The long-awaited health care reform bill crafted by Sen. Max Baucus, D-Mont., was unveiled this week. The $856 billion, 10-year proposal would insure tens of millions of Americans now lacking health insurance and would make other changes to the way health care is delivered in the United States.

Baucus is head of the Senate Finance Committee, and he led the health care reform effort with three Democrats and three Republicans from the committee. The work of the group was described as "behind the scenes," but there can be little doubt these six lawmakers did not work alone on the health care legislation.

Also present in the room were the campaign contributions and lobbying efforts of the health care industry. Money from health insurance companies, drug makers, and groups representing hospitals and doctors surely influenced the lawmakers' efforts.

That's no different from the influence of donations from big banks and Wall Street firms on pending financial reform, but the public must understand the influence of money when it comes to health care reform.

Health care reform is as much about protecting profits as it is about providing universal coverage.

The six key senators have received more than $10 million from groups impacted by health care reform since 1989. That figure, which amounts to about $1.8 million for each senator, is triple the average donations to other members of Congress from health care interests.

According to the Center for Responsive Politics, the health care sector has donated about $328 million to members of Congress over the past 20 years. In the first half of this year, the health care sector has contributed $23 million. And the health insurance industry alone has donated $42 million to members of Congress, including $2 million to the six senators on the Baucus committee.

Baucus told a Montana newspaper that he resents "any implication that any of my actions or decisions are a result of contributions." But giant health insurance companies don't give millions of dollars to lawmakers in the interest of "good government." They give money to try to shape legislation and to protect their profits. They give money, for the same reasons that other industries, including Wall Street bankers, give money — to protect their interests.

The Baucus bill was described by the Associated Press as "the closest to what the insurance industry wants" with no government-run insurance option and mandates that require everyone to purchase health insurance.

Baucus boasts, "This is a good bill. This is a balanced bill. It can pass the Senate." Maybe so, but it also is a bill that reflects deference to the interests of the heatlh care industry.

The fact that the health insurance industry, drug makers as well as groups representing hospitals and doctors now support health care reform, when they bitterly fought similar efforts during the Clinton administration, suggests these groups are content that their interests have been protected. They also might see reform as now inevitable, so they are working to get the best deal possible.

Health insurers have promised, through "efficiencies," to trim $200 billion a year from the nation's health care costs of $2.2 trillion a year. Drug makers have stepped forward and promised savings of $80 billion over the next decade.

In both these cases, special interests — and profits — are being protected. The so-called "public option" for health insurance would have created real competition and forced down health insurance costs. The Baucus bill's plan for health insurance co-ops is not expected to threaten private insurance companies' profits or their CEOs' multimillion- dollar salaries.

And by promising some cost savings, drug makers have avoided the prospect of the government using its massive bargaining power to bid down the price of drugs — something done in most other countries.

Despite promised savings, both the insurance companies and the drug makers expect to see higher profits when the tens of millions of Americans currently not covered by health insurance become customers.

The American Medical Association also now backs reform efforts. The Los Angeles Times reported on the AMA's new perspective on health care reform, saying, "Of all the interest groups that have won favorable terms in closed-door negotiations, the association representing the nation's physicians may have taken home the biggest prizes, including an agreement to stop planned cuts in Medicare payments that are worth $228 billion to doctors over 10 years."

Robert Laszewski, a former health insurance executive who now tracks health care policy, says the groups that once opposed health care reform, meaning insurance companies, drug makers and doctors, have all received sweetheart deals in exchange for their support.

So, health care reform might move America toward universal coverage, but it still protects the interests that have caused health care spending in the United States to cost twice as much as it costs, per capita, in most other industrialized countries.

Nobody is talking about bringing America's health care spending in line with other advanced countries' spending — because real cost control would mean reduced profits for health insurance companies, drug makers, hospitals and doctors.

Explaining why cutting health care costs is so difficult, U.S. Rep. Jason Altmire, D-4th, got it right when he told a Pittsburgh newpspaer, "Every dollar spent has a constituency." That means that when there is talk about cutting costs, it is generally a threat to someone's profits. And hundreds of millions of dollars is being spent on campaign contributions and lobbying to protect those profits.

Heatlh care reform, if passed, might very well help millions of people and bring other positive changes. But based on current proposals, it will, more than anything, protect the interests of insurance companies, drug makers, hospitals and doctors.

Baucus and his fellow committee members were not working alone behind those closed doors.