WASHINGTON (AP) _ Health care professionals are giving Democrats a second look after more than a decade of opening their wallets in favor of Republican candidates.
The shift in giving is apparent in the presidential contest, where leading Democrats are raising more cash from doctors, nurses and other caregivers than are Republicans.
Two main factors are at play: Democrats now control Congress and Democratic presidential candidates are raising more money than are Republicans.
``The health care industry wants to influence the majority in Congress and ... they are reading the same tea leaves as everyone else that suggest the Democrats could have good results in the 2008 elections,'' Jonathan Oberlander, a health politics expert at the University of North Carolina at Chapel Hill, said in an e-mail.
No one better represents this realignment than Hillary Rodham Clinton. She leads all presidential candidates with $700,000 in donations from doctors and nurses, according to an Associated Press analysis of Federal Election Commission data for the first six months of 2007.
The three leading fundraisers in the Democratic field _ Clinton, Barack Obama and John Edwards _ have combined to amass nearly $2 million from health professionals, according to the nonpartisan Center for Responsive Politics.
The top three GOP fundraisers _ Mitt Romney, Rudy Giuliani and John McCain _ have raised a total of nearly $1.9 million from the health sector.
If the pattern holds, Clinton's success could be a political turning point _ and one full of irony.
As first lady, she led a failed effort by her husband's administration in the early 1990s to overhaul the health system. By 1994, health professionals and the organizations that represent them were beginning to tilt Republican. This pattern continued throughout Republican control of Congress from 1995 until last year.
Buttressed by well-financed political action committees, physicians in particular preferred Republicans by at least a 3-2 margin in federal races from 1996 to 2006. President Bush did even better in 2004, getting $6.7 million to Democratic nominee John Kerry's $4.1 million, according to the center.
Four years earlier, Bush outraised Democratic rival Al Gore among health professionals by 7-to-2.
The message, according to MIT economist Jonathan Gruber, was clear: no more attempts at overhauling the health care economy.
Then the landscape changed.
Democrats swept Republicans out of power in last November's elections. Bush slid into a public opinion rut. Republican donors failed to get as motivated for their presidential candidates as Democrats did for theirs.
What's more, Democrats stopped advocating top to bottom changes in health policy.
``It's not the kind of rip it all up and start over approach that we saw in the early '90s,'' said Gruber, who has been advising Democrats on health care policy. ``That's just not what you're hearing now. You're hearing it from Michael Moore. But you're not hearing it from Hillary Clinton or Obama.''
The health care terrain does not all belong to Democrats, though.
Romney, the former governor of Massachusetts, spearheaded his state's bipartisan health plan, with its goal of providing health coverage to the state's uninsured. Gruber was among those who advised Romney's health team.
Romney's work may be paying off. He is not far behind Clinton in contributions from health care professionals and leads her among employees of drug companies, the AP analysis shows.
``There is a change in the politics of health care reform that is in part reflected in these numbers,'' said Anthony Corrado, a campaign finance expert at Colby College in Maine. ``We have an increasing segment of health care professionals who recognize that the current system is gravely ill and that change is needed.''
Obama and Edwards have offered detailed plans that aim to provide universal insurance. Edwards' requires everyone to have coverage; Obama's does not.
On Thursday, another Democratic contender, Sen. Chris Dodd of Connecticut, proposed insurance coverage paid by businesses and individuals, with premiums based on their ability to pay.
Clinton has not been as specific, indicating she will roll out her plans over time. She has offered cost reduction proposals such as computerized medical records and emphasis on disease prevention and drug purchasing plans to reduce the price of medicines.
Her deliberate pace has not hurt her with health professionals or even with some drug manufacturers.
She received $4,600 from Kevin Sharer, the chairman, chief executive and president of Amgen, a California-based pharmaceutical company. Sharer also gave $4,000 to McCain and $2,300 to Romney.
Sheila Krumholz, the center's executive director, cautioned about reading too much into contribution figures. Donors at this stage are more likely to be driven by personal ideology, she said, than by industry considerations.
``I'm not sure this can be attributed to an industrywide shift,'' she said.
It could be the first hint of one, however.
``Surely, ideology is important to them, but they are also political investors,'' Oberlander said. ``I assume they want to make sure they have ties _ political and financial _ to candidates they see as plausibly winning the White House in 2008, even if that candidate's ideology doesn't exactly match their own.''