According to the Center for Responsive Politics, the health sector spent $544 million lobbying in Washington last year, an increase of about 12 percent over 2008. The “pharmaceutical and health products” industry put $267 million into lobbying, the most ever spent by a single industry in one year. The U.S. Chamber of Commerce, a powerful opponent of President Barack Obama’s health reform push, spent $123 million lobbying in 2009, although not all on this one issue. What about Obama’s allies? Unions, for instance, supported him. But the AFL-CIO spent just $2.26 million, and the American Federation of State, County, and Municipal Employees, $2.87 million—not much in the scheme of things. More than 3,300 lobbyists were registered to try to influence U.S. policy on health care at one point last year, or six for every member of Congress. So how did Obama beat them in the crucial House of Representatives vote? On the big question, arguably, he didn’t: the health care bill passed was long ago stripped of the so-called “public option,” so even with the new law, no government alternative will be competing with America’s private insurance companies.