Program Note: Tune in tonight to hear Joe Johns' report on lobbying and the financial industry. AC360° at 10 p.m. ET.

Joe Johns and Justine Redman
AC360°

It may be a recession on your street, but good times are rolling along K Street in Washington DC – otherwise known as the home address for lobbyists.

Health care has become one of the most crucial political issues of 2009, and more than $293 million has been spent on health care lobbying so far this year. At this rate, 2009 looks like it will set a new record for lobbying.

The heat is still on, as the future of health care reform rides to a large extent on the power of individual members of congress. Today Senate Majority Leader Harry Reid announced he will introduce a bill including a "public option," when only a few weeks ago, a "public option" was considered as good as dead. These last few days, TV airwaves have been a seeming barrage of politicians and pundits frantically pushing their agendas. Whether it's Reid or other pivotal Senators such as Olympia Snowe, with every move they make, a frantic dance of lobbyists has preceded it.

According to figures published by the Center for Responsive Politics, there are currently 3,185 lobbyists working all sides of the health care issue. Congress has 535 members. That means there are nearly half a dozen lobbyists for every elected official on Capitol Hill on this topic alone.

Representatives from the health care industry say all those lobbyists are carrying important messages in the policy debate. "The American people need to hear from us what we're for," says Karen Ignagni of American Health Insurance Plans. "We also need to correct the record to make sure people hear from us where the record is wrong, and we will do that."

But during his presidential campaign, Barrack Obama was highly critical of the influence of lobbyists in Washington. Now that he's president, critics say that by launching the health care debate, he is helping put money in the pockets of the same lobbyists he railed against.

And what exactly are lobbyists are pushing for? Everybody's got a different angle, and the most active lobbyists are those advocating for the business interests with the most to win or lose. It's not surprising, then, that the pharmaceutical and health product sectors are spending the most on health care lobbying.

TOP SPENDERS ON HEALTH CARE LOBBYING THIS YEAR:

1. PHARMA, the Pharmaceutical Research Manufacturers of America: NEARLY $14 MILLION

2. Blue Cross/ Blue Shield: NEARLY $12 MILLION

3. Pfizer: NEARLY $11 MILLION

But that's not all. The industry has also been very generous in its donations to politicians. According to the Center for Responsive Politics, members of the Senate Finance Committee, who have been especially influential in health care reform, have received big bucks. Committee chairman Max Baucus (D, Montana) got more money from the health insurance and pharmaceutical industry in the last election cycle than any other Democrat currently in congress. Senator Baucus told CNN, "No one gets special treatment" because of that, and money "plays no influence" in how he makes his decisions.

In this election cycle, of the top 20 congressional recipients of health care donations, 5 are members of the Senate Finance Subcommittee on Health Care who have all been critical of the industry:

Sen. Blanche Lincoln (D, Arkansas) $412,450

Sen. Charles Schumer (D, New York) $349,650

Sen. Ron Wyden (D, Oregon) $317,500

Sen. Orrin Hatch (R, Utah) $206,187

Sen. Debbie Stabenow (D, Michigan) $163,990

All together, the dollar amounts may look staggering to people struggling just to pay their own medical bills. But to the industry, what they're spending on trying to get their way is only a fraction of what they fear losing in whatever reforms the government may eventually make.