On September 19, 2019, House Speaker Nancy Pelosi introduced the Elijah Cummings Lower Drug Costs Now Act. The bill ... would allow the federal government to negotiate drug prices on behalf of Medicare, a right assumed by the governments of every other major economy. Polls showed support ranging from 80 to an eye-popping 90-plus percent. H.R. 3 was delivered stillborn into Mitch McConnell's Senate in November of 2019. Two years later, when Joe Biden released the massive social-spending and climate-change bill dubbed Build Back Better, H.R. 3's reforms were nowhere to be found. And at every level of government, Pharma's endless river of money continues to flow, the widest, steadiest current of lobbying largesse the capitol has ever known. In 2021, the industry reported spending $124 million on a fleet of 846 lobbyists, roughly two for every member of Congress. Sixty-five percent were former government employees. Pharmaceutical manufacturers are part of a larger coalition that includes the insurance, medical-device, and hospital industries. Its combined resources flow downstream through dozens of lobbying firms, communications shops, and front groups. "If a freshman Democrat so much as signs a letter related to drug prices, the lobby hammers them with phone calls and meeting requests, completely locking up the calendar," says Alex Lawson, executive director of Social Security Works. "The calls come in from ex-Democratic officials and staffers, so they have to take the meetings."