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Technology, skills, and health care labor markets

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I examine the role of technological change in health care labor markets. One of the biggest issues in the U.S. economy over the recent past has been rapidly rising health care costs. Conventional wisdom holds the main factor driving these costs increases has been technological change. These changes in technology have lead to a direct transformation in the delivery of health care and have also lead to indirect transformations through the reshaping of the private and public insurance industry. My findings are consistent with the idea that technological change has resulted in an increase in demand for higher skilled workers in the industry, while being labor-saving among low-skill workers. The earnings of RNs and health therapists rose rapidly over the 1983 to 1993 period, declined between 1993 and 1996, but then began to rise again after 1996. It is generally believed that managed care has had a one-time cost reducing effect in the industry by eliminating some of the inefficiencies associated with fee-for-service health insurance (Newhouse, 1992). The results here suggest a similar finding in the labor market.

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References

  • Acemoglu, Daron. “Technical Change, Inequality, and the Labor Market.” National Bureau of Economic Research, Working Paper #7800, July 2000.

  • American Nurses Association. “ANA Applauds Historic Affiliation between UAN, AFL-CIO.” Press Release, www.ana.org, June 28, 2001.

  • Autor, David, Lawrence Katz, and Alan Krueger. “Computing Inequality: Have Computers Changed the Labor Market?” Quarterly Journal of Economics 113 (November 1998): 1169–214.

    Article  Google Scholar 

  • Baker, Laurence. “Managed Care and Technology Adoption in Health Care: Evidence from Magnetic Resonance Imaging.” National Bureau of Economic Research, Working Paper #8020, November 2000.

  • -and Ciaran S. Phibbs. “Managed Care, Technology Adoption, and Health Care: The Adoption of Neonatal Intensive Care.” National Bureau of Economic Research, Working Paper #7883, September 2000.

  • Baker, Lawrence and Joanne Spetz. “Managed Care and Medical Technology Growth.” National Bureau of Economic Research, Working Paper #6894, January 1999.

  • Bartel, Ann P. and Nachum Sicherman. “Technological Change and Wages: An Inter-Industry Analysis.” Journal of Political Economy 107 (April 1999): 285–325.

    Article  Google Scholar 

  • Blau, Francine D. and Lawrence M. Kahn. “Gender Differences in Pay.” Journal of Economic Perspectives 14 (Fall 2000): 75–99.

    Article  Google Scholar 

  • Chernew, Michael E., Richard A. Hirth, Seema S. Sonnad, Rachael Ermann, and A. Mark Fendrick. “Managed Care, Medical Technology, and Health Care Cost Growth: A Review of the Evidence.” Medical Care Research and Review 55 (September 1998): 259–88.

    Article  Google Scholar 

  • Cutler, David M. and Mark McClellan. “The Determinants of Technological Change in Heart Attack Treatment.” National Bureau of Economic Research, Working Paper #5751, September 1996.

  • Cutler, David M., and Louise Sheiner. “Managed Care and the Growth of Medical Expenditures.” In A.M. Garber, ed. Frontiers of Health Policy Research. Cambridge, Mass.: MIT Press, 1998.

    Google Scholar 

  • Demsetz, Rebecca S. “Voting Behavior in Union Representation Elections: The Influence of Skill Homogeneity.” Industrial and Labor Relations Review 47 (October 1993): 99–113.

    Article  Google Scholar 

  • Dranove, David, Mark Shanley, and William D. White. “Price and Concentration in Hospital Markets: The Switch from Patient-Driven to Payer-Driven Competition.” Journal of Law and Economics 36 (April 1993): 179–204

    Article  Google Scholar 

  • Dranove, David and William D. White. “Recent Theory and Evidence on Competition in Hospital Markets.” Journal of Economics and Management Strategy 3 (Spring 1994): 169–209.

    Google Scholar 

  • Engel, Cynthia. “Health Services Industry: Still a Job Machine?” Monthly Labor Review 122 (March 1999): 3–14.

    Google Scholar 

  • Farber, Henry S. and Daniel H. Saks. “Why Workers Want Unions: The Role of Relative Wages and Job Characteristics.” Journal of Political Economy 88 (April 1980): 349–69.

    Article  Google Scholar 

  • Fuchs, Victor. “Economics, Values, and Health Care Reform.” American Economic Review 86 (March 1996): 1–24.

    Google Scholar 

  • Freudenheim, Milt and Linda Villarosa. “Nursing Shortage Is Raising Worries on Patients' Care.” New York Times, NYTimes.com, April 8, 2001.

  • Gaynor, Martin and Deborah Haas-Wilson. “Change, Consolidation, and Competition in Health Care Markets.” Journal of Economic Perspectives 13 (Winter 1999): 141–64.

    Article  Google Scholar 

  • Health Insurance Association of America. “Technology May Account for a Third of Projected Health Spending Increases.” www.hiaa.org/news/news-current/news-current.htm, March 6, 2001.

  • Hirsch, Barry T. “The Interindustry Structure of Unionism, Earnings, and Earnings Dispersion.” Industrial and Labor Relations Review 36 (October 1982): 22–39.

    Article  Google Scholar 

  • — and David A. Macpherson. Union Membership and Earnings Data Book: Compilations from the Current Population Survey (1999 Edition). Washington, D.C.: Bureau of National Affairs, 1999.

    Google Scholar 

  • — and David A. Macpherson. “Union Wages, Rents, and Skills in Health Care Labor Markets.” Journal of Labor Research 19 (Winter 1998): 125–47.

    Google Scholar 

  • InterStudy. The Competitive Edge 9.1: HMO Industry Report, St. Paul, Minn.: InterStudy Publications, April 1999.

    Google Scholar 

  • Jensen, Gail A., Michael A. Morrisey, Shannon Gaffney, and Derek K. Liston. “The New Dominance of Managed Care: Insurance Trends in the 1990s.” Health Affairs 16 (January/February1997): 125–36.

    Article  Google Scholar 

  • Javanovic, Boyan and Yaw Nyarko. “The Transfer of Human Capital.” Journal of Economic Dynamics and Control 19 (July–September 1995): 1033–64.

    Article  Google Scholar 

  • Krueger, Alan B. “How Computers Have Changed the Wage Structure: Evidence from Microdata, 1984-1989.” Quarterly Journal of Economics 108 (February 1993): 33–60.

    Article  Google Scholar 

  • The Lewin Group, Inc. Managed Care Savings for Employers and Households: 1990 through 2000. Prepared for the American Association of Health Plans, May 23rd. 1997.

  • Mincer, Jacob, and Stephan Danninger. “Technology, Unemployment, and Inflation.” National Bureau of Economic Research, Working Paper #7817, July 2000.

  • Newhouse, Joseph P. “Medical Care Costs: How Much Welfare Loss?” Journal of Economic Perspectives 6 (Summer 1992): 3–21.

    Google Scholar 

  • O'Neill, June and Solomon Polachek. “Why the Gender Gap in Wages Narrowed in the 1980s.” Journal of Labor Economics 11 (January 1993): 205–28.

    Article  Google Scholar 

  • Schumacher, Edward J. “The Earnings and Employment of Nurses in an Era of Cost Containment.” Industrial and Labor Relations Review 55 (October 2001): 116–320.

    Article  Google Scholar 

  • —. “Relative Wages and the Returns to Education in the Labor Market for Registered Nurses.” In Solomon W. Polachek, ed. Research in Labor Economics 16 Greenwich, Conn.: JAI Press Inc. 1997, pp. 149–76

    Google Scholar 

  • Simon, Carol J., David Dranove, and William D. White. “The Effect of Managed Care in the Incomes of Primary Care and Specialty Physicians.” Health Services Research 33 (August 1998): 549–69.

    Google Scholar 

  • Spetz, Joanne. “What Should We Expect from California's Minimum Nurse Staffing Legislation?” Journal of Nursing Administration, forthcoming.

  • -. “The Value of Education in a Licensed Profession: The Choice of Associate or Baccalaureate Degrees in Nursing.” Economics of Education Review, forthcoming.

  • Zachary, G. Pascal. “Poor Nations Lose Nurses to Rich Ones, Showing Globalization of Labor Market.” Wall Street Journal, WSJ.com, January 24, 2001.

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I appreciate helpful comments from Laurence Baker, James Bennett, Ann Frost, Barry Hirsch, Joanne Spetz, and Daphne Taras.

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Schumacher, E.J. Technology, skills, and health care labor markets. J Labor Res 23, 397–415 (2002). https://doi.org/10.1007/s12122-002-1043-1

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