Laboratory technicians and assistants at Oregon locations of the multibillion-dollar multinational testing chain Laboratory Corporation of America Holdings (better known as Labcorp) took part in a groundbreaking union election this month. The results came in with a resounding win for labor, as all seven locations involved in the election voted to unionize.

The percentage of workers that voted to unionize in the May 1-3 election was, if not totally unprecedented, at least remarkably high at 86 percent; for a union election, such a rate is practically unanimous. Several factors underlie the widespread assent found among Labcorp employees — their resounding certainty regarding the necessity of a union speaks to both the effectiveness of organizers and the camaraderie and solidarity among staff, as well as the difficult conditions in which they labor.

Ham-fisted interventions by management in hopes of stymying the union proved counterproductive, and laboratory workers would later describe feelings of jubilation as the affirmative results poured in. With numerous medical organizing campaigns ongoing in the Pacific Northwest, and with stirrings of similar efforts elsewhere, unionists see cause for optimism around this new turf as the tide of health care unionization among doctors, nurses and other high paid professionals begins to reach less-unionized laboratory workers at private companies.

To understand why this victory among Oregon Labcorp workers was so sweeping, it’s important to consider how their working conditions reached their present state — which means considering the structural role of companies like Labcorp and their place amid a number of shifts underway in U.S. medical labor.

The domestic health care field has infamously seen the profit motive become the guiding principle of operations. Part and parcel of the neoliberal era of deregulation and rapacious profiteering, the nonprofit roots of the health care sector have been left behind as a new class of profit-focused administrators and private equity vultures have set about inflating higher-ups’ salaries, “upcoding” to wildly escalate patient costs and instrumentalizing hospital property and assets as capital for investment. Their destructive operations have been intertwined with the influences of insurance profiteering, medical device corporations, and innumerable other factors that have made U.S. health care both the most expensive and the worst among capitalist countries in the Global North. As facilities have transformed from nonprofit public goods into profiteering entities more akin to investment funds, patients have suffered immensely from poor outcomes and tumbling life expectancy — and have gone bankrupt in exchange.

Of course, health care employees have also paid the cost of enriching investors. In response to the intensifying workloads, staffing shortages, shrinking pay rates, schedule demands and general precarity accompanying the rise of the “travel nursing” model, waves of nurses have joined together to collectively bargain. Nursing, especially in recent decades (and with the pandemic serving as an inflection point), has been a critical front for organizing medical labor, with remarkable success.

Labcorp is a noteworthy example of the kind of corporations that have risen up around the privatization that has come to dominate health care. Hospital laboratories — which draw blood and take samples to conduct routine biometric tests of all kinds, from toxicology to disease screening to genome analysis, with all the safety precautions and responsibility to accuracy that such work entails — were traditionally part of the wall-to-wall workforces at individual hospitals, operating under the nonprofit banner.

However, with hospital administrations increasingly feeling themselves obligated to cut costs wherever possible on everything from equipment to skilled labor to serve the purposes of investment returns, a new market has been pried open. Now, a hospital lab’s responsibilities can be outsourced to one of a few properly equipped private companies. Swelling in size thanks to a series of mergers and acquisitions (another signature of the neoliberal era in medicine), Labcorp went public on the NASDAQ, and eventually, along with competitors like Quest Diagnostics, bloated into one of the world’s preeminent laboratory networks. It is now a ubiquitous contractor for all manner of U.S. health care services, from major hospitals to private practices.

Labcorp operates on a high-volume model, processing millions of tests weekly, and relying heavily on automating procedures while keeping the minimum possible skeleton crew of low-paid staff to slash labor costs. While the staffing shortage seen among highly trained workers like nurses did not have as extreme an impact on laboratory........

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