Reforming Miners' Lung Disease Compensation in South Africa--Long Overdue but What Are the Options?

A number of countries have workers' compensation systems which reserve specific arrangements for workers in certain sectors, notably mining. This article describes the current impetus to reform of the century-old South African mining compensation system. It is intended as a case study of the implications of harmonization of two disparate compensation systems for occupational lung disease, specifically in relation to equity in financial benefits, equity in coverage, linkage of compensation to disease prevention, and efficient administration. After decades of neglect, it is clear that while inferior financial benefits for miners are no longer tenable, the costs of equalization are not supportable by the current actuarial status of the miners' Compensation Fund. There is also an argument for two miner-specific entitlements to be retained--free medical examinations for ex-miners and autopsy-based posthumous compensation. A new dispensation to support the casualties of a declining industry will require sustained political will.