America


Main Street Pharmacies Squeezed Out of Business


System rigged to benefit large chain stores.


I BY JUSTIN LEVENTHAL


ndependent drugstores are vanishing, especially in low- income, minority, and rural communities, in part due to


pharmacy benefit managers (PBMs) having rigged the system in favor of their own pharmacies. By squeezing independent phar- macies with hidden fees, PBMs


are driving local pharmacies out of business. PBMs sit between insurers, drug manufacturers, and pharmacies. Many PBMs are even owned by or partnered with major pharmacy chains. This vertical integration offers an opportunity for greater efficiency, but that can only take place in a competi- tive market. In practice, PBMs steer patients


away from independent pharmacies by using “preferred networks” — phar-


U.S. States Edging Closer to Assisted Suicides


Opponents fear they will copy Canada, which allows death for the disabled and mentally ill.


Oregon Leads the Way S


everal U.S. states, led by Oregon, have already


adopted assisted suicide programs based on medical aid in dying (MAiD). Oregon’s 1997 Death with


Dignity Act influenced states like Washington, Vermont, and California. In 2023, Oregon and


Vermont removed residency restrictions, allowing out-of- state residents to access MAiD,


18 NEWSMAX | DECEMBER 2025


paralleling Canada’s model. In Washington, similar legislation to Oregon’s has expanded, with studies showing increased requests from individuals with nonfatal conditions. Seven more states, including New York and Massachusetts, are considering bills to legalize assisted suicide, often referencing Canada’s model as a blueprint for


C BY MATTHEW LYSIAK


anadians are being pressured to end their lives through euthanasia in an escalation of a pro- gram that critics warn may soon be coming to the United States.


During a Parliamentary Finance Committee meeting in


October, Inclusion Canada CEO Krista Carr, a critic of medi- cal assistance in dying (MAiD), said that Canada’s expansion of its program to include individuals who are not terminally ill has led to several unintended effects — including people with disabilities feeling pressured to end their lives. In Canada, the MAiD program was legalized in 2016 ini-


tially for terminally ill patients. Since then, it has expanded to include individuals with chronic, nonterminal conditions. By 2027, eligibility will further broaden to cover peo- ple with mental illnesses like depression or anorexia,


“compassionate care.” Last year, New York


advanced its attempt to legalize physician-assisted suicide (PAS) with an 81-67 vote in the state Assembly on MAiD. It would allow terminally


ill adults with a prognosis of six months or less, and mental competence verified by two doctors, to request medication to end their lives, say the bill’s authors. According to New York


state Sen. Brad Hoylman-Sigal,


a Democrat who sponsored the proposal, the bill is “not about hastening death but ending suffering.” Currently, 25 state


senators support the bill, which needs 32 votes to pass. If the state Senate approves it and Gov. Kathy Hochul signs it — though she has not yet publicly stated her position — New York would become the 12th jurisdiction to legalize PAS.


macies where patients pay lower copays — to direct customers to those stores. According to a recent study, only


0.8% of independent pharmacies were preferred by PBMs for Medicare Part D in 2023, compared to 70% of chain pharmacies. Pharmacies left off preferred net-


works are more likely to close than those that are included. This under- cuts independent pharmacies’ volume and profits. While PBMs claim to reimburse


LILLISPHOTOGRAPHY©ISTOCK


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