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MELISSA BLOCK, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.

ROBERT SIEGEL, host:

I'm Robert Siegel.

And we are going begin this hour by meeting some lobbyists who are trying to influence the health care debate. It's part of a series that we debut today. It's called Dollar Politics. NPR is tracking the flood of money washing over Capitol Hill as Congress takes up three massive subjects: financial regulation, energy policy, and health care.

BLOCK: On MORNING EDITION today, we heard about the swarm of lobbyists that gathered as the Senate began working on a health care overhaul. Now, correspondents Andrea Seabrook and Peter Overby, together, introduce us to a few of those lobbyists.

(Soundbite of crowd)

PETER OVERBY: When the first Senate committee took up health care reform the room was filled with lobbyists.

ANDREA SEABROOK: They watched the Senators working, took notes, leafed through the copies of the bill.

OVERBY: Meanwhile, we took panoramic photos of them. After all, congressional hearings are open to the public.

SEABROOK: We wanted to know how many lobbyists go to these important hearings. What are they hoping to influence? Who are they?

OVERBY: We've already began to identify them. Take a look at the npr.org.

SEABROOK: In the front row, over to the right, sits Sharon Cohen. She is a health care lobbyist at the Podesta Group, one of Washington's biggest lobby firms.

Ms. SHARON COHEN (Health Care Lobbyist, Podesta Group, Washington): When you're in the room, the phones not ringing. You're not looking necessarily at your email, although everybody has berries these days. But it allows you to focus a bit much more than if you're just sitting at your desk.

OVERBY: Most of Cohen's clients are drug companies, Novartis and Genenpac are the biggies. She also represents a large national hospital and a coalition of nursing home operators.

SEABROOK: Cohen later told us, as she sat in that first health care session, she was listening to the Senators position themselves in their opening statements.

Ms. COHEN: Financially, about the amendments, in terms of how they're being discussed and the ultimate votes on those amendments.

SEABROOK: Also in the front row, a little over to the left, sits Marsha Simon. She has her own three person boutique firm.

Dr. MARSHA SIMON (President, Simon & Company LLC): I work with companies that are involved in implementing the health system. They do information tech, health information technology firms. They're firms that handle, they process claims in the Medicare program. They do appeals when a Medicare beneficiary is turned down by a managed care plan and the like.

OVERBY: Now look way in the back by the wood paneled walls you'll see Richard Miller. He lobbies for the American Chiropractic Association. He told me later it's important that the chiropractors keep on top of the bill.

SEABROOK: And make sure Senators and staff see them doing that.

OVERBY: Because the chiropractors are small dogs in a big fight.

Dr. RICHARD MILLER (Director, American Chiropractic Association): I mean, there are some very big picture issues here, some very large players. We have a fairly active and aggressive lobby, but in the grand scheme of things, the cost of this legislation could easily be over a trillion dollars a year.

SEABROOK: Now the fact that these lobbyists were there makes perfect sense. Every citizen has a constitutional right to petition the government. And remember Congress is attempting to overhaul an industry that affects literally everyone.

OVERBY: But add all of the lobbyists together, and throw in the campaign money that comes along with lobbying, and you've got a problem.

SEABROOK: Gridlock. President Obama certainly sees it as an obstacle to change. He's tried limiting lobbyists in their access to the executive branch. But that runs into the constitutional question.

OVERBY: And in any case, it's really up to Congress to set the lobbying rules for Capitol Hill.

SEABROOK: I spoke with Julian Zelizer. He is a professor of history and politics at Princeton University.

Professor JULIAN ZELIZER (History and Politics, Princeton University): It's extremely hard, because every time a legislator genuinely wants to try to craft a new policy, they have to contend with very powerful interest groups who threaten, who cajole.

SEABROOK: There's another way to tell this story: with numbers. These are from the Center for Responsive Politics.

OVERBY: Between 1998 and 2008, the number of registered lobbyists on health care more than doubled, to 3,600. Then there are those that don't have to register, like former members of Congress who are senior advisers and grassroots organizers and producers of TV ads.

SEABROOK: The jump in spending is even greater. Organizations lobbying on health care spent more than $484 million last year. That's two and a half times what was spent a decade ago and it's more every year.

OVERBY: Why spend so much? Three words: return on investment.

SEABROOK: While a drug company might spend a few million lobbying, they stand to gain, or lose, billions in the outcome.

OVERBY: Let's take one big example from 2003, when Congress added prescription drug coverage to Medicare. One provision shifted consumers from Medicaid to Medicare from a program where the government can bargain down drug prices, to one where, under the new legislation, bargaining was prohibited.

SEABROOK: Most estimates find this was worth billions to the drug makers. The amount they spent on lobbying that year: about $126 million.

OVERBY: A bargain. Peter Overby.

SEABROOK: And Andrea Seabrook.

OVERBY: NPR News, Washington.

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