Last week Bush's liaison to the Senate, Sen. Bill Frist, R-Tenn., attempted to begin negotiations with leading Senate Democrats on the patients bill of rights. But talks immediately fell through because Frist, apparently at the direction of the White House, refused to let McCain, the Republican cosponsor of the bill, in on the negotiations.

This is, of course, completely at odds with the image Bush is trying to sell to the voter. "I'm very hopeful that we can get a patients bill of rights on my desk, pretty soon," Bush said on Feb. 6, the day a bipartisan patients bill of rights was announced. "And the fact that John McCain and Senator Kennedy and others have come together is a good sign."

A "good sign" for whom? According to knowledgeable Democratic sources close to negotiations, last week Bush made the message clear to Democrats: If you want my support on the bill, McCain can't be a part of it.

This is remarkable not only because McCain is a member of Bush's own party -- not to mention, supposedly, a "friend" of the president's -- but because McCain is one of the two cosponsors of the Senate bill. And, according to everyone from the primary House GOP cosponsor, Rep. Greg Ganske, R-Iowa, to liberal Democratic Senate supporter Sen. Ted Kennedy, D-Mass., McCain's support is key to its success.

There seems to be one clear reason for Frist's attempt to elbow McCain out of negotiations on a bill that bears McCain's name: the personal animus Bush and his chief political advisor, Karl Rove, still feel for the man who came perilously close to toppling Bush in the primaries. McCain does not display the trait most treasured by the Bush team: Bush loyalty. The new president might also be sizing up the man who could, potentially, be his true nemesis in Congress: a Republican senator popular with Democrats, independents and moderate Republicans with the ability to build a majority impervious to a filibuster, and perhaps even to a presidential veto.

McCain has already made it clear that his agenda is not the same as the president's by working with Democrats on campaign finance reform, closing the gun show loophole and the patients bill of rights. This has fostered resentment in the White House among those who see the Arizona maverick as disloyal and an egoist.

For his part, McCain sees himself as doing what he thinks is right, fighting battles he was working on long before the ugly South Carolina primary fight that took place a year ago this week. No doubt he also sees himself making good on the bipartisanship Bush has promised but so far not delivered.

But whatever the reasons behind the animosity, it is now intruding on legislation that could affect millions of Americans. And, at least in this instance, the pettiness is Bush's.

This particular power struggle began Feb. 13 when Frist telephoned Sen. Ted Kennedy, D-Mass., on behalf of the Bush White House to begin a conversation on patients protection legislation, according to a knowledgeable Democratic source. Frist wanted to talk about reducing the cap on punitive damages for patients who sue their HMO in federal court, now set at $5 million in the bill already before the Senate.

Kennedy told Frist he would be interested in setting up a time to talk, but that Frist would have to talk to McCain as well.

"I can't do that right now," Frist said, according to a source close to Kennedy.

In an apparent attempt at an end run around both Kennedy and McCain, Frist then telephoned Sen. John Edwards, D-N.C., McCain's cosponsor of the Senate patients protection bill.

Edwards, too, told Frist that McCain would have to be in on the deal.

Edwards had phoned Bush Feb. 6 to talk about the bill and ways they could work together. That call has still not been returned, but last Thursday Frist again approached Edwards, this time on the Senate floor, to try once more to negotiate without McCain, but he was again rebuffed.

An Edwards spokesman diplomatically refrains from saying anything other than "Senator Edwards is looking forward to that conversation [with Bush]. He thinks their differences aren't that big and can be hammered out."

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