Throughout 2009 and early 2010 U.S. healthcare was involved in a huge power struggle with special interest groups lobbying to retain their profit margins, the Democrats trying to get their bill passed and the Republicans opposing every Democrat move in that direction to regain seats in both houses in November 2010. How did profit motive of special interest groups impact health reform? How did traditional market forces or government forces impact health reform? How was the welfare of the uninsured addressed while select groups argued over the extent to which they would have to cut into profits? This article addresses these quandaries by examining six major health care industry special interest groups sitting at the Obama bargaining table. These groups include pharmaceutical manufacturers, medical equipment companies, health care insurers, hospitals, physicians and employers. It examines the deals that were made to contribute toward paying for health reform while protecting current profits. A price/cost volume breakeven analysis (present and potential) is estimated for these special interest groups to illustrate the fears and the response including extensive lobbying in 2009.