WASHINGTON — When President Barack Obama comes to Raleigh, N.C., Wednesday, he'll visit a state heavily invested in the health care debate and spending millions to shape its outcome.
The pharmaceutical industry, working to fight off new generic competitors and Canadian imports, employs 118,000 people here. Medical schools churn out doctors torn between careers as specialists or taking the less lucrative but sorely needed path of primary care. And major corporations such as Mooresville-based Lowe's are trying to figure out how to cover their employees' medical needs.
In all, North Carolina companies and agencies with an interest in shaping the debate over the nation's health care system have spent $4.8 million this year in Washington lobbying — a jump of nearly 40 percent over this time a year ago, according to an analysis by the Charlotte Observer and The News & Observer of Raleigh.
National pharmaceutical companies with significant interests in North Carolina have spent millions more. Together, lobbying dollars for GlaxoSmithKline, Merck, Novartis, Biogen and Wyeth have shot up 23.8 percent over this time last year, to $15.7 million.
GlaxoSmithKline, which spent $4.7 million in the first six months this year, has U.S. headquarters in Research Triangle Park. The other companies either now have or plan to build drug manufacturing plants in the state.
The lobbying boost comes as the health industry also pours thousands of dollars into lawmakers' campaign chests. The state's two senators sit on the Senate health committee that wrote significant chunks of the health care bill. Several Democratic lawmakers are viewed as sitting on the fence about the health care overhaul.
"There's no question special interests wouldn't be providing money or spending huge sums of money to lobby if it wasn't for the purpose of influencing decisions," said Bob Phillips, executive director of Common Cause North Carolina, a nonpartisan organization that monitors influence spending.
"While it is legal, it's certainly not on a level playing field," he said. "When gobs of money are going to people who are supposed to be writing the legislation, how fair is that process going to be?"
Several of the state's federal lawmakers have benefited from health industry dollars.
Sen. Richard Burr, a Republican, received $85,100 from the health care and pharmaceutical industries this year, according to Common Cause.
On Monday, Burr was one of three featured Republican senators at an exclusive “Roundtable on Healthcare Issues” at a Washington steakhouse. All are on key Senate committees shaping the overhaul.
The fundraiser, which cost from $2,000 to $5,000 per person, seated just 35 guests and was put on by the National Republican Senatorial Committee, which works to get Republicans elected to the Senate.
Burr is up for re-election next year and could receive help from the NRSC.
Sen. Kay Hagan, a Democrat who just won election last year, received $12,500 from the health care industry, nearly half her total campaign take this year.
Hagan also sits on the Senate health committee and played a key role last month in slowing a Democratic push for a public option that many thought would threaten private insurance companies.
In the House of Representatives, Democratic Rep. Bob Etheridge of Lillington received $24,150 this year. He sits on the powerful Ways and Means Committee, which included a hefty tax increase on the wealthy as part of its contribution to the health care debate.
Other top recipients included Democratic Reps. Larry Kissell, Heath Shuler and Mike McIntyre.
Kissell, Shuler and McIntyre, all fiscally conservative, are seen as key swing votes who could side with Republicans on many of the overhaul bill's details.
Federal lobbying records don't say exactly what issues companies are pushing for as their lobbyists walk the halls on Capitol Hill.
Federal law does not require a company to say how much of its lobbying dollars are being spent on a specific issue. Lowe's, for example, lobbied this year not only on health care, but also on credit card legislation, weatherization programs and unionization of employees, according to its reports to the Senate.
But many of the firms in North Carolina do most of their business in health care and pharmaceutical manufacturing. Drug companies are worried about Canadian imports, the cost of drug coverage for Medicare recipients and Obama's push for a publicly run health insurance option. Those who make biologic drugs also worry about legislation that would allow cheaper generic drugs to quickly enter the U.S. market.
Carolinas HealthCare System, which runs 25 hospitals in North and South Carolina, spent $153,000 since January on lobbying. Spokesman Kevin McCarthy said the company is especially interested in two aspects of reform: providing a medical home to underserved patients and increasing federal reimbursement rates to hospitals.
"Regarding our lobbying efforts, we're very fortunate in North Carolina to have a congressional delegation that's not only very interested in this topic, but in many cases we have legislators who are playing an active role," McCarthy said. "We're hopeful that we'll help frame a solution that's beneficial to everyone going forward."