You hit the nail on the head; principles are important and a measurement of your character. I understand that ignorance plays into it as well - I'm sure I support some crappy companies inadvertently. If we all tried our best however, there'd be less kowtowing to bigotry, fascism and exploitation of vulnerable people.
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You're right, unfortunately. That's a reality in some rural areas. My experience does come from a city with options, and I'm judging those folks. One positive is that so many things can be delivered now, which helps to supplement the absence of local businesses put under by Walmart, and can even create more local businesses. While you may not have the option with certain medications, spending 30% less there will make a difference.