CANNABIS COLUMN: The Medical Marijuana Conundrum

Medical marijuana’s an effective treatment for many ailments. Otherwise, there wouldn’t be such a strong movement in so many states to make it legal for patients in need. However, marijuana is still illegal under federal law, which prevents it from being covered under most health insurance policies. Seeking reimbursement for the cost of this medicine also can be difficult. Therefore, what are patients – many of whom are too ill to work or have little to no income – supposed to do?
Some states, such as Rhode Island, have taken a proactive strategy to such questions and written a low-income solution into their medical marijuana laws. Such strategies require caregivers and dispensaries to supply medicine to patients in need, leaving the onus on them to seek reimbursement from insurance companies and health care providers. This still doesn’t guarantee that the provider of the medicine will ever receive funds, but it is a patient – first approach that I can respect. This does, however, create a disadvantaged market for those seeking to become caregivers or open dispensaries in which the long-term cost of producing medicinal marijuana ends up costing too much money.
First you have to consider the overhead associated with becoming a caregiver or opening a dispensary, which, in states such as Massachusetts, can be close to $1 million[1]. Depending on the state, dispensaries are required to have large escrow accounts, special permits, licenses and monitoring systems. Then there is the cost associated with the growing facility itself, which is relevant to both dispensaries and caregivers. The growing, lighting and ventilation systems themselves can cost more than $10,000, in even a small-scale operation. Nutrients, fertilizer and water are another high priced factor that most lawmakers don’t take into consideration. When you stack all of those costs on top of the time it takes to complete the first growing process, which includes producing healthy mothers, generating clones and raising them through a complete harvest, you end up with a time-consuming and hefty investment.
Now consider that the majority of the patients in need of medical marijuana fall into that low-income category. Many are patients who are terminally ill, physically disabled or battling sicknesses that prevent them from being able to function in a work environment. Not only is it inhumane to restrict access of this medicine to those in need, but it is also unjust to place the burden of providing such medicine solely on those who must produce it.
So is there an answer to this conundrum? I believe that there is and until the federal government legalizes marijuana as a medical alternative to the “death dealing” drugs of modern day pharmaceuticals, that answer lies in the individual state’s ability to legalize recreational use.
In a state where recreational use is legal, caregivers and dispensaries have an alternative market to sell to. In those states, where recreational use is not legal, that market is commonly referred to as the “black market.” It is this recreational market that currently serves as a supplement for those who can’t afford to pay for their medicine.
By legalizing recreational use, two things are accomplished. 1) Those currently taking advantage of the medical marijuana laws, who don’t truly need them, will not flood the health system, allowing for more accurate analysis and decision-making by insurance companies and other health agencies. 2) Those who are not in need of marijuana for medicinal purposes will be required to pay the standard excise and sales taxes associated with recreational use, therefore supplying an alternative and legal revenue for those who are giving marijuana away as medicine.
As long as regulations for recreational marijuana are handled in a responsible and intelligent manner, there is no need to restrict access to patients or force caregivers to shoulder the burden of cost. Legalization is nothing more than a common sense approach to those in need.
1: Toke Signals, “MA Marijuana Dispensaries May Need $1 Million to Open”, Steve Elliott, April 4, 2013
Other Sources: Medical Marijuana Business Daily, RI Department of Public Health, Anonymous Patients and Caregivers,, Marijuana Policy Project, The Massachusetts Department of Public Health.