The health insurance sector has grown significantly, becoming a major business area. With rising healthcare costs, especially in private hospitals that offer advanced specialty services, people increasingly rely on health insurance. However, private insurance companies often face criticism for finding excuses to deny claims. This was evident when the state government introduced a compulsory insurance scheme called Medisep for government employees and pensioners three years ago.

Employees and pensioners initially appreciated the government's initiative but, as two months only remain till the closing, they now pray that if the scheme gets renewed, it should be optional and not compulsory. The reason is that few good hospitals have approved of Medisep, and those that have do not provide full benefits from it. Then, the compulsory premium taken for Medisep becomes a concern. In business, typically only the owner benefits, while the consumer suffers. There are about 5.5 lakh government employees and more than that number of pensioners in the state. Including dependents, over 30 lakh people are covered under Medisep, with a monthly premium of Rs 500.

Oriental Insurance Company manages Medisep. Initially, the government allocated Rs 500 crore to the scheme, but claims in the first year totaled Rs 717 crore, later adjusted to Rs 697 crore. This resulted in a loss of Rs 20 crore for the company. The premium is Rs 500 per month for all employees and pensioners, regardless of pay scale. There have been ongoing complaints about the scheme's shortcomings, and the government has not addressed them or added more hospitals. A committee led by Dr. Sriram Venkitaraman is set to submit a report on these issues within two weeks.

The government will decide on the scheme's continuation after receiving a report. In compulsory insurance schemes, customers have the right to receive services as promised. Employees should be confident in receiving free treatment at nearby hospitals, with prompt reimbursement to hospitals. The scheme should be reorganized to ensure this or, at the very least, made optional to avoid forcing employees to pay premiums without adequate benefits.