If you can’t influence the federal government, work around it. The health-care industry has been working the state houses to gin up opposition to health-care reform. In Florida, it made outsized donations totaling $765,000 in 2008 to nearly all 42 Republican co-sponsors who are trying to amend the state constitution to block, at least symbolically, much of the health-care overhaul. In fact, during the 2008 election, health-care providers donated more at the state level than they did at the federal level—$102 million versus $89 million. The pharmaceutical trade group is officially backing health-care reform, but industry lobbyists tell The New York Times that they are preparing to fight Congressional proposals to help states meet their Medicare obligations by saving money on drugs.