Politics is about difficult and sometimes painful decisions.

The Heritage Center auditorium was packed on Tuesday for a hearing on the proposed repeal of North Dakota's unique pharmacy law. It made front-page news in this newspaper. The testimony was passionate, sometimes uncomfortably so.

The repealists make a strong case for fair competition, wider variety and lower prices. The anti-repealists make a persuasive case for rural access, community stability and the kind of personal attention we all used to get before the giant multinational corporations ate America.

The repeal proposal is generating so much passion because we are wrestling with two of our biggest concerns in life - access to affordable health care and the future of rural America.

My head and my heart are at odds on this question.

I live in the amenity haven of Bismarck, where I have "take for granted" access to all of the basic and some of the finer fruits of life. What I know about rural America comes from my wanderings and my visits to my daughter, who lives in a windswept village in northwestern Kansas, population 682.

One gas station. Two car washes. A bar that sells 3.2 beer. A couple of hair shops. A bank. A modest grocery store. An appliance store. A bare-bones lumber yard and hardware store. An implement dealership. Ephemeral knickknack and craft shops. A library open a couple of afternoons per week and a one-screen movie theater open Friday and Saturday nights. Two cafes. No fast food.

We all know these towns. They have been the incubator of the character of the people of the Great Plains.

From a certain point of view - you have to point the lens pretty carefully - my daughter lives in a kind of rural paradise. It's 4-H country and the land of family livestock menageries. It's a place where "neighbor" is still a verb.

At the same time, as a parent, I'm all too well aware that there are things that are glaringly missing out there in godforsakia that my daughter will need to thrive in the 21st century. I deplore that, and try to supplement her "education" as much as I can, but the fact is that I know she is gaining much more than she is losing by growing up in a small rural town in the middle of nowhere.

I have been watching my daughter's town decline for 25 years. My former wife believes in the small town verities. She shops locally whenever possible, even though the produce is often meager and wilty in the grocery store, the seafood locked up like ancient mammoths in blocks of ice, the card selection clunky and severely limited.

She'd rather buy a more expensive washing machine at the local store than a cheaper, better one from the big box store an hour away.

She understands that every purchase is a vote.

But as the local grocery store continues to decline in a slow but inevitable trajectory, she buys a little more every month from Darth Wal-Mart, because she cares about nutrition as much as she cares about the economic survival of the local grocer, her friend, whom she greets on main street a dozen times a week.

She knows that every head of lettuce she buys from Wal-Mart, even though it is dramatically better lettuce than the local grocery offers, accelerates the decline of her hometown. She feels this dilemma every week, almost every day, of her life. This is the story of our time on the Great Plains of America.

And this, essentially, is what the North Dakota pharmacy debate is about. That's why it is so painful.

Like all North Dakotans, I have been worrying about outmigration and the death of rural America off and on for 30 years. We have watched once-thriving small towns struggle and decline. Some have died.

Those that remain are almost all on life support. It's heartbreaking if you let it get beneath the protective shrug. Our agony and at the same time our solace has been the chorus that "there's not a darn thing we can really do about it."

Now, suddenly, the pharmacy bill reminds us that we are not entirely helpless. This is one of those rare moments when the representatives of the people of North Dakota have the power to decide what our future will look like.

This is quite different from our normal role of standing on the margins wringing our hands as the impersonal dynamos of change roll over us. This Legislature must make a really hard choice that is going to have a measurable impact on the survival prospects of rural North Dakota.

It seems to me undeniable that the repeal of the pharmacy law will damage our towns and villages and isolate them further, even if it provides greater variety and lower costs to individual health care consumers. Nobody believes that the existing law will save rural North Dakota. But it will help a little, and a little means a great deal in towns that are teetering on the brink of further collapse.

I spend a lot of time wandering around the blacktop back roads of North Dakota. It gives me great pleasure to meander the streets of small towns, to make a few purchases, to order a piece of pie in a village cafe, to buy the prized local sausage in the meat market.

Most of these towns have a drug store, as often as not in a brick building on a corner of Main Street, sometimes with an old Rexall sign creaking in the wind. These drug stores are the last gasp of the old general stores that served as de facto community centers in rural America. They provide a modest selection of paperback books, local crafts and jellies, Hallmark-knock-off gifts for the various rites of passage like graduation or confirmation, a few fuses and farm parts, and once in a while a nut cart or a soda fountain.

They are modest (and marginal) little department stores that manage somehow to meet an amazingly wide set of consumer needs at home rather than 50 or 100 miles down the road. Make no mistake: the engine of these shops is the pharmacy, without which, they'd have shut their doors a decade or more ago.

The economic and social orthodoxy of our time is that the consumer is king, that the free market should prevail, and that saving costs is more important than saving communities.

In other words, if you can get a better deal on a new car in Minot than in Minto or Max, you ought to do it. That orthodoxy, unfortunately, spells the death of rural North Dakota.

My view is a very simple one. In those very rare moments when we have the power to vote yes for rural life, we have a moral imperative to do so, even if it means that our lives will be a little more expensive.

Target, Wal-Mart and Walgreen's are gigantic faceless corporations that regard North Dakota as an outback market, not a home. Mott and Wishek and Cavalier are North Dakota.

We must do what we can for them. It's about who we are, not what we consume.

(Clay Jenkinson is the director of the Dakota Institute. He also is the Theodore Roosevelt Scholar-in-residence at Dickinson State University. He lives in Bismarck. Contact Clay at Jeffysage@;aol.com.)