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Berginski: Vote ‘no’ on Measure 7

By Staff | Oct 3, 2014

I’m going to be as honest and as forthcoming as I can be here: very few of the measures on next month’s ballot interest, let alone impress, me. The only measures I’ve taken an interest in this year are Measures 3 and 7. This column is about the latter.

A “yes” vote on Measure 7 would allow big retailers like Wal-Mart, Walgreens and the like to operate pharmacies in this state. I know what you’re thinking: “But Bryce, aren’t there some big box stores that have pharmacies already?” Yes, there are. Take Fargo for example. There’s a pharmacy in the Wal-Mart on 13th Avenue there. CVS has a foothold in the state because they bought a bunch of Osco Drug stores in the ’60s. Let me break it down for you.

Section 43-15-35(e) of the North Dakota Century Code (which the legislature passed in 1963) requires a licensed pharmacist own 51 percent, or the majority stock, of a pharmacy. Currently, a pharmacy can exist in a Wal-Mart, or even a Pamida, as there used to be one here, as long as it meets that guideline. Hospital pharmacies, post-graduate training programs and “grandfathered in” stores, like CVS, are the only exceptions. Measure 7 would repeal that and allow those businesses to operate their own pharmacies.

Supporters of Measure 7 love to point out the fact that health care and prescription drug costs are rising, and North Dakota isn’t immune. To that end, they cite a Kaiser Foundation study in which North Dakotans per capita spend just over $3,000 on hospital care, about $1,300 on physician services and $1,185 on prescription drugs. Sounds expensive, doesn’t it? However, the Kaiser study supporters cite information that only goes up to 2009. A lot can change in five years, including the cost of prescription drugs. In fact, in a Reuters article from last month, a survey of independent pharmacies in the state compared the price of a 30-day supply of clopidogrel (a blood thinner). Prices at these pharmacies ranged from $10 to $60, versus $150 at a CVS in Bismarck. Also of those prices, how much of that was due, in part, to insurance? You pay a lot less out of pocket with insurance than you do without.

Supporters also point out the convenience factor. For some, it would no doubt be easy to pick up prescriptions in the same place they buy groceries. True, but then again, how crazy are the roads going west? Who around here has said Minot, for example, is terrible and wouldn’t go there unless he or she absolutely had to? Who around here has gone to Wal-Mart and had to face unholy, long lines at the checkout lanes (including the newfangled self-checkout lanes)? It isn’t exactly “convenient” when your risks of getting into a car accident or cussing out someone paid by the hour to ring you up are high.

Supporters point out that this law would allow an open marketplace for consumers. But if Measure 7 is passed, what is to stop insurance providers from limiting people to certain pharmacies, especially when some companies own certain stores or plans? What is to stop Caremark, as an example, from forcing customers to only buy prescriptions at CVS stores? What is to stop Humana, as another example, from forcing customers on its Rx plan to get their drugs from either Wal-Mart or by mail via RightSource? What is to stop the big box stores from setting expensive prices on prescriptions?

Here’s another thought: how many independent, small pharmacies will be put out of business? What will happen to people in small towns who can no longer purchase the drugs they need at a local pharmacy? How much money will those communities lose thanks to the limits on choice they will have if the law gets passed?

Regardless of whether you live in a big city or a small, tight-knit community, do yourself and the place in which you live a favor and vote “no” on Measure 7.

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