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How can health-access advocates beat the wealthy pharmaceutical industry, which has the biggest spending lobby in Washington? Ramon Castellblanch provides a ringside seat at the battle as he reveals how activists in Vermont, Maine, and California took on Big Pharma in their state legislatures to promote better and cheaper access to prescription drugs - and ultimately pushed Congress to enact a Medicare prescription drug benefit. He also draws lessons from these cases about the possibilities for success elsewhere in the health policy arena, highlighting the crucial role that voters' righteous indignation plays in fuelling popular support for grassroots political leaders who are taking on powerful business interests.