Saturday, June 15, 2024

Union Drive at Labcorp Is the Latest in a String of Health Care Organizing Wins

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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.

Parasitizing U.S. Health Care

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 technicians and assistants, the inpatient (in-hospital) and outpatient staff at Labcorp facilities have still been affected. They face extreme workloads, forcing them to work at a pace that can induce safety concerns.

After all, not only is COVID an omnipresent threat for any health care worker interacting with infected patients, but Labcorp techs also deal with all manner of biohazards and disease vectors, to say nothing of the risk to blood-draw patients posed by overworked and stressed staff. (COVID, while significantly intensifying the risk to its low-paid employees, was also, unsurprisingly, a tremendous boon to the corporation’s profits.)

For all the challenges they face, and despite their professional training, Labcorp employees from phlebotomists to sample couriers are poorly remunerated. Technician salaries in Oregon can be startlingly low; according to the crowdsourced salary site Indeed (and corroborated by other sources), phlebotomist pay has been reported at as little as $18.20 per hour. Specimen accessioners, clinical assistants, histology technicians, sample processors, and those in other jobs are widely reported to make $17 to $23 an hour, or only around $40,000 a year, which, especially for the Portland area, is hardly a living wage. Phlebotomists are making about the same pay as Labcorp customer service call center representatives. Labcorp CEO Adam Schechter, for his part, is paid in salary and benefits to the tune of $16 million a year.

Oregon’s “White Coat Labor Movement”

One critical element of context for the Labcorp drive is the impending and massive merger of Legacy Health assets with the Oregon Health & Science University, which will create the largest employer in Portland. Accordingly, there has been something of a shake-up going on at Legacy Health facilities. The threat of job loss or contract revisions accompanying the sale has led quite a few medical workers to recognize the power they can potentially exert over their own circumstances.

It was only toward the end of 2023 that Legacy Health doctors scored their own overwhelming union victory across six Oregon and Washington locations, certified by the National Labor Relations Board (NLRB) on November 17. In fact, frontline health workers in the Pacific Northwest have been on a significant run of unionization across the span of only a year, to the extent that the process has earned the moniker “the white coat labor movement.” The latest installment came earlier this month, as another crop of doctors, physician assistants and nurse practitioners at Legacy’s Primary Care Clinics announced to management their intent to seek a union, explicitly citing their desire to have “a voice in the controversial merger,” as The Columbian described it.

So far, the organizing wave has been made up of “advanced practice providers” — higher-tier workers like doctors and nurses, who have been joined by mental and behavioral health workers, and, at Legacy Health’s women’s clinics, by “nurse practitioners, certified nurse-midwives, registered nurses, social workers and genetic counselors,” among others, per a press release from the Oregon Nurses Association.

New spates of health care organizing, however, are far from limited to the Oregon-Washington area: In concert with the neoliberalization of health care and the corresponding corporate-driven degradation of conditions, physicians, who until recent times were rarely unionized in the U.S., have also been organizing at a remarkable rate. In other words, the Labcorp drive is only the latest outgrowth of a labor organizing ferment. What is new about this victory is that it has taken place among lower-paid workers at a private medical contractor, rather than advanced practitioners working under the auspices of a hospital.

Labcorp employees, newly unionized, spoke with Truthout about their organizing efforts, working conditions and clumsy management missteps that generated such comprehensive assent in the seven Oregon labs. The fact that the high affirmative rate was sustained across multiple Legacy Health locations also attests to the systemic nature of the underlying issues.

Kayleigh Sisson is a Labcorp phlebotomist at an outpatient Labcorp facility in the Woodburn, Oregon, area, though she sometimes also staffs locations in Tualatin. Speaking to Truthout, she talked about her role in winning a union for her coworkers. Recruited to the effort by a coworker, Sisson would come to play an important role, spearheading new avenues of communication with fellow Labcorp employees, many of whom are lab assistants scattered across outpatient facilities; their job is to collect samples to send to the technicians who work at hospital facilities in inpatient labs.

Sisson is one of the former outpatient phlebotomists who takes samples for hospital techs. Among her cohort of lower-paid assistants who draw blood and collect specimens at Labcorp facilities scattered across the country, the incessant overwork has primed conditions for organizing. As she underscored, “There’s low wages and instability among the lab professionals. It ensures that short staffing continues.”

A feedback loop is in place: Excessive workloads and low pay keep applicants away from the job, creating short-staffed conditions, and thereby sustaining the excessive workloads. Outcomes are worsened for patients and employees alike; as Sisson aptly summarized, “When you work with short staff, there’s a greater risk of everything.”

Meagan Hollis is a medical laboratory scientist at the blood bank at Legacy Health’s Good Samaritan facility, one of the seven Labcorp sites that unionized. In an email to Truthout, she shared a little more about her role as a frontline essential worker providing a critical, lifesaving service, and what drove her and her coworkers to band together:

Essentially, it was the feelings of uncertainty and feeling powerless in [our] workplace. All seven sites decided to collectively come together to try and get that equal seat at the table with our employer.… Lab professionals are sort of a hidden profession. We aren’t visible to the public, but laboratory results are involved in around 70 percent of medical decision-making. We see the patients as our patients too and care deeply about the direction of our profession. By unionizing, we feel we can get the respect and recognition we deserve. Increased pay, better benefits and safe staffing help creating happier employees who will produce higher quality results, leading to overall better outcomes and patient care.

Labcorp management, on the other hand, feels otherwise. Truthout reviewed an internal company policy document that made management’s thoughts on the matter abundantly clear, if utterly predictable; it states: “The Company believes that a union-free environment is in the best interests of the employees and the Company. In short, we do not think Company employees need a union.”

Labcorp workers Hollis and Sisson both individually pointed out that the decision by management to contract specialty anti-union consultants (a boutique industry in its own right, as previously reported by Truthout) was as oblivious to conditions for workers as it was counterproductive. Each described being subjected to long captive audience meetings where consultants lectured about the excesses of unions and the degradations of pay and work conditions that would surely ensue were employees to unionize. Consultants listed reasons why a union is “not right for us,” and, Sisson said, repeated the reliable catchphrase, “We’re all a family here.”

Hollis confirmed in an email to Truthout that, at her location, “Several consulting firms across the country [spoke] to us at meetings over several weeks. Although, I do believe the consultants wanted to provide some education on the law, it was clear to everyone from the beginning they were not a neutral party.”

Sisson also said that at her location, the fact that the meetings gathered workers together actually created an opportunity for the union advocates; they were able to address their coworkers as a group and countermand the anti-union narrative with questions and comments. Both cited a general frustration with the imposition of the mandatory meeting, which, with a touch of irony, worsened, at least for the day, the overburdened workload that had catalyzed the union drive in the first place.

“I had to go to three meetings, and I was pulled out for about an hour and a half each meeting — to listen to them educate us,” said Sisson, with acrid sarcasm. “It created a lot of frustration. It almost helped solidify us more. We came in with a plan: We wanted all these people around, so let’s use these meetings to our advantage, and kind of fact check [the consultants] — and also bring our issues and see how they respond to it.”

Hollis agreed: “It backfired in that people resented that the meetings took us away from our work — which for people who may have been open-minded, it may have had an impact on their feelings toward the anti-union messaging in those meetings.”

The anti-union consultants, according to a hiring contract with Labcorp that was reviewed by Truthout, worked for companies with unsettlingly innocuous names like “Progressive Labor Solutions LLC,” “Reliant Labor Consultants” and “Innovative Employee Solutions.” It’s obvious that such anodyne euphemisms are a limp effort to cover up the nature of their work — i.e. union-busting.

Broadening Medical Union Horizons

These early forays into lab unionizing will certainly not remain confined to Portland. A similar effort is underway elsewhere in the Pacific Northwest, to the north in Seattle, where Labcorp workers represented by the United Food and Commercial Workers Local 3000 have been bargaining with management for better pay and a solution to short-staffing issues. And last October, across the country in Atlanta, Georgia, laboratory workers at Quest Diagnostics faced down an “aggressive” anti-union campaign and successfully joined Teamsters Local 728.

On top of that, a contingent of workers at PeaceHealth Southwest Medical Center in Vancouver, Washington, are in the midst of a union vote to join the Washington State Nurses Association (WSNA). As of this writing, their NLRB election, which began May 6, is currently ongoing. There has been little progress on securing gains on promised wages, benefits and working conditions. On May 10, the WSNA filed an unfair labor practice charge with the NLRB, claiming that management had disparaged the union, threatened employees for wearing union T-shirts and bargained in bad faith.

The set of employees at PeaceHealth is not dissimilar to Labcorp workers in that it includes ancillary nondoctor, nonnurse medical employees. According to Mallory Gruben writing for Northwest Labor Press, the PeaceHealth group of 300 includes “audiologists, behavioral health workers, bereavement counselors, chaplains, physiologists, pharmacists, counselors, dieticians, physical therapists, speech-language pathologists, and psychologists.”

Their ambition is to join an American Federation of Teachers affiliate called the Oregon Federation of Nurses and Health Professionals, which “already represents about 1,400 hospital techs and service and maintenance workers at PeaceHealth Southwest,” Gruben noted. And, as reported in the same article, PeaceHealth management’s response was to bring in the high-priced boutique anti-union law firm Ogletree Deakins.

As the latter point evidences, the series of events that recently swept through Northwestern Labcorp locations contained few surprises, save for perhaps the completeness of its victory — with, again, 86 percent of Labcorp employees voting to unionize. The landslide probably came as quite the shock to the corporate overseers who had paid a premium for the anti-union consultants.

All this is to say that the Labcorp victory is in keeping with the same patterns being seen across the health care system: Privatization and the profit motive degrade pay and working conditions, leading workers to mull the idea of asserting their power — to which administrations respond with a vicious backlash, using all manner of union-busting subterfuge, disinformation and intimidation tactics, up to and including the hiring of third-party anti-union specialists. (These are, ironically, the very definition of “outside agitators” and third parties — the same terms with which they attempt to smear unionists.)

Organizing and counterorganizing are, of course, the timeless cycle of labor. But for health care workers in the Pacific Northwest and elsewhere, the ultimate outcome is proving to be reliable wins for workers. The multiple overlapping union efforts at Legacy Health and elsewhere have a multiplicative effect, both inspiring and pragmatically supporting one another.

As Hollis noted, “We took so much inspiration from our colleagues in the Tech unit at PeaceHealth, the Lab Pros at PeaceHealth St. John, Legacy Meridian Park, the Legacy Hospitalists and our Kaiser colleagues. Their organizing efforts and contracts they have been able to secure not only inspired the organizing committee, but their success and letters of support meant a lot to our coworkers deciding how to vote.”

Kayleigh Sisson also referred to a letter of solidarity sent to her workplace by Legacy Health doctors, and just how meaningful that was to Labcorp staff. Sisson remarked on her hopes for the future of the laboratory worker organizing drive: “I would love to see all health care professionals from caregivers all the way up to doctors unionize. I would love to see every employer value and give a voice to the employees…. I hope to continue to see a rise in unions everywhere. I would love for employees to have their voices heard.”

Solidarity was already resonant throughout Labcorp’s embattled workforce, a result of the everyday struggles, the common ground and the hopes shared between them. It was for this reason above all that corporate intervention proved ineffective, and actually galvanizing to the union. Asked about Labcorp management’s attempt to quash her and her fellow organizers, Sisson remarked, “I guess they didn’t realize how united lab workers were already.”

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