Abstract
This article presents an economic assessment of the mechanism currently in use in the Republic of Kazakhstan for the distribution of social guarantees and compensation for work in hazardous working conditions. The aim is to identify and quantitatively substantiate the economic inefficiency of the list-based model for providing five types of guarantees: additional paid leave, reduced working hours, therapeutic-prophylactic nutrition, milk or equivalent products, and increased pay. The empirical basis comprises official data of the Bureau of National Statistics for 2021–2025. Total expenditure on social guarantees increased by 103.7% over five years, while the number of recipients remained virtually unchanged (+0.01%); the share of compensatory (passive) measures in total occupational safety expenditure reaches 66.0%, whereas integrated occupational risk assessment accounts for only 0.14%. A systemic gap is revealed between guarantee recipients and workers actually employed in harmful conditions (a 1.72-fold excess), caused by the decoupling of guarantees from measured risk. The absence of cost–outcome feedback is established: despite the expenditure growth, occupational injuries and diseases did not decline steadily, indicating a fall in the productivity of spending. Directions for the transition from a list-based to a risk-oriented model are proposed.