Since the earliest days in the lobbies of the House of Commons, many had attempted to approach members of Parliament in an effort to gain political favors. Originating in the United Kingdom, the term ‘lobbying’ is simply the process of petitioning the government to influence public policy. Crucial to the process of democracy, interest groups and their lobbyists convey their expectations and demands to Congress in accordance with the First Amendment to the Constitution that provides that Congress may make no law abridging the right of the people to petition the government for a redress of grievances. Even with a 2006 CBS/New York Times survey that found 75 percent of Americans agreed that most members of Congress are more interested in serving special interest groups than the people they represent, federal governments deal with vast numbers of complex economic and political issues, allowing limited time for direct constituency contact, ultimately creating the legion of professional lobbying firms and associations.

As Congress has continued to grow, their reliance on committees and subcommittees for writing the details of most legislation has given outsiders many points of contact with legislators and their staff. This access has encouraged the formation of groups to facilitate communication between their agencies and the sector they serve in order to build support for their own programs and budgets. These groups then hire lobbyist who work toward finding legislators willing to champion their causes. Lobbyists need members to introduce their proposals as legislation, offer amendments in committee and on the floor, and to help them get issues on, or sometimes keep issues off, the agendas of committees and subcommittees.

Lobbyists know that most representatives are in Washington for three or more nights a week without their families. They use this time to build personal relationships and attempt to gain policy insight. Successful lobbyists develop access to well-placed members and staff on Capitol Hill by using their network of contacts, mastery of the political process, and money. The most obvious and/or important tool lobbyist have is their money, or access to money, that can be used for campaign contributions for reelection. Some lobbyists are able to make considerable contributions themselves, while others are able to pull funds together from various political action committees or wealthy individuals to maximize their influence.

More often than not, interest groups seek out members in key positions, such as party leaders or committee chairs specifically related to their efforts. In recent years, representatives have increasingly called upon lobbyists to organize fundraising activities on their behalf. From the resulting behaviors of the interest groups, we can infer that there are returns to making these contributions.

The American Medical Association, or AMA, is one of these groups lobbying Congress. Founded in 1847 and incorporated in 1897, the AMA’s mission is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education. Despite only representing 18-20% of American physicians, the AMA is still regarded as one of the country’s premier lobbying forces and may be one of the most trusted voices by the public in the health care debate.

Apart from its self-proclaimed public service nature, the AMA’s political positions through history have been highly controversial. After nearly 60 years of vehemently opposing any government overhaul of health care, the AMA is now lobbying and advertising to win public support for President Obama’s sweeping plan –a proposal that promises hundreds of billions of dollars for America’s doctors. With the goal of eliminating cuts in Medicare spending and the potential expansion and reformation of health insurance, the government has become a vital source of revenue and stability for doctors. Since the beginning of 2008, the AMA has spent $30 million on lobbying, a sum only surpassed by the United States Chamber of Commerce.

When Congress is drafting tax legislation, there is no committee busier and more popular than the House Ways and Means. Lobbyists often pay people to stand in the corridors of Congress watching every move. Because when it comes to this type of complex legislation, every detail counts for something. Special interests often use these behemoth bills as vehicles for their legislative wish lists, hoping the sheer size of the proposals will divert attention from their sought-after provisions. Since tax bills affect so many industries’ bottom lines, it is little surprise that members should attract generous donations from a variety of sources, including health professionals and insurance companies.

In addition to the House Ways and Means, the House Energy and Commerce Committee, formerly known simply as the Commerce Committee, is often where some of the biggest legislative battles get started. From deregulating the telecommunications industry, to relaxing promotional standards for drug companies, to changing the nation’s health care laws, this committee’s members are often the subjects of intense industry lobbying. Without question, these two committees, their chairmen, and their health care subcommittees are a prime target of lobbyist interested in the health care debate.

The AMA, an association that had traditionally supported Republican candidates, agreeing with the Grand Old Party on such issues as medical malpractice reform, has begun to shift their support to Democrats in favor of their attempts to pass legislation for an expanded role of the government in health care. The swing in support can clearly be seen from the nonpartisan center for responsive politics, OpenSecrets.org. Since the 2004 campaign cycle, the percentage of money given directly to representatives from the AMA has seen a 28 point shift from 76% Republican to 52%Democrat. While those number alone prove nothing, taking a closer look, during the 2010 campaign cycle, the top two committees receiving funds from the AMA are the Energy and Commerce Committee and the Ways and Means Committee. Together, these two committees account for 31% of all money given by the AMA.

Of the top 24 individual recipients of AMA money, nine (38%) of the representatives are either on the Energy and Commerce or Ways and Means committees, including both Representative Charles Rangel (D-NY), chairman of the Ways and Means Committee, and Representative Frank Pallone Jr. (D-NJ), chairman of the Energy and Commerce’s Subcommittee on Health. Interestingly enough, these two representatives combined have received over $6 million (out of $10.7 million) from the entire health care industry, putting them head and shoulders above the rest.

Why would these two men be individually targeted? Rangel is one of three heads of committees responsible for drafting the legislation on health care reform, while Pallone’s subcommittee has sole jurisdiction over Medicaid. Pulling specifically from the AMA’s “Vision for Health System Reform,” two of their top goals are: insurance market reforms that expand choice of affordable coverage and eliminate denials for pre-existing conditions, and a repeal of the Medicare physician payment formula that would trigger steep cuts and threaten seniors’ access to care.

In addition to the $8.2 million spent on lobbying efforts in the first six months of 2009, the AMA has spent even more money advertising in an attempt to sway public opinion of the president’s proposed reforms. For example, since August 13, viewers in key markets have seen $8 million in ads sponsored by the “Americans for Stable Quality Care,” an organization that includes the AMA and a handful of other institutional backers of Obama’s proposal. Most of these ads have been focused on the states of key representatives and where conservative Democrats are thought to be wavering.

As mentioned before, while the AMA may be one of the most trusted voices by the public in the health care debate, some economists argue that it helps perpetuate one of the biggest problems with the American system: a cartel that limits the number of doctors. President Obama and his fellow Democrats blame the current health care mess on the free market. But a free market can’t exist when a cartel with the ear of the government is allowed to control the key input for its own self-aggrandizement. It is very clear that the AMA, while appearing to have the best interest of their patients in mind, clearly have self-serving interests in regards to their lobbying efforts, their money, and their authority.