The last graph of a relatively recent New York Times story hinted at the politics of health reform. The story, a rather routine piece about a Congressional Budget Office report, described the potential savings from various cost containment nostrums. At the end of its story, the Times revealed what's at stake. Medicare is scheduled to cut doctors' fees by 21 percent in 2010 and by 5 percent in each of the next few years. If those cuts materialize, the government would save $318 billion over the next decade, far more than would be saved by other remedies.

In a presentation to Congress, acting CBO director Robert Sunshine amplified this point: "Significantly reducing the level of growth of health care spending would require substantial changes in the incentives faced by doctors and hospitals to control costs," he said. Translation: to really reduce medical spending, doctors and hospitals might face cost controls that could lower their incomes. The American Medical Association successfully fought this possibility every time health reform rose on the national agenda, and it's a good bet they will fight again, while angling for a prominent place at Obama's table.

In the current round of reform mania, the media have hardly discussed the role of doctors and other health professionals. For starters, they have given gobs of money to Obama and to those legislators who will be gatekeepers for reform. According to, the Web site of the nonpartisan Center for Responsive Politics, health care professionals—including doctors with lucrative specialty practices as well as dentists and nurses—rank sixth out of eighty-some industries in campaign donations this year, spending nearly $87 million on various candidates, with more than $10 million going to Obama. Senate recipients include influential Republicans John Cornyn and Mitch McConnell, who got about half a million dollars each, and Senate Finance Chairman Max Baucus, who got almost $360,000. That's not chump change.