What's Best For The Patient?

For months, George W. Bush and Ted Kennedy were Washington's Odd Couple--the Texas conservative and the Massachusetts liberal who had teamed up and become something like friends. They swapped stories, watched a movie, got things done. Just two weeks ago, the Republican President phoned the Democratic Senator to congratulate him on the education bill they had maneuvered through Congress together. But if one week is a long time in politics, two weeks is an eternity. The Odd Couple has split up, because Washington has resumed its four-year war over the patients' bill of rights. The issue: How much power should government give people to sue and second-guess the insurance companies and health-maintenance organizations that make life-and-death decisions about medical care?

Last Wednesday morning Bush convened a war council of top aides in the Oval Office. For weeks he had hinted at the possibility of a veto if Congress sent him Kennedy's version of the patients' bill of rights. Now Bush decided to make the threat explicit the next day--in a three-page document from his Office of Management and Budget that laid out a stinging indictment of the measure. In legislative warfare, this was the equivalent of a 16-in. gun.

Thursday afternoon Kennedy charged into the L.B.J. Room off the Senate floor feeling pumped. Bush's first broadside hadn't sunk him. Kennedy's team had just defeated the Republicans' initial attempt to amend his bill. When Kennedy appeared inside the room, 30 lobbyists for patients'-rights groups and powerful health-care organizations like the American Medical Association broke into applause. But he quieted them. This President was good at snatching back victory, he knew. The grassroots activists had to keep the phones ringing in Senate offices. "We can't let up," Kennedy told the lobbyists. "We've got to keep the pedal to the metal every hour."

Bush and Kennedy are adversaries this week, but each will be ready to wrap his arms around the other when doing so suits his purpose. That makes each man's camp more than a little nervous. Kennedy often thrives during a Republican Administration. He despised Jimmy Carter and suffered in silence as Bill Clinton tilted to the center. During a G.O.P. Administration, he is freer to bend Democrats to his agenda without competition from a President of his party. And Bush realized before he arrived in Washington that he would have to go through Kennedy to pass his domestic agenda.

The two men began their courtship while Bush was still a presidential candidate. Last July, during the funeral in Atlanta for Georgia Senator Paul Coverdale, Bush walked up to Kennedy and said, "I understand that what you do, you do well." Kennedy wasn't sure if that was a compliment or a jab, but five months later, while Kennedy was vacationing in the Caribbean, President-elect Bush phoned him and sounded him out about working together on education. Kennedy liked the idea. On Jan. 20, during a congressional lunch after the Inauguration, Kennedy got former Wyoming Senator Alan Simpson, a conservative friend, to take him over to Bush's table for a chat. "Mr. President," Simpson said, "here's Ted Kennedy, the orneriest s.o.b. in this place. But if he tells you he's going to stick, he'll stick."