When AdvancePCS was gatekeeping and helping the State of North Carolina save money by blocking some prescription drugs from members of the State Health Plan, AdvancePCS was also offering a discount card for uninsured and underinsured U.S. residents and their pets. When our state employee friends had a hard time paying for their prescriptions, we ordered a card for each of them and arranged for it to be mailed directly to their homes. That effort was expanded to anyone we discovered who was having trouble affording drugs. CareMark bought AdvancePCS, then CareMark and CVS merged. Meanwhile the National Association of County (NACo) officials started promoting the CareMark card nationally for distribution to all residents in a county. It was about four years after NACo offered the Wake County Commissioners an opportunity to distribute the card and two years after we started calling them on the missed opportunity, before they agreed to bring in the cards. Of course we did tell the press and a lot of other people to contact the county commissioners, too. Once the English and Spanish cards arrived and were available by the thousands, our distribution became much easier and faster.