State decision best for public health

Originally written February 24, 2006 for The Poly Post.

The recent decision by the Massachusetts Pharmacy Board to require retail giant Wal-Mart to stock emergency contraceptives, the so-called "morning after pill" was the correct decision to make.

Even more encouraging is Wal-Mart's response: compliance. This is, quite frankly, shocking from a company that has previously circumvented employment and competition laws and ethics whenever they can.

Massachusetts is the second state, after Illinois, to require the retail chain to stock the sometimes-controversial medication. The morning after pill is simply a high dose of the same hormones that are in every birth control pill and prevent the implantation of an egg.

It is not an abortifacient; that is, it does not terminate a pregnancy after it has already begun and thus any comparisons to abortion are invalid. Rather the pill ends up preventing abortions, to the tune of an estimated 800,000 every year.

Even opponents of abortion can get behind that. Or so you'd think.

Regardless of one's own personal feelings on the matter, it is not the job of a pharmacy to decide which of a doctor's orders they will let a patient follow. One wonders if the people who want to keep Plan B off the shelves would still be okay with a pharmacy refusing to stock other prescription drugs, say Lithium or Ritalin.

Hell, why stop there? Why should a pharmacy stock Allegra or Singulair if the market is not demanding them in sufficient quantities? I mean, it's just allergies we're talking about, it's not the end of the world.

The reason we don't allow them to do that is because a pharmacy occupies a rare spot at the intersection of private enterprise and public good. And when it comes to our health, the public's interests outweigh whatever small harm might come from keeping a few boxes of Plan B in stock.

Besides being the moral thing to do, it was also the law. Massachusetts regulations state that pharmacies must provide "commonly prescribed medications in accordance with the usual needs of the community."

Now all of this might be a moot point if we were talking about someone other than Wal-Mart. If it were just one of your local pharmacies not prescribing the medication, it would be a simple matter to just go to another one in town, provided there is another in town, and get it there. The matter likely would have never become an issue. But Wal-Mart's own business practices have come back to haunt them. By aggressively taking over the retail needs of entire communities and driving competitors out of business they've set themselves up as the only place to go for your needs.

When there is only one pharmacy for miles and miles that pharmacy better well have the drugs you need to get better.

And this is doubly true of a time-sensitive drug like Plan B. The pill has to be taken within 72 hours of intercourse to have a reasonable chance of success.

Therefore Massachusetts and Wal-Mart should both be applauded in this case for doing the right thing. It's just regrettable Wal-Mart couldn't do the right thing voluntarily and had to be forced.