We examine the effect of unions on the earnings of health care workers
, with emphasis on the measurement and sources of union wage premiums.
Using data constructed from the 1973 though 1994 Current Population S
urveys, standard union premium estimates are found to be substantially
lower among workers in health cure than in other sectors of the econo
my, and to be smaller among higher skill than among lower skill occupa
tional groups. Longitudinal analysis of workers switching union status
, which controls for worker-specific skills, indicates a small impact
of unions on earnings within both high and low skilled health care occ
upations. Evidence is found for small, but significant, union threat e
ffects in health care labor markets. It has been argued that recent le
gal changes in bargaining unit determination should enhance union orga
nizing and bargaining power. Although we cannot rule this out, such ef
fects are not readily apparent in our data.