By e-mail: chairman.sail@sail.in
FORSE/SAIL-C/0624
27/04/2024
To
Sri Amarendu Prakash,
Chairman,
Steel Authority of India Ltd,
Ispat Bhavan, Lodhi Road,
New Delhi – 110 003.
Sub: A comprehensive demand for Healthcare of SAIL Retirees as also for drastic improvement in SAIL Mediclaim Scheme (2024-25).
Sir,
We would like to draw your kind attention to the discussion held in the XIVth FORSE Apex Council meeting held at Bokaro on March 15-17, 2024, regarding Healthcare issues of the Retired Employees as well as demand made by the Council. Members present expressed resentment over inadequate healthcare for the retirees. While thanking SAIL management for increasing the IPD limit made effective from July 2022, there is more needed to bring improvements in the present system. Members also expressed the serious economic malady and social disparity in the whole system in respect of prevailing healthcare of the retirees who had spent all their lives in the Company and helped the Company to grow and to come to this shape.
In fact, a reference was made to the Directive Principles of the State Policy as enshrined in the Constitution (Articles 36 – 51), Article 38 which specifically envisages that the State shall strive to promote the welfare of the people by securing and protecting as effectively as it may, a social order. The concept of ‘social justice’ enables quality of life to flavor and enliven the practical content of life. With the Amendment in Article 44, the State shall in particular strive to minimize inequalities in the total social system which encompasses the healthcare system which is more Cardinal point in safeguard of one’s life. However, in this canvass also, there is glaring disparity and discrimination while protecting and maintaining proper health and life of the retirees.
The injustice being done with SAIL Retirees, on this count, becomes more glaring when the available healthcare facilities in SAIL, a Maharatna PSU is compared vis-à-vis other few schedule-‘A’ PSUs like ONGC, IOC, BHEL, NTPC, and BPCL etc. (Comparative chart is in Annexure –‘A’). SAIL’s Healthcare policy/ scheme for retirees is inferior even to that of our sister concern RINL. As can be seen there were wide aberrations and disparity in the matter of healthcare management inter-se Schedule-‘A’ PSUs for reasons not known. Historically, it prima-facie appears that there has been complete apathy and neglect towards the life and healthcare of SAIL retirees though being a Maharatna Company and known to be an enlightened and professionally managed Company.
The criteria of profit / profitability / affordability etc. which are shown as normal impediments, are no more valid in view of SAIL reaching at pinnacles of glory and fortunes. It is only the misfortune of disparaged class of SAIL retirees suffering from abject neglect and apathy by keeping the permissible limits of OPD/ IPD fixed at very low level when the cost of living has gone skyrocketing for last dozen of years, though during last two years, some remedial actions have been taken but not much. It is not much of a profit and loss concept as taking into account the premium being paid by the Company, if an additional amount of Rs. 120 – Rs. 130 crore is spent, it is felt and reasonably estimated that SAIL can provide free treatment to all retirees at par with their serving employees – keeping the present free treatment in plant hospitals open as hitherto. In that case., the hassles of providing Mediclaim Scheme / Insurance coverage will altogether be eliminated.
Members strongly felt that most of the maladies of ‘Healthcare for Retirees’ are born of keeping the FORSE representatives away from policy making in spite of our several requests at regular intervals. There is an imperative need for direct involvement of FORSE representatives in formulation of comprehensive healthcare policy as they are more apprised about the intricacies of the operative paras and also, they are the beneficiaries paying part of the premium.
It was also felt that there has to be uniform application of the policy and accrued benefits therefrom and to make it at par with serving employees as envisaged in SAIL NJCS AGREEMENT, 1978.
The following issues also need to be settled to provide more widespread benefits.
1) NO INCREASE IN EXISTING PREMIUM RATES
2) FREE MEDICAL CHECK UP PERIODICALLY
3) SAIL must ensure inclusion of all IRDAI circulars for Sr Citizens in the SAIL Mediclaim Scheme for 2024-25.
4) SAIL must ensure 'Cashless Everywhere' initiative of the General Insurance Council (GIC) to extend the cashless treatment at all hospitals.
5) SAIL must ensure ‘no deduction from Bills’ for the medicines or the line of treatment prescribed by a doctor of a Medical College Hospital or a Network Hospital as their superiority cannot be questioned.
6) Better OPD facilities with ensured supply of all medicines to all the Retirees at par with Corporate Office and CMO, Kolkta.
7) All pathological / diagnostic tests recommended by SAIL doctors / Medical Units may be undertaken in SAIL hospitals / SAIL nominated hospitals free at par with serving employees.
8) For all terminal diseases, e.g. cancer, organ transplant, major heart surgery, CKD, liver transplant etc., SAIL should come forward with free treatment as in the case of serving employees.
9) Insurance Co./TPA has stopped reimbursement of a combination of Leuprolide + Bicalutamide + Shelcal- a medicine for Cancer recently which used to be reimbursed in the past. This and other medicines for treatment of cancer should be incorporated.
10) Free periodic medical check-up for self and spouse
11) To start 24-hour working help desk
12) Doctors’ prescription should be kept valid for one year for medicines
13) Members also stressed for reduction in Top Up / Super Top Up premium rates which are very high.
14) There has to be clarity in “exclusion list” and it should be comprehensive.
15) Similarly, there has to be clarity in “the list of Day Care Treatments list” and it should be comprehensive.
16) That treatment as well as the charges for the retirees at Rourkela Super Specialty Hospital to be made at par with serving employees.
17) It is also demanded that comprehensive dental treatment and Ayurvedic treatment should be covered under the scheme.
18) Capping should be stopped in empaneled hospitals. It was observed that in case of capping, some hospitals are demanding additional amounts as Doctors Charges / medicines and also sometimes as special equipment / gadget charges.This practice should be stopped forthwith or should be given full medical coverage.
19) It was stressed by the representatives from Metro cities that treatment by RMP (minimum MBBS) should be allowed at par with serving employees as consultation charges at nominated OPD centres / hospitals are very high and there is also a logistic / movement problem in cities. For the diseases of less serious nature, one can always go to a local doctor in the vicinity and avail the consultation at lower cost.
20) Our long pending demand of increasing OPD limit to Rs. 20,000/- each for self and spouse with clubbing facility should be met from this year.
21) More procedures e.g. Cystoscopy, Colonoscopy, Endoscopy, Bronchoscopy, ERCP/ MRCP and all types of MRI should be brought under Day Care treatment.
22) SAIL must honour the terms and conditions as given in para 14 of the Appointment Order to its employees for post-retirement free medicare to the Employees and the spouse.
23) In VISL as of now Mediclaim scheme is from 1998 onwards, however, it should be from 1989 onwards since VISL became part of SAIL (subsidiary) in the year 1989.
24) ICCU / ICU / ITU / Ventilator charges are to be paid on an actual basis. But the diagnostic / pathological charges while the patient is in such critical beds, should not be raised high and are to be paid at normal rate as in entitled beds.
25) There is need to increase the entitlement limit of room rent further from 1%, 1.25%, 1.5% to 2% and 3% of individual sum insured value, depending upon the category of the respective city, as such charges in specialty hospitals have enormously increased or actual of entitled / available rooms is to be allowed.
Sir, in view of the ever-increasing cost of living and Healthcare and ever-decreasing return on investment by Retirees we request you to kindly take a liberal view towards the above demands and accept and implement them from this year. Further, we request you to kindly involve us in the formulation, negotiation and finalization of SAIL Mediclaim Scheme 2023-24 so that a “more meaningful, helpful and beneficial to retirees’ scheme” is implemented. We are eagerly waiting to hear from you soon. We also propose for a SAIL-FORSE meeting at an early date to discuss these and other issues.
We hope to hear favorably from you soon.
With regards,
Yours faithfully,
For & on behalf of Federation of Retired SAIL Employees
(V. N. Sharma) Chairman | (Ram Agar Singh( Gen Secretary |
ANNEXURE-‘A’
Note: Besides, there are provisions also for giving financial aid under Felicitation Schemes in some PSUs to help the retirees at old age ONGC circular was sent by us to all concerned on 13th April 2023.
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