> I wonder, what changed in America? Why is the mom and pop pharmacy not viable anymore

Deregulation at every level = small/low leverage players get squeeeeezed.

Most likely in Spain (and much of the world), you have controlled pricing of drugs and fixed markups/fees at pharmacies. Quite possibly it’s illegal there for a non-pharmacist to own a pharmacy and they can’t own a bunch as a silent/relatively inactive partner either.

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wolvoleo a day ago | parent | next [-]

True all those yes. In fact the govt pays for the meds, I just pay an issuance fee of 2€ or so. You can get private health insurance but I didn't bother, the state one is fine.

And yes you need to be a licensed pharmacist obviously.

I think the pharmacists mainly make their money on value add stuff and non prescription drugs.

People here mainly pick their pharmacy by familiarity and service not price. They're all the same anyway. I've never been to the other ones close to my house :)

It's kinda weird there's so many but it works so why not. And it's nice that she knows my name and what I'm on in case of issues. I live only 5 doors down the street. I really like that about here.

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mindslight a day ago | parent | prev [-]

> Deregulation at every level = small/low leverage players get squeeeeezed.

I love how stating a simple truth gets you downvoted. Deregulation doesn't mean "less regulation". Maybe in the abstract, but in practice after it passes through the political machine it means increasing regulation that entrenches a handful of large "private" businesses, while removing regulations that would constrain those businesses commensurate with their market power.

It's a plain fact - the players in the health care industry are closer to de facto governments rather than productive businesses in a competitive market. But yet they're allowed to squeeze pharmacy owners, patients, and anyone they can due to lack of effective regulation. That is why our small pharmacies are going away.

Note that I personally favor more market based reforms (eg the sheer majority of visits/procedures/medication should have up-front prices, and those prices should be uniform no matter who might be paying). But we've currently got the worst of both worlds and I would basically support any angle of reform as long as it actually reforms rather than resulting in more regulatory capture.

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wolvoleo 13 hours ago | parent [-]

I think regulation and deregulation doesn't mean good/bad for small business anyway.

For example the EU just extended mandatory packaging regulations (PPWR and EPR) for businesses of any size, today. Meaning small artists sending as little as one package to an EU country have to register in that country (there is no central EU registry) and pay yearly fees which add up to thousands for all EU countries. In advance, no less. This even applies if you just chuck one single pendant in a tiny bubblewrap envelope, it's ridiculous. And it applies even within the EU where there is supposed to be a free open market. They have to pay the same fees as a Temu or Amazon, for whom a few thousand euros is peanuts.

So a lot of independent artists are cutting shipping to the EU or only allowing some where registration is free. This is one example where regulation is literally targeting small businesses to kill them.

	▲	mindslight 3 hours ago \| parent [-]
		Yes, you are describing the dynamic I am talking about. My point about "deregulation" was in the US context where there is a strain of people who reflexively infer that deregulation must be good, from a general idea that regulations are bad. Regulations most certainly can be bad (as is the one you're describing), but this does not imply that blindly "removing regulations" is good! Because what tends to happen is that the type of regulation you are describing (registration/compliance/etc creating a fixed costs that are hard on small businesses but easy for large businesses) never gets removed. Rather what does get removed is regulations that are inconvenient to the large businesses - things like right of withdrawal [0], liability, anticompetitive restrictions on large businesses who have now become unavoidable parts of an uncompetitive market [1], etc. [0] IIUC "right of withdrawal", at least. It's an EU thing where you have a legal right to return products after a purchase, right? Whereas in the US it operates more on custom, customer satisfaction, and marketing. [1] eg if artists have to start selling through Amazon (etc) rather than shipping direct