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.
