India's healthcare crisis leaves millions without medical attention in 2024

Nearly half of all recorded deaths in India in 2024 happened without medical attention from a trained professional. The issue is even worse in rural areas and states like Bihar, where the figure reaches close to two-thirds. Workers covered by the Employees' State Insurance Corporation (ESIC) also report persistent problems with accessing care and benefits. The ESIC is a social insurance system for low-income workers in the formal economy. It provides medical care and income protection, covering sickness, maternity, disability, workplace injuries, dependants' benefits, unemployment support, and lifelong pensions for permanent disablement. The scheme currently covers about 3.84 crore insured persons and nearly 14.91 crore beneficiaries, roughly one-tenth of India’s population.

Despite its vast resources, including a large hospital network, medical colleges, land assets, and a corpus exceeding Rs 1 lakh crore, workers face major delays. Many complain of long queues, poor information, medicine shortages, slow referrals, indifferent staff, and extended waits for cash benefits. For example, 73% of injured workers waited more than six months for temporary disability benefits, while 78% waited over a year for permanent disability benefits.

The ESIC operates on contributions from both employers and employees. For a worker earning Rs 15,000 a month, the total annual contribution is about Rs 7,200. Yet, the system’s inefficiencies continue to hinder access to timely care and support. The ESIC’s reform agenda must address these gaps. Proposed measures include simplifying processes for workers, publishing clear service standards, strengthening primary care, improving human resources, introducing digital tools, and reforming governance. These changes aim to ensure that contributions translate into reliable and accessible benefits for all covered workers.