Three Essays on Market Structure Variation and Labor Market Outcomes.

Abstract

This dissertation consists of three chapters focusing on market structure variations and labor market outcomes in the health care sector. Chapter 1 estimates the labor market outcomes--employment and wages--of two types of hospital consolidation: mergers and system-joinings. It uses a difference-in-difference approach and propensity-score weighting to correct for selection bias in my analyses, which rely on data from 1983-2009. Large and persistent employment decreases are found following a hospital merger, but much smaller decreases are found following a system-joining. There is zero wage effect from either type of consolidation, suggesting that the employment decreases are driven by efficiency gains rather than an increase in monopsony power. Chpater 2 (with Kevin Stange) examines the effects of the Nurse Licensure Compact (NLC) on the nurse labor market. The NLC was introduced to reduce licensing burdens by permitting registered nurses living in member states to practice across state lines in other NLC member states. The staggered adoption of the NLC across states and over time is exploited to examine whether a reduction in licensure-induced barriers alters the likelihood of cross-state commuting, commuting times, and labor force participation. The results indicate no effect of adoption on labor force participation. However, there are positive effects of adoption on travel time to work and on the likelihood of working across state lines, particularly among nurses living in MSAs that cross state boundaries, suggesting that eliminating cross-state licensure restrictions expands the geographic scope of the nurse labor market. Chapter 3 (with Mario Macis) examines the effects of obesity on wages and employment levels. The results from previous studies are confirmed-- obese white females suffered a wage and employment penalty in the period 1989-2000. However, these wage penalties disappeared after the year 2000. This chapter also distinguishes between competing explanations for the wage and employment penalties by examining the wages of obese individuals in regions with relatively higher BMIs. The findings are consistent with explanations based on labor market discrimination against obese females, whereas they are not consistent with explanations based on higher health care costs.