It seems to me like they are going to great lengths to preserve the ability to jail a disproportionate number of black people for possession of the plant. They essentially are preoccupied with creating a market for processed medicinal cannabis, without any medical justification whatsoever, while keeping the illegal market as large as possible. That is, there is no evidence to support the superiority of oral administration for all medical purposes. It's primarily, if not entirely, a cultural bias to prefer pills exclusively to vaporization or smoking. There is a commonly held perception that smoking cannabis would naturally have the same negative impact as smoking tobacco, but there is actually no scientific evidence to back that up.

So when people note the "complexity" being introduced and propagated by Pennsylvania legislators, I really think what were noticing is an out-of-place interest in simply ensuring that the plant remains illegal, even if that means that an entire infrastructure for cannabis processing delays availability, adds to the cost, creates opportunities for favoritism and corruption, detracts from accessibility by patients, and fails to address the viability of a black market even for medical purposes. My main issue is that this is just not a viable long-term strategy. If you're going to recognize cannabis as a medicine, you have to address all of these things. Otherwise, you just end up reinforcing the black market, with all of its undesirable associated elements — like felony convictions for non-violent end users.

I'm not saying it's the worst situation. For instance, Massachusetts clearly has been dragging their feet with respect to medical cannabis, even though they have a theoretical mandate from the people to make it available. But I think it's pretty clear that in Pennsylvania, they are definitely preoccupied with maintaining the illegality of cannabis as one of their major considerations. Once the legitimacy of cannabis for medical applications is recognized, it's very difficult to evade the fact that we're talking about a plant that you can grow outdoors or in a controlled, indoor environment.

All of these acrobatics around approved formulations and sources are not intended to benefit the people in any way, IMO. It's going to be really complicated, and counterproductive, to allow people to believe that they will obtain a legitimate medical benefit from cannabis, while requiring them to pay several times the cost, just to have less control over basic things like route of administration, bioavailability of the drug, and duration of action, all of which are intimately related.