Mineworkers with pneumoconiosis, work-related injury compensation, and empty institution in China

This study investigates the ineffectiveness of China's work-related injury insurance in protecting mineworkers with pneumoconiosis. Using the FAT (Formal, Actual, and Targeted) institutional analysis framework, the paper examines the discrepancy between the formal rules, the actual practices and the targeted outcomes of the system, based on interviews with 20 pneumoconiosis mineworkers. The paper reveals that the work-related injury insurance system is an empty institution that does not cover most mineworkers, does not compensate them adequately, and does not prevent or treat their disease effectively. The paper also explores the factors that contribute to the system's ineffectiveness, such as the political compromise behind the revision of laws and regulations, the complexity and exclusivity of the eligibility criteria, and the transient and precarious nature of mineworkers’ employment. Furthermore, the paper discusses how the system's failure is mitigated by other social security and assistance mechanisms that provide basic medical and living support for pneumoconiosis patients, but do not address the root causes of their occupational disease or ensure their access to justice and compensation. The paper situates the findings within the political economy of occupational health literature and proposes policy recommendations for a more comprehensive and compassionate approach to occupational disease prevention and control in China.