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Whichever way the Viagra wars turn out, there is no going back. Gatekeepers and cost controls will always be with us. In the end, each of us is going to have to learn to play the managed-care game. And if we can't get what we need from our health plans, we're going to have to speak up, not just to the nurses and doctors but to our employers as well. After all, they're the ones that picked our plans and pay the premiums. And they're the ones with the financial clout to change the rules of the game.

--Reported by William Dowell/New York, Tammerlin Drummond/Miami, Ron Stodghill II/Chicago, Dick Thompson/Washington and Richard Woodbury/San Francisco

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