Doctoral Dissertation Research: Healthcare Markets and Labor Structure

本研究分析医疗保健服务商业化对医疗保健劳动力的影响，特别是医疗保健员工工会和专业协会的结构、策略和增长。虽然近几十年来整个私营部门的工会密度一直在下降，但自20世纪90年代初以来，医疗保健工作者工会一直在大幅增长。这一增长与医疗保健行业的强劲市场渗透相吻合，医疗保健服务系统迅速集中和公司化，专业医生的传统自主权下降。本研究着眼于加州医疗保健工作人员工会化的历史，这是一个这些趋势特别强烈的州，为了探索工人暴露于市场力量和工会的兴衰之间的联系。该研究结合了人口普查数据和原始联盟成员数据集的定量分析，以及使用文件档案和口述历史的比较历史调查。这将能够创建医疗保健组织变化状态的详细描述，并允许分析医疗保健提供结构如何影响劳动力。医疗保健组织和政策是学术、政策和公共利益的主题。向市场治理转变对医疗保健员工及其组织的影响是该行业的核心组成部分。评估关于医疗保健向市场治理转变的假设可能刺激和/或为工会发展提供了机会，可以为有关产业组织的社会学理论提供信息，并可能影响对医疗保健政策的理解。

This research analyzes the effect of the commercialization of healthcare delivery on the healthcare labor force, specifically the structures, strategies, and growth of healthcare employees' unions and professional associations. While labor union density has been in decline throughout the private sector in recent decades, healthcare workers unions have been growing substantially since the early 1990s. This growth has coincided with a period of strong market penetration into the healthcare industry, with rapid concentration and corporatization of healthcare delivery systems, and a decline in the traditional autonomy of professional physicians. This research looks into the history of the unionization of the healthcare workforce in California, a state where these trends were particularly strong, in order to explore the connections between the exposure of workers to market forces and the growth and decline of unions. The study combines quantitative analysis of census data and an original union membership dataset with a comparative historical investigation using document archives and oral histories. This will enable the creation of detailed descriptions of the changing state of healthcare organization and allow for an analysis of how healthcare delivery structures affect the labor force. Healthcare organization and policy is a subject of academic, policy, and public interest. The effects of shifts toward market governance on healthcare employees and their organizations are central components of the industry. Assessing hypotheses about healthcare's shift toward market governance may have stimulated and/or provided opportunities for labor union growth can inform sociological theories about industrial organization and may impact understandings of healthcare policy.