By Matthew Romano, Contributing Writer

With health care being on the verge of either passing or failing, it has nevertheless provided a jolt to the lobbying business. In 2009, health care industry lobbyists spent $1.4 million a day or about half a billion dollars, averaging $2600 per day per member of the House and Senate. While the outcome is unclear, at present the pharmaceutical industries made sure the bill did not permit the government to import drugs from foreign countries—including Canada. It gave a guarantee to biological drug makers that there would be no generic competition for 12 years, keeping Amgen and Genentech happy. Hospitals accepted lower government payments from Medicare knowing that the bill requires 94 percent of Americans to have health insurance, which will more than compensate for the Medicare loss. AARP received generous drug protection for seniors.

The principal recipient of this lobbying largess was Senate Finance Committee Chairman, Max Baucus, who developed the bill and, while doing so, received $453,649 from 109 lobbyists representing the pharmaceutical industry, health care services, medical professionals and other related groups. However, Baucus was not alone. Lobbyists made sure that other members of the Senate Finance Committee and the House Ways and Means Committee and their health subcommittees received nearly $60 million.

There were also those who lost on the bill, but not the lobbyists. Doctors failed to limit medical malpractice suit awards and failed to increase their Medicare payments in spite of their nearly $60 million dollar lobby effort. Generic drug manufacturers were also losers. They could not compete with brand name drugs for 12 years. Nonetheless, the lobbyists received credit for raising millions in support of their position.

Who are these lobbyists? They are no longer people who hang around the Congressional lobbies. They are people who spend at least 20 percent of their time influencing the formulation and implementation of federal legislation. They can be permanent staff members of a corporation, or issue group or can be hired as freelance lobbyists. Most of them work for firms on K Street, in the nation's capital. Some, because of their affiliations, can earn up to of $2 million a year.

In total, there were over 3,300 health care lobbyists working in Washington during the 2009 congressional debates. And a considerable number were former Congressmen, or former congressional staff members, all of whom well connected to Capitol Hill. This is called the "revolving door," whereby former politicians, military men, and staffers rotate between the private sector and the government. Part of the lobbying pressure on current members of Congress and staffers comes results from the powerful lure of financially lucrative post-Congressional positions.

What are the lobbyists' sources of money? Obviously, individual donors, but they are restricted to $2,400 per candidate. There are employee lobbyists who generally raise the bulk of their money from membership contributions. But most money is corporate representing businesses that have similar interests. Lobbyists funnel the money to political action committees, or PACs. PACs can use money to express "advocacy" to support or attack a candidate by name. They present their ads without the input of the candidate, as is seen in the expression "I approve this ad." However, PACs can use money for fundraising or contribute to politicians' favorite causes. PACs can create money for politicians so that they can have access to the money solely for political campaigning by giving it to a candidate's political campaign fund.

From the voter's viewpoint, they may or may not be a bill they like. To lobbyists, there will be revisions.