President Barack Obama has stressed the need for lower health care costs, increased coverage and timeliness to Congress. But behind the scenes other forces are working to protect their turf in the high-stakes legislation. Pharmaceuticals, hospitals and insurance companies have all ratcheted up their lobbying efforts. Health professionals and professional groups like the American Medical Association spent more than $160 million on 2008 campaigns, while hospitals, nursing homes and HMOs threw just below $40 million into the ring. Between lobbying and campaign contributions, insurers like AFLAC spent $200 million in 2008 and have already spent more than $50 million lobbying this year. And big pharma might have a little say on the health reform table: since 2007 companies like Pfizer and Amgen have sent more than $600 million to Washington . Though these interests have cast wide influence over Congress itself, key players in health care reform may find it costly to serve the people over their financiers. Rep. Henry Waxman, D-Calif., who chairs the Energy and Commerce Committee where the reform bill currently sits, received $180,000 in 2007-08 from health professionals and pharmaceuticals. But this is small potatoes compared to the money insurance giants have sent to Max Baucus, D-Mont. The centrist chair of the Finance Committee received $2.3 million from insurers, pharmaceuticals, medical groups, hospitals and health service organizations for his 2008 Senate bid. With legislation now topping two thousand pages , one canâÄôt help but wonder for whom it will cater. Can a politician take a few million from an industry and vote for the common good? Is this fight already rigged?