The agreement reached last Saturday, however, did not satisfy House conservatives such as Rep. Mike Pence, a second-term member from Indiana who is regarded highly enough by the party leadership to be named a deputy whip. When Pence heard the news at the Restoration Weekend attended by conservatives at The Breakers in Palm Beach, Fla., he informed House Majority Leader Tom DeLay he could not vote for this bill. DeLay was not happy.

DeLay, arguably the single most powerful House member, had told colleagues that the prescription drug subsidy was the price for market reform of Medicare. Now, in the opinion of Pence, Rep. Pat Toomey of Pennsylvania and other conservatives, DeLay has delivered the subsidy but not reform. The tough Texas conservative, in trying to fix Medicare, has become one of its bigger fans -- sounding like Col. Nicholson building the bridge in "The Bridge on the River Kwai."

"A great opportunity for the Republican Party has been lost," Pence told me. "We should not be the party of entitlements." Scores of Pence's colleagues agree with him, but only 19 voted against the bill in June and fewer will do so this time. Many might contemplate defying George W. Bush, but breaking with Tom DeLay would be more painful. The AARP and the pharmaceutical industry have joined arms supporting this bill. Bush senior adviser Karl Rove, the author of the inoculation theory, assembled private lobbyists late Monday in Room 450 of the Eisenhower Executive Office Building for a pep rally.

But will the Republican inoculation turn out to be an infection? Republican seniors who now get their prescription drugs through supplementary private programs will not be happy about being driven into Medicare. The new bill's "means testing" turns out to be a tax increase for upper income senior Americans. Democrats who are raging over this bill sound like they are protesting being thrown into the briar patch.