The time, money and manpower that lobbying firms devote to courting lawmakers reveals an investment inside the Beltway of staggering proportions. For every lawmaker in Congress, there are about six lobbyists pushing their health care priorities, according to a Bloomberg News investigation released today. That's about 3,300 registered health care lobbyists working Capitol Hill. A total of $263 million has been spent on health lobbying in 2009, according to the latest data from the Center for Responsive Politics. That's more money spent on health than any other sector this year. The list of the top 20 spenders in 2009 across all sectors includes the U.S. Chamber of Commerce at No. 1, spending more than $26 million, Pharmaceutical Research and Manufacturers of America (PhRMA) at No. 3, spending $13 million, and Pfizer in the No. 6 spot, spending $11 million. Also joining the ranks of the top 20 spenders this year are Blue Cross Blue Shield, AARP, American Hospital Association, American Medical Association and Eli Lilly, each having doled out between $7 and $10 million this year. Wendell Potter, a 20-year health insurance veteran and former CIGNA vice president, ... spoke out about insurance companies operating behind the scenes. Potter recalled previous health care fights, saying insurers have undoubtedly tried to shape the battle. It is usually done through the PR firms that work for them," Potter said. "They want to keep their fingerprints off stuff like that. "With this history, you can rest assured that the industry is up to the same dirty tricks, using the same devious PR practices it has used for many years to kill reform this year, or even better, to shape it so that it benefits insurance companies and their Wall Street investors far more than average Americans," he said.