Employer-sponsored Health Insurance (ESHI) Scheme- A New Model of Health Micro Insurance for the Garment Workers in Bangladesh

Abstract

Organized universal health coverage has not yet been introduced in most developing countries, including Bangladesh. Private health care is affordable only to the high-income group. The aim of this retrospective observational study was to evaluate health service coverage with disease prevention, access to health information, and cost control through health financing to help take appropriate decisions for the betterment of garment workers in Bangladesh. The study was conducted in seven readymade garments (RMG) factories in the Gazipur district from 24 April 2014 to 23 April 2015.A total of 9717 workers aged 18 to 60 years and belonging to the lowest salary groups were included in this Employer-Sponsored Health Insurance (ESHI) scheme. This new model of Health Micro Insurance (HMI) had treatment, laboratory facilities, health education, and medicine supply. The annual coverage for treatment cost was up to 15000 Bangladeshi taka (BDT) or US$192.8 and the premium for enrolment in the scheme was 487 BDT (US$6.3). An agreement foresaw that the surplus cost accrued was equally shared between the insurance company and the factory owner. A common software was used to generate and view all medical information. A total of 4524 (46.6%) workers (60.5% male and 39.5% female) received treatment. The participant's mean age was 28.3 years. The mean consultancy rate was 4.7 times. Participants mostly suffered from gastrointestinal problems(24.4%), and most prescribed medications were anti-ulcer drugs. The median value of drug cost, investigation cost, consultancy fees, and total medical cost were 126 (1.49 USD), 315 (3.71 USD), 200 (2.36 USD), and 734 BDT (8.66), respectively. The annual net premium paid by the factory owner was 4094504 BDT (48744 USD), and the total healthcare cost accrued was 5230156 BDT (62263 USD). This ESHI scheme is a better option for HMI for making healthcare accessible to the largest RMG sector in a developing country like Bangladesh.