If the devil is in the details then the health legislation wending its way through Congress has Lucifer's autograph on it. The reform bill that passed the House last week (p 1118) is touted as being a lifesaver for Medicare, the insurance plan for 37 million elderly Americans. What has not been greatly discussed are the deals that were made with various interest groups.

The American Medical Association, which represents about 45% of US doctors, has done especially well. House Speaker Newt Gingrich admitted that he cut a deal with the AMA that protected doctors from draconian fee cuts. What he did not admit so openly were more subtle …