.10
925.60
2051.17
1124.75
5756.14
Location
Bombay
608.68
8.92
186.86
6.46
2751.89
1107.68
765.36
Calcutta 4 East
205.81
225.41
West India
338.25
516.55
South India
71.16
1.63
138.46
76.34
North India
270.82
704.00
5.02
148.21
1008.02
198.03
1940.84
2269.23
1.96
774.73
39.04
856.26
809.66
137.39
379.99
2.26
725.11
9.38
31.25
21.88
1318.75
393.17
2132.64
Type of Conpany
Non-MRTP/non-FE
RA
FERA 4 HRTP
153.13
HRTP only
227.69
21.18
616.89
508.34
365.37
pre-1975
157.29
.40
918.66
195.74
238.45
1.57
835.31
2347.42
1975 4 later
117.33
.46
491.40
795.60
6.88
365.35
1777.01
584 .08
8.27
655.53
.40-
26.14
582.66
432.19
2226.68
715.04
5675.89
1103.12
Incorporation
Industry group
Food Products
15.80
13.54
Textiles
547.21
8.91
33.85
Minerals 4
Metals
Chemicals
608.60
60.53
552.59
633.30
2823.02
956.74
1108.47
12.11
Engineering 4
Durables
91.44
926.29
101.48
922.86
7.93
326.65
2382.46
Services
63.96
872.12
15.63
.73
.91
1526.72
2480.06
Diversified
259.96
271.56
2.58
96.25
630.34
Others
16.89
190.51
925.55
1878.80
5.81
745.85
Profitability
Group
Negative
261.38
Low
44.91
212.84
1669.46
Average
81.22
.79
High
12.16
91.56
136.10
1120.71
1609.75
307.07
.92
409.49
3046.44
1010.54
1054.63
17.83
328.15
2493.17
2047.02
393.19
733.68
3186.06
401.76
Returnability
Group
90.26
Negative
257.09
Low
57.07
.76
1651.82
Average
High
5.84
896.82
64.33
138.16
1134.96
1620.47
5.13
430.80
3194.20
510.71
2735.89
108.19
14.62
356.03
1793.37
531.52
1080.97
6.73
771.16
4001.30
18.77
79.03
.73
1360.46
2655.96
356.24
692.38
1010.38
55.81
256.33
1220.97
29.24
1588.50
929.16
Vai.Add. Group
Poor
22.42
Low
64.41
Average
348.02
167.89
5.40
196.89
1.08
53.14
772.42
High
69.63
1079.60
122.21
11.37
14.21
267.57
1564.59
203.41
47
Table 0.2(c): Expenditure on Medical Benefits - Private Sector
by Selected Characteristics of Coapanies
(figures are rupees per eaployee)
ESI per
Eap.
Claias
Luapsua
Own
Retain
Other
Medical
per Eap. per Eap. per Eap.
Hosp.
per Eap. Medical
Ben. per
Insur.
per Eap.
Private Sector
Benefits
Eap.
101.50
84.55
499.97
55.96
222.08
3.65
257.76
1225.46
135.95
919.06
80.54
200.76
1.23
418.23
1844.04
175.94
929.90
Location
Boabay
88.28
North India
43.84
Calcutta I East
72.03
17.36
45.16
37.34
268.26
West India
262.99
98.81
168.32
84.77
South India
305.71
149.18
392.85
189.06
102.31
307.84
26.07
81.96
.27
396.62
1104.14
66.34
41.17
608.33
88.76
143.19
1.17
524.49
1473.45
69.26
88.27
561.87
61.08
311.90
5.98
115.38
1213.73
pre-1975
123.20
113.37
630.16
75.59
183.55
4.92
320.10
1450.89
1975 J later
140.89
27.82
■511.41
9.63
10.78
.80
101.98
803.31
3.81
9.46
27.82
46.58
343.67
9.69
103.38
544.42
477.87
59.70
45.21
6.50
123.18
2.62
169.83
884.90
447.69
262.43
7.95
100.05
548.15
189.59
32.82
837.30
98.87
215.29
1161.90
Type of Coapany
Non-HRTP/non-FE
RA
FERA S MRTP
MRTP only
Incorporation
Industry group
Food Products
Textiles
Minerals 4
Metals
112.48
75.58
312.15
4.91
498.45
163.99
1167.56
Cheaicals
51.09
135.19
1326.03
105.98
69.71
.47
377.49
2065.96
Engineering 4
Durables
33.22
143.39
96.79
2.34
14.03
.37
681.53
971.68
Services
79.35
242.93
2875.32
151.19
174.51
.40
476.03
3999.72
Diversified
43.23
118.01
409.59
96.49
129.85
.63
315.31
1113.11
Others
79.79
21.76
169.25
16.92
50.77
Profitability
Group
Negative
194.13
95.43
70.25
33.85
49.43
765.82
1208.92
Low
135.47
167.94
429.77
108.01
48.26
13.13
431.38
1333.98
Average
132.08
79.62
436.18
69.03
230.99
.99
175.96
1124.86
2.28
15.56
775.45
1.71
429.26
.95
70.74
1295.95
Negative
188.85
102.64
74.56
31.92
21.75
822.19
1241.92
Low
191.88
126.71
1176.53
86.04
235.47
11.06
243.52
2071.21
Average
High
104.69
120.45
482.15
49.09
161.65
.71
315.52
1234.25
6.66
16.32
59.16
45.02
303.61
.82
107.93
539.50
Poor
131.73
68.55
2040.76
21.57
326.47
30.34
381.47
3000.89
Low
96.02
59.72
443.62
87.15
182.58
.32
354.27
1223.68
Average
High
44.16
92.02
292.30
4.20
251.99
.79
170.82
856.28
64.29
15.30
127.38
276.91
2.19
314.06
800.12
High
Returnability
Group
Vai.Add. Group
48
expenditures on
the
companies,
of
and services groups
companies and
For the same reason the chemical
medical care.
the poor
and return
profit
low
value added companies have significantly
higher expenditure on medical care. (Table D.2(b)).
In
case
the
private
the
of
interesting to
note that
and poor
added
value
medical care.
This
doing so
(c))
it is
companies with low profits and returns
have
also
highest
the
clear indicator
is a
appropriate higher profits and show
added are
D.2
(Table
sector
at the
that companies which
higher
a
expenditures on
return
and value
cost of the employees i.e. by paying
lower wages and benefits.
This is further substantiated
D.4 where
by the
ratios presented
in Table
we clearly see that medical expenditure is much higher
in the public sector as a proportion to all the crucial variables
like sales
turnover, profits, value added and dividend payments.
Infact, the
gap between
highest where
the public
profits and dividends are concerned because in the
private sector profit appropriation (before tax)
of the
the
value added
public
sectors is the
and private
sector
maximizing profits,
takes away half
in comparison
to only one-fourth in case of
companies.
Thus,
with
the
objective of
the private sector companies, on an average,
tend to keep benefits (including medical
benefits) for employees
at a very low level as compared to the public sector companies.
49
ESIS
In the
sample companies the expenditure by companies (employer’s
share) for premia to
million or
the ESI
all types
7% of
a total
Corporation is
medical expenditures.
have
seen
earlier
that
the
actual
of the
thus, for
(Table C.l);
beneficiary, the employer’s contribution works
ESIS
out to an average
only 2%
only 17.6% of the employees in the
under ESIS
sample companies are covered
(Table D.2)
(Table D.2(a)).
This is a mere Rs. 117.31 per employee annually.
We
of Rs. 53
such employee
664.34 per
of Rs.
and this is
total emoluments of these employees (Table D.3).
For the public sector employees the latter proportion is 2.5* and
for the private sector employee much lower at 1.6% of emoluments.
ESIS, by
its definition
of coverage, is applicable to employees
with wages at the lower end of the
group of
industries which
have low wages on the average, have a
higher coverage
under this
scheme as
premium payout
per employee.
The
companies
and
those
having
However,
this
is
expected
an
Thus, the textile
spectrum.
a
well as
true of loss making
same is
return
negative
result
a higher average
because
on
it
capital .
is
more a
consequence of statute than of company policy.
The other medical benefits discussed below
are not
statutory in
nature but a consequence of negotiations and labour struggles.
50
Group Health Insurance
too
This
negotiates
is
based medical benefit which the company
premia
a
General
the
with
There are no specific standards set by the
sector institutions).
Insurance company for premia and amount
It
is
an
tailoi—made
entirely
and
agreement between the
company
often, the
premium is
amount of
volume of other insurance
the number
of employees.
of coverage permissible.
scheme
through
the
Insurance
dictated by
a
bilateral
firm.
Most
two factors - the
the company
business that
offers and
Larger the insurance business and the
number of employees, lower is the
per employee.
(all public
Companies
Insurance
premium that
the company pays
There may be different rates of premia and extent
of coverage (upper
limits
number
and
different grades of employees.
of
family
members) for
The ultimate cost of medical care
(within the confines of upper limits
specified) is
borne by the
insurance company, through reimbursements.
As we have seen earlier, in our sample this scheme is provided in
The total expenditure on this scheme
very few companies.
sample
companies
is
Rs.
36.44
medical expenditure of companies.
scheme
in
total
private sector.
is the
medical
(Table D.l)
single largest
by the
million or only 4.82% of total
However,
the
is
twice
expenditure
Infact, in
share
of this
larger in the
the private
sector, it
scheme for managerial employees, covering
56% of them. (Table C.l).
medical care expenditure.
A total
293.12 million was spent by the sample companies
of Rs.
on claims / reimbursements
to employees
for medical
care.
The
public sector accounted for 52% of this expenditure.
The overall expenditure on this scheme among the sample companies
was Rs. 628.43 per employee - Rs. 812.09 in the public sector and
499.97 in
only Rs.
the private
sector.
(Table D.2 ( a )( b )( c ) ) .
For employees actually receiving
these benefits
the
narrows.
private
sector
employee covered by this
scheme
public
and
against Rs.
D.3)
claimed
the gap between
The
public sector
1786.73 by an employee in the private sector. (Table
For the private sector
lucrative one,
atleast in
the employers the most
public sector
it is
employees this
terms of
the money received, and for
expensive scheme
the second
sector (except
the most
scheme is
to administer.
In the
most expensive scheme.
A point
worth noting here is that the gap between the various
the public
per year
1868.90
Rs.
is very
for ESIS)
private sector claims/reimbursement stand
schemes in
small; but in the
apart
from
the other
medical benefit schemes whose expenditure levels are more or less
similar - the former averages three times the
latter.
expenditure of the
(Table D.3).
Since the payout to the employee in this scheme is the highest as
compared to all
other
schemes
it
is
expected
that
the poor
performing companies do not have th s scheme as the dominant one.
52
Table 0-3 = Expenditure per Actual Covered Employee under Various Medical Schemes and as
Percent of Total Emoluments
PUBLIC SECTOR
Medical Benefit Scheme
(Rs-)* (Percent of
PRIVATE SECTOR
(Rs)* (Percent of
ALL SECTORS
(Rs)* Percent of
Emoluments)*
Emoluments)*
Emolument )•
ESI3 (Employer ©hare)
680.66
2-5
649-33
1.6
664.34
2.0
Group Health Insurance
1377.91
3.2
S71.42
1.1
73S.21
l.S
Claims / Reimbursements
1868.90
4.2
1786-73
5-1
1828.32
4-7
Lumpsum
2237-34
5-3
460.93
1-1
931.72
2.2
Own Hospital/Clinic
1060-25
3.1
407-01
1-4
610-22
1-8
*
Figures are Rs. per actual employer recipient of each benefit. It must be also
noted that in many <^ases an employee received more then one type of benefit.
0
Figures are percent that the preceding column is of average per employee emoluments
in companies with th* relevant medical schemes-
Table 0.4 : Selected Ratios of Medical Care Expenditures
Disparity
Public
Private
All
.joc tors
1
2
3
(Times)
1-2
1. Sales Turnover
0.34
0.23
0.28
1.48
2- Value Added
1-90
0-69
1.09
2.7S
3- Profits before Tax
7-14
1-34
2-48
5-33
4- Total Emoluments
5-79
3-36
4-40
1-72
5- All Benefits
28-57
20-12
24-13
1-42
6. Dividend Paid
65.29
11-24
21.04
5.81
Medical Expenditure as Percent of (on per employee basis)
53
Also companies in the North of country (mainly around Delhi) have
than
their own hospital more often
“Claims",
and
companies in
South India have ESIS more often than "Claims" .
Lumpsum Payment
Paying a
fixed medical allowance as part of emoluments is one of
the least common schemes, especially in
an average,
private employer
what the
also one of the lowest per employee.
sector , where
group
scheme has
too the
insurance,
beneficiary of
the
per
this scheme
On
spends on this scheme is
in the public
In contrast,
the lowest coverage alongwith
payout
employee
is the
highest.
for the public sector employer this is the
while for
sector.
the private
the
actual
(Table D.3)
Thus,
to
most expensive scheme
sector employer the cheapest, aggregating
the private
5.3% and 1.1% of emoluments, respectively (Table D.3).
Own Hospital/Clinic
Companies which on the average have
find
it
economical
to
have
their
a larger
own
employee strength,
health care facility.
becomes the
Consequently, on the whole,
having such
a facility
cheapest form
health care
to employees and their
dependents.
of delivering
This is generally
true
for
the
companies
sample and more so for the private sector companies.
54
in our
On
the
the
whole,
per
employee
expenditure on hospitals and
clinics by the sample companies is Rs. 284.37 - Rs. 373.44 in the
- (Table D.2(a)(b)) but the actual cost of running
public sector
a hospital / clinic for providing health care
employee in
a company
is Rs.
610.22 per
which has this facility (Table D.3).
The
costing in the private and public sectors is very different.
In the
private
sector
through
their
own
those
facility
companies
have
benefit, a mere Rs. 407 per employee.
the
providing
health care
cost of medical
lowest
In the public sector it is
the second
lowest cost
(after ESIS) medical benefit scheme, but
compared to
the private
sector the
amount spent
(Rs. 1060 per
employee) is much larger (Table D.3)
Retained Facility
The total expenditure for such a facility by the sample companies
is merely 0.2% of all
medical
benefit
senior
managerial
is
medical
expenditure.
directly
borne by the company for selected
employees,
directors,
This
etc..
category of
None
of the
companies gave any details about coverage of employees under this
scheme though 9% of the companies stated having
Interestingly 75%
of these companies were
the rest in Calcutta.
55
such a facility.
located in Bombay and
Other Medical Benefits
This is a large category of expenditure constituting 27% of total
medical expenditure - 20% in the private sector
public sector.
A
total of
benefits, which are mostly
various
Acts
such
as
Compensation Act etc..
the
Rs. 201
Most of
nature, covered
Benefit
the companies
by the
Act,
Workmen’s
did not
give any
details about these expenditures and the beneficiaries.
56
in the
million was spent on these
statutory in
Maternity
and 31%
CONCLUSIONS AND ISSUES
The foregoing
exploration of medical care benefits for the work
force in the organised sector may
general population
indicate that
relative to the
this segment is perhaps privileged in getting
wages and benefits with minimum decent levels of protection.
The Factories
Act
and
other
associated
protect about
only 10%
of the
work-force.
Acts,
we
have seen,
The remaining 90%,
mostly in rural areas and small towns, has no legal protection at
are entirely
all; they
condemned to
various
at the
types
of
mercy of
their employers or are
unremunerative self-employment.
Even from among the 10% protected work-force only about half gets
complete
protection,
the
balance
because
the
audit
and monitoring machinery of the
under various
Acts is in .itself deficient and
protection,
state constituted
getting
nil
inadequate
or
inadequate.
In the
present economic
“small mercies" enjoyed by
threatened.
scenario of structural adjustment these
this
small
work-force
is generally
In the last one and a half decade employment in the
factory sector has stagnated, infact declined in real
to the
economic policies
pursued by
the government, especially
those with regard to liberalisation and privatisation.
57
terms, due
be noted that the decline in organised sector employment
It must
is not due
to
organised
sector
economic
has
recession,
grown
largely due to shifts in the structure of
the
putting-out
system
segment, and it is
both due
this which
production.
In India
has always been a large
is replacing
factory production,
increase of ancillarisation and miniaturisation
to the
of technology.
production
of
The decline is
rapidly.
fairly
in the
investment
because
To support these processes the legal framework is
being altered to narrow the focus of the factory-sector .
consequence
going
of
all
this
and
decline
in
wages,
adversely
affected
are
social
benefits.
With unions totally immersed in issues of unemployment
and wages,
the small increase achieved in awareness about social
A
major
unemployment
is
but
wages,
to
what
in
be
rise
will
be
more
health
care
including
wages amongst workers is going to plunge.
It is
in this
context that
one must
view the
findings of the
present study.
We
have
seen
that
medical
companies’ is merely one
percent of
emoluments.
the
care
expenditure
of
percent of
their value
added and four
About one-third of the value of medical
care benefits are statutory and the remaining two-thirds
result of
larger
are the
negotiations and struggles. Ofcourse what is statutory
today was also a consequence of labour struggles in the past.
58
Relative to the resources that the general population can command
for access to medical care the organised sector
workers (who get
are better off in the sense that they get some
medical benefits)
additional
support
(especially
so
if
to
meet
they
health
their
get
direct
care
requirements
services) beyond what the
government provides for the population as a whole.
However, this additional resource at the command of these workers
is
in
used
mostly
private health care, which, as we
availing
know, gives placebo, unnecessary or inappropriate
to
70%
the
of
time.
resource goes waste.
Thus
a
treatments 60%
fair chunk of this additional
Besides, it also contributes
to escalation
in the cost of health care.
Since we
have not
looked at the actual availing of medical care
by workers it is difficult to comment any
the
resources
provides
a
at
service
their
disposal,
(clinic
diredly
further on
the use of
except that if the employer
or
hospital)
the
then
expenditure indicated is an acutal expenditure on medical care by
the employer.
produced as
All other payments, except where bills have
in the
reimbursements against insurance or
case of
employers’ provision (these too
the
employer
for
medical
used for medical care but
to be
are often
manipulated), made by
care may not necessarily be actually
for
more
urgent
needs
(quite often
nutrition itself because of the generally low level of wages).
59
While these
very important,
issues are
exploratory in nature has
workers
who
receive
acquire
an
analytical
the present study being
Interviews of
not
addressed
them.
medical
benefits
need to be conducted to
understanding
of
medical
actual
care
benefits and expenditures.
We would
like to
saying that medical care benefits
conclude by
given to employees are given by employers more as a supplement to
wages
which
are
barely
subsistence
above
another number to the list of allowances.
not
at
all
a
adequately
In most
cases, it is
thought out system of benefits which gives
wel)
Only where companies run well-equipped
actual relief to workers.
and
and to add
levels
and hospitals do workers get a
clinics
staffed
real benefit as they are not dependent on buying an expensive and
a doubtful quality of health care in the market place.
And finally, under the present structural adjustment changes, the
organised sector
employment
union
is
(declining
organisation
increases,
rising
vigourous
under
now
(changes
prices
a
for
in
Acts which
freeze
Act),
declining
last, but not the least, the changes (against
labour protection
with
threats to
decade in real terms), trade
the
with
attack,
on
wage
purchasing power and
labour ) in various
provide different
benefits to the
wor ker.
To counter this,
workers
have
to
review
their organisational
policies and demands, because a one point battle of protecting
60
employment and
wages (though
very important) dilutes the larger
social security issues in the demand agenda of
struggles.
the working class
The latter are very important for long term stability
and only
with
their
struggles
of
the
firm
working
establishment
class
of
the
as
a
right
organised sector get
extended to the large mass of the non-formal sector.
61
can the
REFERENCES
CBHI , 1989:
India 1989, Ministry of Health
Health Information
and Family Welfare, Central
Bureau of
Health Intelligence,
Govt, of India, New Delhi.
:
.
(j i
a
CMIE , 1989 : Data on Larger Business Units, Centre for Monitoring
Indian Economy, Bombay.
EFI, 1962 : Fringe
India. Employers’
benefits in
Federation of
India , Bombay.
EFI, 1972 : Fringe Benefits in Indian Industry ■ A Report of the
2nd
IIM,
1987
Survey, Employers’ Federation of India, Bombay.
:
Study
of
Health
Care Financing in India, Indian
V
Institute of Management, Ahmedabad.
Labour-Bureau 1986 and 1990 :
Indian Labour
Year Book, Ministry
of Labour, Labour Bureau, Shimla.
' &
EMPLOYEE MEDICAL BENEFITS IN THE CORPORATE SECTOR
This is one of a series of studies on Health Expenditure carried out by FRCH with ICMR grants.
As an exploratory study looking into the medical care benefits provided to the employees in the organ
ised industrial sector (both public and private) it looks at employee medical benefits as 'social wages'
and not as benefits provided due to the 'goodness of the employer'. The author takes a detailed look
at the companies studied (about 143 in all), discusses various types of medical benefits and
analyses disaggregated costs. In the concluding section, the author comments on the limited out
reach of the corporate medical benefit schemes and discusses the threat of structural readjustment.
He states that there is a shift in production structure supporting greater ancillarisatlon and miniatur
isation of technology and alteration of legal framework to support these processes. This will have an
adverse effect on social wages including health care. He thus throws a challenge to trade unions
to raise broader social security issues that used to be prioritised on the agenda of working class
struggles.
The monograph contains detailed tables (totally numbering 11) in each analytical section of the
study.
ABOUT THE FOUNDATION
The Foundation for Research in Community Health (FRCH) was established in 1975. It is a
non-profit voluntary organization which carries out research and conducts field studies, primarily in
rural areas, to gain a better understanding of the socio-economic and cultural factors which affect
health and health care services. Major projects carried out include a 10 years field health project at
Mandwa, Health Education in Schools and an action research project on Health Education and
Development at Malshiras in Purandar taluka of Maharashtra. Major research studies are currently
in the areas of Health Cost, Tuberculosis Control, Drug Utilization and Costs, and a study of ANMs.
FRCH's larger aim is to create a people's health movement by demystifying medicine and increasing
public awareness.
SOME OF OUR RECENT PUBLICATIONS
1. State Sector Health Expenditures, A Database : All India and the States, 1981-1985
(Ravi Duggal, Sunil Nandraj, Sahana Shetty);
Cost : (Postage Free) Institutions : Rs. 500/- / US $ 50/- / £ 25/-
2. State of Health Care in Maharashtra : A Comparative Analysis
(Alex George and Sunil Nandraj);
Cost : Rs. 20 + Rs. 8 (Postage); USS 4/- / £ 2/- + Rs. 20 (By Air Mail) or Rs. 8/- (By Sea Mail).
3.
Private Sector and Privatisation in the Health Care Services
(Amar Jesani with Saraswathy Anantharam)
Cost : Rs. 50/- + Rs. 8.50 (Postage);
US$ 10/- / £ 5/- + Rs. 23/- (By Air Mail) or Rs. 8/- (By Sea Mad).
4.
Some Issues in the Community Participation in Health Care Services
(Amar Jesani with Shilpl Ganguli);
Cost : Rs. 25/- + Rs. 8/- (Postage); US $ 5/- £ 2.50 + Rs. 50 (By Air Mail) or Rs. 8/- (By Sea Mail)
5.
People's Health in People’s Hands - Indian Experiences in Decentralised Health Care :
A Model for Health in Panchayati Raj - (Eds. Dr. N. H. Antia and Kavita Bhatia);
Cost : Hard Cover Rs. 200/- + Rs. 10/- (Postage); USS 35/- / £ 17.5 + Rs. 160/- (By Air Mail) or
Rs. 55/- (By Sea Mail) Soft Cover : Rs. 100/- + Rs. 9.50/- (Postage);
USS 15/- / £ 7.5 + Rs. 160/- (By Air Mail) or Rs. 55/- (By Sea Mail).
Copies of the above publications may be ordered from :
THE PUBLICATIONS UNIT, FOUNDATION FOR RESEARCH IN COMMUNITY HEALTH,
3/4 Trimiti - B Apts., 85, Anand Park, Baner Road, Aundh, Pune - 411 007, Maharashtra, INDIA.
* Buyers abroad, please specify whether you would like the publications to be sent by Sea Mail
or Air Mail and please add postage amount accordingly.
- Media
5105.pdf
Position: 2816 (3 views)