Impacts of Unionization on Employment, Product Quality and Productivity: Regression Discontinuity Evidence From Nursing Homes
AbstractThis paper studies the effects of unions in private-sector nursing homes on a broad range of labor, firm, and consumer outcomes. We link national data on nursing home characteristics from the Centers for Medicare and Medicaid Services to records on establishment-level unionization from federal labor agencies, and employ a regression discontinuity design to identify union effects by contrasting outcomes in nursing homes where unions closely won representation elections to outcomes in facilities where unions closely lost such elections. After showing that these two sets of homes are similar leading up to the election, we estimate union effects on staffing levels, care quality, and other outcomes. We find negative effects of unions on staffing levels and no decline in care quality, suggesting positive productivity effects. Consistent with these results, supplementary analysis shows significant increases in wages for some classes of nursing labor. Some evidence suggests that nursing homes in local product markets that were less competitive and had lower union density at the time of election experienced stronger union employment effects. We find no impact of unionization on facility survival. By combining credible identification of union effects, a comprehensive set of outcomes over time with measures of market-level characteristics, this study generates some of the best evidence available on many controversial questions in the economics of unions. Furthermore, it generates evidence from the service sector, which has grown in importance and where evidence on these questions has been thin.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoPaper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 17733.
Date of creation: Jan 2012
Date of revision:
Note: HC LS
Contact details of provider:
Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
Web page: http://www.nber.org
More information through EDIRC
Find related papers by JEL classification:
- I12 - Health, Education, and Welfare - - Health - - - Health Production
- J51 - Labor and Demographic Economics - - Labor-Management Relations, Trade Unions, and Collective Bargaining - - - Trade Unions: Objectives, Structure, and Effects
This paper has been announced in the following NEP Reports:
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Hirsch, B.T. & Scumacher, E.J., 1996.
"Union Wages, Rents, and Skills in Health Care Labor Markets,"
1996_03_02, Department of Economics, Florida State University.
- Barry T. Hirsch & Edward J. Schumacher, . "Union Wages, Rents, and Skills in Health Care Labor Markets," Working Papers 9603, East Carolina University, Department of Economics.
- Barry T. Hirsch & Edward J. Schumacher, . "Union Wages, Rents, and Skills in Health Care Labor Markets," Working Papers 9721, East Carolina University, Department of Economics.
- Barry T. Hirsch & Edward J. Schumacher, .
"Unions, Wages, and Skills,"
9606, East Carolina University, Department of Economics.
- David S. Lee & Thomas Lemieux, 2009.
"Regression Discontinuity Designs in Economics,"
NBER Working Papers
14723, National Bureau of Economic Research, Inc.
- Richard B. Freeman & Morris M. Kleiner, 1994.
"Do Unions Make Enterprises Insolvent?,"
NBER Working Papers
4797, National Bureau of Economic Research, Inc.
- Elhanan Helpman & Paul Krugman, 1987. "Market Structure and Foreign Trade: Increasing Returns, Imperfect Competition, and the International Economy," MIT Press Books, The MIT Press, edition 1, volume 1, number 026258087x, November.
- Gertler, Paul J & Waldman, Donald M, 1992. "Quality-Adjusted Cost Functions and Policy Evaluation in the Nursing Home Industry," Journal of Political Economy, University of Chicago Press, vol. 100(6), pages 1232-56, December.
- Daron Acemoglu & Jorn-Steffen Pischke, 1999.
"The Structure of Wages and Investment in General Training,"
Journal of Political Economy,
University of Chicago Press, vol. 107(3), pages 539-572, June.
- Acemoglu, Daron & Pischke, Jörn-Steffen, 1998. "The Structure of Wages and Investment in General Training," CEPR Discussion Papers 1833, C.E.P.R. Discussion Papers.
- Acemoglu, D. & Pischke, J.S., 1997. "The Structure of Wages and Investment in General Training," Working papers 97-24, Massachusetts Institute of Technology (MIT), Department of Economics.
- Daron Acemoglu & Jorn-Steffen Pischke, 1998. "The Structure of Wages and Investment in General Training," NBER Working Papers 6357, National Bureau of Economic Research, Inc.
- Thomas J. Holmes, 2006.
"Geographic spillover of unionism,"
368, Federal Reserve Bank of Minneapolis.
- Farber, H.S. & Abowd, J.M., 1990. "Product Market Competition, Union Organizing Activity, And The Employer Resistance," Working papers 551, Massachusetts Institute of Technology (MIT), Department of Economics.
- Booth,Alison L., 1994.
"The Economics of the Trade Union,"
Cambridge University Press, number 9780521464673.
- Hirsch, Barry T., 2003.
"What Do Unions Do for Economic Performance?,"
IZA Discussion Papers
892, Institute for the Study of Labor (IZA).
- John R. Bowblis, 2011. "Ownership conversion and closure in the nursing home industry," Health Economics, John Wiley & Sons, Ltd., vol. 20(6), pages 631-644, June.
- Richard B. Freeman & Morris M. Kleiner, 1990. "The Impact Of New Unionization On Wages And Working Conditions: A Longitudinal Study Of Establishments Under NLRB Elections," NBER Working Papers 2563, National Bureau of Economic Research, Inc.
- Stewart, M.B., 1989.
"Union Wage Differentials, Product Market Influences And The Division Of Rents,"
The Warwick Economics Research Paper Series (TWERPS)
323, University of Warwick, Department of Economics.
- Stewart, Mark B, 1990. "Union Wage Differentials, Product Market Influences and the Division of Rents," Economic Journal, Royal Economic Society, vol. 100(403), pages 1122-37, December.
- Dustmann, C. & Schonberg, U., 2009.
"Training and Union wages,"
Open Access publications from University College London
http://discovery.ucl.ac.u, University College London.
- Cawley, John & Grabowski, David C. & Hirth, Richard A., 2006. "Factor substitution in nursing homes," Journal of Health Economics, Elsevier, vol. 25(2), pages 234-247, March.
- David G. Blanchflower & Alex Bryson, 2004. "What Effect Do Unions Have on Wages Now and Would Freeman and Medoff Be Surprised?," Journal of Labor Research, Transaction Publishers, vol. 25(3), pages 383-414, July.
- Reynolds, Morgan O, 1986. "Trade Unions in the Production Process Reconsidered," Journal of Political Economy, University of Chicago Press, vol. 94(2), pages 443-47, April.
- Freeman, Richard Barry & Kleiner, Morris M., 1990.
"The Impact of New Unionization on Wages and Working Conditions,"
4632238, Harvard University Department of Economics.
- Freeman, Richard B & Kleiner, Morris M, 1990. "The Impact of New Unionization on Wages and Working Conditions," Journal of Labor Economics, University of Chicago Press, vol. 8(1), pages S8-25, January.
- Mellow, Wesley S, 1981. "Unionism and Wages: A Longitudinal Analysis," The Review of Economics and Statistics, MIT Press, vol. 63(1), pages 43-52, February.
- McDonald, Ian M & Solow, Robert M, 1981. "Wage Bargaining and Employment," American Economic Review, American Economic Association, vol. 71(5), pages 896-908, December.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ().
If references are entirely missing, you can add them using this form.