Clinton gets tough with White House team: As problems mount over the budget, health care and Bosnia, the President seeks a disciplinarian for staff shake-up

WITH problems crowding his administration on every side, President Clinton is planning staff changes to stiffen discipline at the White House in preparation for weeks and months ahead which could make the travails of his first 100 days look mild.

From health care and campaign finance reform to detailed congressional examination of his economic plans, a string of battles is looming. Admitting the need for tighter 'focus and co-ordination', the President indicated he intended to appoint a hard- nosed administrator as deputy to the Chief of Staff, Thomas McLarty, to oversee the shake-up. 'There needs to be a little tighter co-ordination here to make sure we've got our priorities straight,' Mr Clinton said yesterday.

By the common consent of a city perforce fixated on what happens at 1600 Pennsylvania Avenue, the mea culpa was not before time. From the domestic economy to the crisis in Bosnia and the lukewarm reception in Europe for the military options canvassed by Warren Christopher, his Secretary of State, harsh realities are catching up with Mr Clinton.

Yesterday's news of a full one point drop in the government's key forecasting indicator for April is further evidence that the turn-of-year spurt in economic growth is fizzling out - in part due to consumer worries over the big tax increases in the fiscal 1993/94 budget, detailed congressional scrutiny of which also began yesterday.

The political signals must also concern him. The defeat of his jobs stimulus package was a cruel reminder of Senate arithmetic. That arithmetic looks all but certain to worsen after 5 June when - if the first round of voting in Texas last weekend is anything to go by - the Republicans should pick up the Senate seat of the Treasury Secretary, Lloyd Bentsen.

In what would be another psychological blow, the Democrats risk losing the House seat in Wisconsin that belonged to the new Defence Secretary, Les Aspin, for which a by-election was being held yesterday. Although turn-out may not top 25 per cent, the Republicans have been presenting the contest as a mini-referendum on Mr Clinton's first 100 days.

These struggles are tiny compared with the battle looming over the health care proposals, to be formally presented by the end this month. In his much-noted rush of public candour when he pleaded for delay, the Budget Director, Leon Panetta, was only saying out loud last week what many were muttering privately: that early unveiling of the health plans might only further complicate passage of the budget, central to the President's goal of slashing the deficit by dollars 500bn ( pounds 320bn) over five years.

Almost certainly Mr Clinton will opt for a system of 'managed competition', creating a small number of large insurance consortia able to bargain for lower rates from doctors, hospitals and drug companies. Temporary price controls are also under study. But Mr Clinton is also committed to extending coverage to the 37 million Americans without any insurance whatsoever.

The cost of this measure, put at dollars 100bn to dollars 150bn a year, will have to be met by yet more new taxes (a form of VAT has been mentioned) or higher government spending.

Thus far Mr Clinton has insisted he will stick to his timetable. But sometimes the doubts creep in. 'Maybe we can only do one thing at a time in this town,' Clinton ruefully conceded at a reception last week for the 500 experts who have been beavering away in Hillary Clinton's health care task force.

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