The Serpent on the Staff.

• Author: Birnbaum, Jeffrey H.

President Clinton has been pretty tough on lobbyists. In 1992, he promised to break their "stranglehold" on Washington, and one of his first acts as president was to ban his appointees from lobbying their agencies for five years after they leave government. Now Clinton is pressing for campaign finance and lobbying disclosure reforms that have a decent chance of passing.

But what he is not doing is ending the influence of influence peddlers. To the contrary, in many important ways, Washington is even more lobbyist-friendly now than it was when Clinton came to town.

One of the great truths of life in the capital is that change in any form creates more business for lobbyists. And Bill Clinton is stirring the pot hard and fast in a way that is especially profitable for the lobbying industry. Clinton is an activist president who believes in an activist government. This combination means big-paying corporate clients have a lot more to fight for--and to protect themselves against--and that translates into more work for lobbyists.

Take the president's health care legislation. Conceptually, it is as populist a proposal as has been floated in years. One of its chief aims is to provide health coverage for the 37 million Americans who aren't,t covered now. But to do so, some of the nation's richest and most powerful interests, such as drug companies and physicians, will have to change. As a result, health care is likely to be the most lobbied bill in history.

Even the anti-lobbying president knows this and, despite his rhetoric, is including lobbyists in his plans. He put three former lobbyists in his cabinet. And like previous presidents, Clinton has an entire division of his White House devoted entirely to keeping lobbyists, and the interests they represent, in line. It's called the Office of Public Liaison. One of this department's chief targets this year, as in almost any other year, is the nearly 300,000-member American Medical Association (AMA).

The AMA is the subject of an informative new book called The Serpent on the Staff, by Chicago Sun-Times reporters Howard Wolinsky and Tom Brune. The authors start off with a promising--and interesting--depiction of the way the AMA got and holds onto its influence in Washington. Unfortunately, this line of analysis dissipates as the book moves along. Where it does continue, it relies too heavily on campaign contributions as its basis; there is much more to the doctors' lobby than that.

Still, The Serpent...