A success to dwarf his failures: One year on, has Clinton changed anything? Not yet, says Ben Pimlott, but his health plan is genuinely radical

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IS PRESIDENT Bill Clinton turning out to be a 'different kind of Democrat', as promised? Should Britain's would-be mould-breakers care? A year after Clinton's election - and following as many banana skins as initiatives - it is a fitting time to ask.

The election to the White House on 3 November 1992 of the first Democrat for 16 years caused delight in battered Labour Party circles. Perhaps there was a secret formula: shadow cabinet members sped across the Atlantic to find out. On their return, there was a flurry of excitement about the possible 'Clintonising' of Labour policy. For a while, it looked as if so-called New Democrats offered a way forward for British new socialists - a path that could inspire the faithful, gain approval in the media and please the voters.

In many ways the dilemma that faced American Democrats in the early 1990s was astonishingly similar to Neil Kinnock's in Britain. In America, as in Britain, the right-wing fervour of the early Eighties had given way to something a lot limper: in the United States George Bush, in the UK John Major. But the opposition remained deeply uncertain. The Democrats seemed to have a choice between clinging to a hallowed New Deal welfarism that wasn't pulling votes, or leapfrogging into a new radicalism that, as evangelists of the New Democracy claimed, was concerned - and cost-conscious.

Clinton made a serious bid in his campaign to do both. His propaganda mixed revivalist fervour and electoral candy with an unusually large dose (for an American audience) of theorising. The last element pleased the nation's powerful newspaper columnists, helping to make Clinton the candidate with content.

Obviously, there was an element of clever marketing. But there was also some solid weight behind it. Clinton's message was born from the Democratic Leadership Council, a ginger group whose mission is to rescue the party from hands-off conservatism and old-fashioned do-goodery. The DLC seeks to distance the party from 'special interests' which supposedly give it an image problem: gays, feminists and, as with the new-look Labour Party, the trade unions. In some ways, the New Democrats go a good deal further than Labour's most zealous reformers have even contemplated. In a book published earlier this year intended as a blueprint for their new administration, the Progressive Policy Institute, research arm of the DLC, stoutly declares its rejection of 'the recent liberal emphasis on redistribution in favour of pro-growth policies that generate broad prosperity'. Such policies include 'managed competition', a favourite catch-phrase, and 'reciprocal responsibility' which is think-tank jargon for give and take. On social issues, the New Democrat approach might be summed up as 'helping people to help themselves', with as much stress on the stick as the carrot. There is a lot of talk about 'empowering' people in education, welfare, crime prevention, and 'enabling' them, while at the same time cutting bureaucracy down to size. Teachers are to be encouraged to set up their own schools, the long-term unemployed are to be made to work for their benefits, and so on.

It is easy to see the attractions of this agenda, which combines populism with bits of Thomas Jefferson and John Stuart Mill. But is it an ideology with substance? Is it genuinely new? There are no politically neutral answers to either question. Neither right nor left, however, is particularly impressed by the claim to novelty.

Conservatives pooh-pooh the 'empowering' and 'enabling' rhetoric as marginal frills, and point (with relief) to economic continuities. They note that Clinton has not only given the deficit hawks their head within his administration, he has abandoned his initial project for a Keynesian-style public investment package, and has been prepared to face angry opposition from within his own party by pushing ahead with the unpopular North American Free Trade Agreement, which many see as a threat to US jobs.

Meanwhile the left, noticing the same things, voices its disappointment: it doesn't see much that is new either. In the current issue of the American Prospect, the left-inclined economist Jeff Faux savages Clinton for promising a public investment programme before the election, and then failing even to get his modest stimulus package through Congress. Witheringly, he compares the best- known New Democrat politicians (several of whom, like Clinton, are from Southern states) with the leaders on Capitol Hill who used to be called Boll Weevils - Southerners who got their committee chairmanships as Democrats and voted like Republicans. 'Southern conservatives who favour big business and expensive military budgets while opposing social spending,' he writes, 'are hardly new.'

Not all Democrats, however, judge Clinton so harshly, and there are many activists for whom the honeymoon is still continuing. They delight in a White House occupant who is young, open-minded and interested in ideas. Most of all they are optimistic about the possibility of movement in the field that Clinton has made his own: health care. They see this, rightly, as a Democrat issue. They are also aware that the President's colossal new document on the subject is going to be a good deal more important in the 1996 election than all other social issues put together. It is of some significance, therefore, that this particular proposal transcends the divide between 'old' Democrat and 'new'.

The Clinton plan was outlined last month by the First Lady: during a series of gruelling interrogations, she gave a virtuoso performance to gnarled Congressman as a kind of svelte Eleanor Roosevelt - intense seriousness plus glamour. ('She disarmed the guys,' is how a veteran female columnist put it.) One of her achievements was in showing that there is a 'New Democrat' angle to what is proposed, and that it is a long way from the scheme for socialised medicine put forward by Harry Truman in 1949, and killed by Congress. The Clinton aim is not to abolish the market system in medicine, but to make sense of it, through 'managed competition'.

Yet, at the same time, the health plan also meets at least two old liberal criteria. Though it doesn't take away the profit motive, it is an example - in the best traditions of the New Deal - of using big government to sort out an area of public need in which capitalism has failed catastrophically. (And what a catastrophe. In 1970, US public and private spending on health care was roughly equal to spending on education. In 1992, America spent more on health than on education plus everything spent on defence, prisons, farm subsidies, food stamps and foreign aid. Yet the system still leaves 37 million people uninsured and on the wrong side of a medical apartheid that is in some ways as devastating as old-fashioned racial segregation, which it resembles because many of its victims are black.) Second, if implemented, the Clinton plan would not only provide the historic breakthrough of a universal right to mainstream medical treatment, it would also be radically redistributive.

But there is something else that puts the health care plan into a special category: it addresses an almost universal anxiety. Lobbying against it by vested interests has barely begun, and we do not know how much will have been hacked away by the finish. The attitude of the general public, however, is beyond doubt. Polls show that more than 90 per cent are in favour of abandoning the present system, which threatens not just the poor, but also a growing proportion of ordinary citizens worried about their insurance status. As a result, health is the social question that has pushed the right on to the defensive. Already, Republican congressmen are scrambling to rescue their capitalist sponsors with alternative schemes that they would have condemned as dangerous socialism if Democrats had put them forward 18 months ago.

The point about this central platform of the Clinton administration is that something should have been done about it long ago. It is a vital missing piece in the jigsaw of an advanced state. 'We were having the Cold War,' as one Republican ruefully put it to me, 'while you were having social democracy.' The health care plan does not belong to a philanthropist's agenda, or to a marketing executive's list of electoral wheezes. There is an overwhelming demand for reform, and Clinton has made it a family project because he sees it as a potential winner.

If he succeeds, other failures will look petty. More than that, it could change the political climate. Just as Republican power in the 1980s raised the status of market doctrine, so a 1996 Democrat victory, on the back of economic recovery but linked to progress on health care, could do the same for remedies which, in the 1980s, went out of vogue. It might, for example, restore the reputation of the state as necessary battering ram for social change.

Nobody doubts that the Comeback Kid is smart: how different he is will be a matter for debate. Bill Clinton is a serious if sometimes over-convoluted student of policy. His critics do not underrate his intellectual grasp even when they query his judgement or morality. But he is a politician first and a philosopher a long way behind. At his best, he is a skilled communicator, a presser of flesh and consummate fireside chatter on television. He is also a conciliator, a believer in political balancing acts, in finding a middle way in his party and in the nation.

In these respects, he is not so much a new FDR or even a new Kennedy as an American Lloyd George or Harold Wilson - hard to pin down and not quite trusted by either side in any particular dispute. He is not a thinker of original thoughts but a sometimes shrewd manager of well-tried ones. His version of the 'vision thing' is to pick up a good issue and run with it. If his style as a Democrat in the White House works, it will greatly encourage the European left: but more because of the reassurance it will give about the efficacy of old bromides than because of experiments with new ones.

(Photograph omitted)