Now that the battle over health care has moved to the halls of Congress, lobbyists will take center stage. Insurance companies, drug manufacturers, physicians, nurses, hospitals, nursing homes and nearly everyone else with a stake in the health-care system will make their pitches to lawmakers.

Note that I didn’t mention patients. The system exists to serve their needs, but they are not organized and, therefore, speak with no clear voice. It’s odd, to say the least, that the group with the most at stake in the great health care debate has the least clout and organized input.

AARP purports to be the voice of consumers, but it is so conflicted by its business deals with providers that it is grievously, and perhaps, fatally compromised. Iowa’s senator Charles Grassley, ranking Republican on the Senate Finance Committee, no bleeding heart and no liberal, castigated the organization last April for “systematically misleading” its members by steering them to a product that was good for AARP”s bottom line but not for consumers in need of health-care security. A Grassley staffer told me that AARP rakes in tens of millions of dollars in royalties from the companies whose products the organization promotes.

If AARP’s performance in the debate over the Part D drug bill is a measure of its dedication to patient interests, consumers will have to look elsewhere for effective support on the pending legislation. Part D is wonderful for insurers and drug companies, but a complex nightmare for many patients.

Congress cannot create a voice for patients in the legislative process. But it can insure that patient interests are fully articulated in rule-making and in all other aspects of the way the legislation is implemented. The press needs to wake up to the minimal role patients play in health-care policy and give this grave defect the coverage it deserves.