Measure 7 is something that has come up on the ballot before in North Dakota: removing the requirement that all pharmacies must be owned by a licensed pharmacist.  This time it seems like it may really have some momentum.  I just got my mind blown in such a way that I have switched from a lifelong YES vote on this to a sound NO.  Why?  The answer will blow you away.

First, let me say that I believe that anyone who wants to operate a business in North Dakota should be able to do so.  I’ve always believed that, and it’s been the core principle behind my opposition to North Dakota’s pharmacy laws.  I’ve voted in favor of changing this every time it’s come up on the ballot.  This time around, however, I was wavering a bit, and I don’t know why. Something just didn’t seem quite right.  More on that later.

I’d classify most pro-Measure 7 folks in three broad categories:

• Those who believe in freedom to open and operate a business, no matter who you are (this was me);
• Those who believe that all medications are going to become cheaper because of more competition;
• Those who stand to profit from the measure.

Like I said, in principle I would have voted yes simply because of the first item.  I’m not so sure that prices will come down as the second group of people believe.  But the third one is the one that didn’t make sense until today.

CVS operates pharmacies in the state.  White Drug does, too.  I bought most of my Atari cartridges and lots of my Star Wars action figures in an Osco.  So what gives?  Why do the “big box” stores claim they can’t operate here?  The answer is so simple and so complicated at the same time that it would never have occurred to me until Matt Evans wrote about it on my friend Rob’s blog.

In that article, Matt pulls back the curtain and reveals that there is no free market in this matter.  The big box stores negotiate with insurance companies for the ability to get certain medications covered, with state regulations giving them the muscle.  This artificially distorts the market, obviously.

So what happens if Measure 7 passes?  The “big box” stores go straight to the insurance companies, negotiate the same thing with them as they do in other states, and the next time you want to get your prescription covered you find out that it won’t be – unless you go to Big Box Pharmacy.

Naturally this stinks for a number of folks:

• My favorite pharmacist, who gives GREAT prices and personal service;
• Senior citizens who are on Medicare Part D and have to abide by it;
• People who don’t live within 25 miles of Big Box Pharmacy and who’ll have to drive to one to get covered medications.

No wonder the bigs have been pouring millions into this issue: rather than it being a matter of free markets, it’s a matter of rigging the game in their favor!  In the guise of making more free, open competition available to drive prices down for the consumer, it’s actually a way to subvert the free market using the state-regulated insurance industry as a crowbar to leverage things in their favor.

I went from a 100% principled YES in this matter to a 100% NO in a matter of seconds after I read this.  If a YES vote would result in true freedom of competition and no protectionism, I’d cast it…but it would do exactly the opposite.

Make sure you read Matt Evans’ post on Say Anything.  It’s a real eye opener.  Cast your NO vote to stop government-enforced cronyism from coming between you, your pharmacist, and your prescriptions.  Otherwise the next time you want to support your local pharmacist, you may be doing it with your own money instead of the insurance coverage you already paid for.