Jul. 31--Back in 1993, when freshly elected President Bill Clinton proposed a universal healthcare plan, the healthcare industry spent millions to lobby and advertise against it. Eventually, that helped kill the plan.

Today, healthcare companies are again lobbying Congress heavily as it considers President Barack Obama's healthcare proposals -- to the tune of $1.4 million per day, according to the Center for Responsive Politics, a nonpartisan group that tracks money in politics. Healthcare has spent more on lobbying than any other industry in 2009.

The difference between now and 1993 is that this time around, the various sectors of the healthcare industry have a tangled web of competing interests. They're not spending just to defeat reform, but to influence it, because they have much to gain from some of the proposals bouncing around Washington, D.C.

"That's something that's very different now than what we had at the beginning of the Clinton administration," said Hal Luft, a healthcare economist who runs the Palo Alto Medical Foundation Research Institute in Northern California. "Even the health insurers are now saying we need some kind of reform."

And that, Luft said, makes it likely some sort of healthcare package will make it out of Congress and be signed into law by Obama.

"The Obama Administration has been very smart in not putting out a specific plan," Luft said. "With the Clintons, almost everybody (in the industry) was angry because they weren't included in the discussion."

Healthcare overtook finance three years ago as the sector that spends the most on lobbying. And among healthcare companies, the biggest spenders by far are drug companies, which have spent $133.9 million on federal lobbying so far this year, according to the Center for Responsive Politics.

"It's not surprising," said Harold Pollack, the chairman of the Center for Health Administration Studies at the University of Chicago. "If you were an industry that was one-sixth of the U.S. economy, and the government was already your biggest customer, and the government was undertaking a major overhaul of your business, you'd be spending a million bucks a day, too."

Thousand Oaks-based Amgen has spent $6.15 million this year on lobbying, more than any drug company except for Pfizer and Eli Lilly. Amgen's Political Action Committee also tripled its campaign spending from 2004 to 2008, to $1.5 million, split fairly evenly between Democrats and Republicans.

A drug company like Amgen has a wide array of policy goals in the current debate, Pollack said.