The Republican Party coalition has two major moving parts: Libertarian Republicans who believe that business should be allowed to do pretty much whatever it wants, and Theocratic Republicans, who want to use government to enforce a single interpretation of the Bible. There is, understandably, some tension between those two factions.
Which is why the first-ever Big Political Flap About Pharmacists is going to be so entertaining.
There have not been many moments when the flow of history has cared much about pharmacists. But now, with the Theocratic Republicans making a big play for political control, the battlefield is shifting from the ramparts of abortion clinics to Terri Schiavo's hospital room to your own local drug store -- which is more-likely-than-not owned by an enormous, publicly-held corporation.
Highly moral pharmacists, it seems, are standing up and refusing to dispense drugs of which they disapprove. That means, primarily, the birth control pills their employers keep stocked on pharmacy shelves. This is from MSNBC:
"There are pharmacists who will only give birth control pills to a woman if she's married. There are pharmacists who mistakenly believe contraception is a form of abortion and refuse to prescribe it to anyone," said Adam Sonfield of the Alan Guttmacher Institute in New York, which tracks reproductive issues. "There are even cases of pharmacists holding prescriptions hostage, where they won't even transfer it to another pharmacy when time is of the essence."
It's safe to assume that these pharamcists are Theocratic Republicans. It's also safe to assume that they work for Libertarian Republicans who don't want government or the courts messing wth business decisions. In the pharmacy business, the leading player is Walgreens, which sold an incredible $17 billion in little pills last year.
Pharmacy is now the solid majority of total business, and that share is growing still as prescription revenues rise and front-end categories jostle for market share amid a slew of competitors.
The medication you buy at one drug store is identical to the medication you buy at any other. For years, the big prescription-fillers -- many of which are embedded in high-traffic businesses like grocery stores -- have competed on convenience. They've automated processes to get you in and out of their stores as fast as possible. Prescriptions are tranferred electronically from physicians' offices and filled at any outlet in the chain, and your insurance info is all on file so you don't have to tangle with nasty paperwork. Drug stores everywhere are tearing up parking spaces to put in drive-through windows.
A side effect of all this convenience is something marketers call "lock-in." Lock-in is something that keeps a customer from leaving one vendor in favor of another. Owners of Hewlett-Packard printers, for example, have until recently been locked-in to buying only Hewlett-Packard replacement cartridges, since HP used a novel interpretation of patent law to keep anyone from manufacturing an HP-compatible cartridge. By maintaining their monoploy, HP was able to keep prices high. The cost of switching to another brand was the cost of a new printer, and most people didn't bother.
The more prescriptions you have, the harder it is to fill them at another drug store, because Step 1 at any other drug store is going to be a registration process. You've already endured that process at your current drug store; at a new store, you'd have to go through it from the begining. People are only going to do that for a reason, and in the pharamceutical business there's not a lot a drug store can do to convince people it's worth making a switch. Drug stores can't compete on price, since the amount the consumer pays per prescription is set by the consumer's insurance company. Stores can lure customers based on quality, because a pill is a pill.
So convenience has been the ticket to landing and locking-in customers, and the big chains have gone to it like maniacs. They know that once they land a customer, that customer is likely to stay. They also know that, given our fondness for prescription drugs, every customer landed is tens-of-thousands of dollars in high-margin revenue down through the years. The only way most people will leave is if the drug store does something to piss them off.
Like, for example, when a local pharmacist refused to fill a morning-after pill prescription for Kathleen Pulz after a condom malfunction
"I couldn't believe it," said Pulz, 44, who with her husband had long ago decided they could not afford a fifth child. "How can they make that decision for us? I was outraged."
It is possible that people like Pulz will start suing drug stores that refuse to dispense prescribed drugs. It is certain that Pulz and others sharing similar experiences will decide it's worth their while to fill out the paperwork at an alternate pharmacy, and that they'll tell their friends who will likely do the same. It is possible, thus, that a single, Theocratic Republican pharmacist could cost his employers millions of dollars in consistent cash flow for years into the future.
This is not likely to sit well with the shareholders of the publicly-held companies that employ the Theocratic Republican pharmacists. Thankfully, businesses have always been free to fire people whose personal habits and beliefs interfere with the conuct of business. Republicans have made sure of that.
So now we have something called a "pharmacists' rights movement." This movement seeks to protect the right of pharmacists to refuse to fill prescriptions they don't approve of. Laws proposed in several states make it difficult or impossible for pharmacy operators to fire pharmacists who won't do their jobs, so long as theyr'e not doing their jobs out of a deeply held, conservative Christianity.
You can't protect just one religious group, under the law, so any success at protecting Theocratic pharmacists will inevitably broaden to protect lots of other deeply-held beliefs. Vegitarians working at grocery stores, for example, could refuse to let people buy meat. Sporting goods store clerks could refuse to sell bullets to hunters and car salesmen could, with impunity, refuse to sell gas-guzzlers when what everyone really should be buying is gas-electric hybrids. Let's let everyone anywhere enforce their own morality in any business environment, and take away the businesses ability to cope with these rogue moralists!
Of course, the Libertarian Republican are never going to stand for that. They're going to fight tooth and nail to prevent what the other half of their party is going to fight tooth and nail to put into place.
It ought to be fun to watch.
Somehow, over the years, the Republican Party has held together despite the diverging interests of Libertarians and Theocrats. This last election, National Security issues trumped all others. This hasn't stopped the Theocrats from claiming victory based on their own concentration on "moral issues," primarily abortion. They are now trying to capitalize on their power, and it's unlikely that the Republican coalition will hold together for much longer.
The pharmacists' rights movement seem to have gotten their start back in the 1980s, when the Theocrat Republicans were only barely getting their feet wet. Thanks for bringing this horrible atrocity up to the light of day. Be sure to let Canada know, too, that their Theocrat Republican Pharmacists are likely doing the same kind of thing. I hear that's the international HQ for Pharmacists for Life.
Getting past the bad snark, though -- unlike Canada, we're pretty much capitalism first & theology second. I would personally move my prescriptions from a pharmacy that failed to provide the expected service to any customer. Filling out a form is a small price to pay for getting what we want. I know you look forward to a nice elephant fight, but this ain't gonna be one.
Posted by: Scott Chaffin | 03/28/2005 at 10:07 PM