Pharmaceutical firms top the list.

• Position: Health Care Lobbies

Pharmaceutical companies spend more money lobbying Congress than other health care organizations, according to a study from Case Western Reserve University, Cleveland. Meanwhile, lobbying by physicians lagged behind, suggesting a decline in their political influence. By reviewing reports required by the Lobbying Disclosure Act, investigators found that health care lobbying expenditures totaled $237,000,000 in 2000. This was more than the lobbying expenditures of every other industry, including agriculture, communications, and defense, thus highlighting the importance of health care issues to a broad range of interest groups.

Among health care organizations, drug companies spent the most ($96,000,000), followed by physicians and other health professionals ($46,000,000). Hospitals and nursing homes outlayed $40,000,000, while health insurance and managed care groups put up $31,000,000. Disease advocacy and public health concerns expended $12,000,000.

Lobbying by physicians and other health professionals grew more slowly than that by other organizations (10 vs. 32%). According to the study's author, Steven Landers of the School of Medicine, this finding may indicate a decline in the political influence of physicians. "The input of physicians is essential at a time of growing concern and debate about the cost of prescription drugs, the influence of pharmaceutical marketing on patients and physicians, and access to health care for the uninsured," he contends.

"In a previous study," adds co-author Ashwini Sehgal, "legislators said they want more input from physicians about public health issues. Physicians should use the credibility...