Ted Kennedy lived hard. It was the family way.

The first time I met him, on a boat trip along the coast in Florida at Easter 1962, just before he was manoeuvred into the Senate by family clout, arguably before he had reached the qualifying age, he and his first wife, Joan, were as beautiful as young gods. They were tanned and toned in seersucker, the very image of the American rich on vacation.

Godfrey Hodgson was director of the Reuters' Foundation Programme at Oxford University, and before that the Observer's correspondent in the United States and foreign editor of the Independent. He reported the presidential elections of 1964, 1968, 1972, and 1976 for various British and American media, and was co-author (with Lewis Chester and Bruce Page) of the best-selling account of the 1968 campaign, An American Melodrama (Viking Press, 1969). Among his other books are The World Turned Right Side Up: a history of the conservative ascendancy in America (Houghton Mifflin, 1996); The Gentleman from New York: Senator Daniel Patrick Moynihan (Houghton Mifflin, 2000); and More Equal Than Others: America from Nixon to the new century (Princeton University Press, 2006)

Among Godfrey Hodgson's openDemocracy articles:

"Barack Obama: at the crossroads of victory" (11 June 2008)

"A game of two halves" (15 July 2008)

"Welcome to the party: American convention follies" (18 August 2008)

"America's foreign-policy election" (28 August 2008)

"America's economy election" (17 October 2008)

"Yes he can!" (6 November 2008)

"Change?" (2 December 2008)

"An end and a beginning" (5 January 2009)

"Barack Obama: don't waste the crisis" (6 February 2009)

"Barack Obama's reality gap" (27 February 2009)

"Barack Obama: end of the beginning" (30 March 2009)

"Barack Obama's hundred days" (29 April 2009)

"Barack Obama: a six-month assessment" (10 July 2009)

"Barack Obama's world" (16 July 2009)

"The United States: democracy, with interests" (10 August 2009)

The last time I saw him, at a fundraising lunch in Boston in the late 1990s, he was ravaged - face brick-red, boozer's nose and eye, grossly overweight, but still charged with rare charm and formidable energy. This was the image that characterised his later years, until his death on 25 August 2009 at the age of 77.

In a Newsweek article he wrote after he had been diagnosed with a brain tumour, called "The Cause of My Life", Kennedy listed just some of the medical and psychological disasters he and his family had survived, among them the plane crash that broke his back and several ribs, a son's leg amputated for one cancer, and a daughter treated for another.

He might have mentioned a sister's crippling by a (possibly unnecessary) frontal lobotomy, the death of a brother, a sister-in-law and a nephew in separate plane crashes, and the murder of his two brothers.

His point in the article was that he and his family survived in part because of his congressional insurance, in part because of his family's great wealth. He understood that many other Americans less fortunate than him, were wiped out financially by healthcare costs, or simply died miserably for lack of the money to pay for care. That was why, he was saying, healthcare was, of all his liberal causes, the one that meant most to him, and it is true that in his forty-seven years in the Senate reform of the American healthcare system was his absolute top priority.

For nearly half a century the American media, and therefore the American public, have been more than slightly obsessed with the Kennedy family. No wonder, for the family had everything that makes for celebrity: money, sex-appeal, glamour, style and the unmistakable whiff of scandal. They knew it and they used it all, ruthlessly when necessary.

There are still Kennedys in public life, but they are a pale shadow of the founding generation: some worthy, as the generation of Old Joe's children never were, some faintly cheesy. The aura has gone.

So it is time to move on. Yes, Ted Kennedy was the lion of the Senate. Yes, his life was certainly flawed. No, he probably would not have beaten Ronald Reagan even if the Democrats had forgotten Chappaquiddick and the ugly way in which well-placed Kennedy loyalists were deployed to rescue a Kennedy reputation and obliterate a young woman's death.

Yes, it is true that, finally forced by realities to forget the dream of the presidency, Ted was a good, and in the opinion of most of his colleagues, a very good senator. His work, like that of any legislative craftsman, can be measured by small victories, modest improvements, disasters narrowly avoided, and mildly cynical successes in finding common ground with colleagues whose principles he despised.

The focus now should be, not on the glorious past, but on the present and the future of the Democratic Party.

The great transformation

Three-quarters of a century ago, at the nadir of an economic disaster even more catastrophic than what we have seen in the past two years, Franklin Roosevelt built a new coalition. Long before his time, the party had been a most incoherent alliance between white southerners, bound to it by their determination never to forgive the Republican party that had emancipated the slaves, and a northern working class, many of them immigrants or their descendants, who did not share the Protestant faith of the Republican middle class.

In 1960, by the narrowest of margins, John Kennedy, whose father served Roosevelt but thought his politics far too liberal, was elected president. But it was Lyndon B Johnson, a southerner but an authentic New Deal liberal who - in the brief years before the tragedy of Vietnam destroyed his political authority - pushed through an extraordinary programme of progressive legislation.

Johnson succeeded in passing Kennedy's civil-rights legislation and added a voting- rights statute of his own. He passed Kennedy's reform of immigration law, the supreme example of what conservatives like to call unintended consequences. It was intended to make life easier for Irish nurses and ended up by ensuring that by the middle of the 21st century the majority of Americans would no longer be of European descent. 

That was not all. Johnson also passed major educational reforms. And he did what neither Bill Clinton, nor Ted Kennedy, nor Barack Obama could claim to have done: he carried through major reform of the American healthcare system, bringing in Medicaid (free for the poor) and Medicare (free for senior citizens).

Many of Johnson's other programmes, meant to transform America into what he called the "great society", were so many bridges too far. By 1968, the war in Vietnam had destroyed his political credibility. In 1968, Richard Nixon defeated Johnson's choice as his successor, Hubert Humphrey. An era of conservative ascendancy, interrupted only by the Watergate affair and by Bill Clinton's "triangulation", meaning a partial adoption of conservative ideas, stretched ahead for forty years.

It was not however, only or even essentially Vietnam that ended the previous period of Democratic ascendancy. Lyndon Johnson's muscular social democracy irritated, or troubled, or outraged, enough of those who had formerly made up the Roosevelt coalition, that it ended an age of Democratic domination.

The reasons for this are complex, and have largely been articulated by conservatives, or neo-conservatives, who were less interested in understanding what happened than in making political points. An important element in Democratic decline was racial feeling, some virulent, some half-acknowledged. Johnson himself understood this. When he signed the Voting Rights Act in August 1965, he muttered to an aide, "There goes the south!"

The party system was transformed. Conservative white southerners, long unshakable in their Democratic faith, became Republicans. The Republican Party became (as it had not previously been) overwhelmingly conservative. The Democratic Party became (as it had certainly not been in the days of the one-party south) predominantly liberal. 

There was also a broader suspicion of government, a set of attitudes fed by propaganda from interests, not least the healthcare industry, feeding an instinct that private initiative and private enterprise were "the American way" (see "The United States: democracy, with interests", 10 August 2009). Indeed, the drumbeat of patriotism was insistent. The Republicans succeeded in painting the Democrats as soft on communism, less willing or able to defend America; Ronald Reagan was especially skilful in playing into a mood that was fed up with people - mostly, of course, Democrats - intent on "running down America".

So for most of four decades, the Democrats, though still in terms of registration the majority party, found it impossible to reassure a sufficiently large share of the electorate in presidential contests that they could be trusted with the nation's fortunes and (in the words of the Declaration of Independence) its sacred honour.

The emerging Democratic...what?

Now, as Senator Kennedy's death ends an era in the fortunes of the Democratic Party, is a good moment to examine the party's prospects in the age of Barack Obama.

There was an epochal moment, from the collapse of Lehman brothers in September 2008 to the president's inauguration in late January 2009, when it was possible to believe, or at least to hope, that the future would be bright, and Democratic.

Already, that is doubtful. Certainly the demographics look good for the Democrats. There has been an almost total reversal of the alignment that created the Roosevelt coalition. Conservative white southerners and northern and middle-western working-class men are now almost as likely to be Republicans as they were likely to be Democrats in the 1930s, the 1940s and the 1950s. But Barack Obama has inherited, and added to, blocs of voters who are now at least as important, and growing faster, than those, among them African-Americans, Hispanics, employed professionals, feminist women, and probably Californians.

Yet Obama is already struggling. He has encountered far more opposition to his all-important healthcare reforms than his team expected, and opposition has only grown stronger over the summer. The kind of angry anti-liberal sentiment symbolised by the manufactured controversy over his American birth, but also relevant to far more important issues, has not disappeared. In January, it might have been hoped that the bitter antagonism between a red and a blue America might be ending. It is all too obviously still there.

Over the domestic scene, too, there is an economic crisis that continues to dislocate lives and deepen fears, however happy Wall Street may be. Abroad, there is a host of actual or potential crises: the prospect of stalemate in the Israeli-Palestinian dispute, impending conflict with Iran, possible collapse in Pakistan, and above all the danger that Afghanistan, like Vietnam, could come to frustrate the hopes of a progressive presidency.

Barack Obama has, with great political astuteness, avoided being flagged as a predictable liberal. His political skills and instincts remain formidable. But what he must now do is to articulate a clear, distinct course of policy.  For all his personal failings, that is what Ted Kennedy did achieve as a legislator. Everyone knew where he stood. As chief executive, Obama must do no less.

The sixth anniversary since a bomb of August silenced the United Nations voice in Baghdad is a moment for commemoration of and tribute to the twenty-two people who lost their lives, and the approximately 150 who were wounded. It is also more: for the horrific truck-bomb attack of 19 August 2003 on the Canal Hotel which served as the UN headquarters in Iraq is now a key moment in history.

Johanna Mendelson Forman is a senior associate at the Center for Strategic and International Studies (CSIS) in Washington, DC, in both the Americas Program and the William E Simon Chair of Political Economy. Among her publications is Investing in a New Unilateralism: A Smart Power Approach to the United Nations (CSIS, January 2009)

Also by Johanna Mendelson Forman in openDemocracy:

"Things Kofi Annan can do now" (17 April 2003)

"We cannot afford to fail" (23 July 2003) - with colleagues from the Iraq Reconstruction Assessment Mission

"From the ashes: a multilateral mission?" (22 August 2003)

"The UN in 2003: a year of living dangerously" (18 December 2003)

"The nation-building trap: Haiti after Aristide" (11 March 2004)

"A 21st century mission? The UN high-level panel report" (25 November 2004) - with D Austin Hare

"In Larger Freedom: Kofi Annan's challenge" (23 March 2005)

"President Bush discovers the world is flat" (19 September 2005)

"Open veins, closed minds " (7 May 2009) - with Peter DeShazo Inside the United Nations headquarters, the event is considered the organisation's equivalent of 11 September 2001. For the UN, the terrorist bombing - four months after the United States-led military coalition had after a three-week campaign toppled the regime of Saddam Hussein - marked a turning-point in its ability to work as an agent of collective security in a changing world. It led to a re-examination of the UN's role, embodied in the then secretary-general Kofi Annan's document In Larger Freedom; this ultimately resulted in a new manifesto for the institution, presented in the general assembly's sixtieth-anniversary summit on 14-16 September 2005.  It also contributed to a new awareness of the vulnerability of humanitarian workers in conflict-zones, symbolised by the inauguration on 19 August 2009 of a World Humanitarian Day.

The Iraqi vortex  

The Baghdad attack robbed the United Nations of fifteen fine and potential-rich servants, as well as taking the lives of others tragically caught by it; they include two NGO representatives, a diplomat, a translator, a contract worker, and the human-rights lawyer Arthur C Helton (also a co-writer of an openDemocracy column into refugee and displacement issues with his close colleague Gil Loescher, who was badly wounded in the blast).

Also among those who died was one of the greatest humanitarian civil servants, Sergio Vieira de Mello, who was courageously leading the UN effort in Iraq. His death represented the loss of a vital interlocutor between the US-led coalition and the international community at a critical moment in relationships between the US, the UN, and the rest of the world.  Indeed, his very international stature - including his role in helping to oversee the independence of East Timor from Indonesian rule, explicitly cited by al-Qaida as part of the twisted logic that justified his murder - had arguably made the UN in Iraq an even more visible and vulnerable target for terrorists. 

In his brief period in Iraq, Sergio Vieira de Mello had pleaded for greater understanding of the Iraqi street and its voices amid the chaos of post-war administration. These were ignored, and the silencing of this voice of reason marked the beginning of a bitter insurgency and civil war that raged in Iraq until 2005-06. It took a long time before much-needed shifts in Washington's military policy and thinking filtered through to better policy on the ground; even after six years, the security situation remains unsettled and the establishment of working relationships with Iraqi leaders have proved tough. How much of a difference Sergio Vieira de Mello would have made here is one of the many unanswered questions of this violent period (see Samantha Powell, Chasing the Flame: One Man's Fight to Save the World [Penguin, 2008]).

The destruction of the Canal Hotel also marked the nadir of multilateralism, and an awful symbol of how the George W Bush administration's foreign-policy "exceptionalism" had destroyed the promise of international cooperation. The leading officials of the administration in effect relegated the UN to the trash-heap of global institutions, opting instead for an approach to international relations that in the end served no interest but to wreak more death and destruction on the "liberated" citizens of Iraq. This posture had started to shift by the time the Bush administration neared its end in 2008-09, but the damage wrought by the events in Iraq was enduring.  

The American military forces in Iraq - amounting to 130,000 troops - have as of 30 June 2009 officially withdrawn from major urban centres, as part of the process scheduled to lead to a final exit of troops by December 2011. The situation on the ground is now the responsibility of the Iraqi government's security forces, which have assumed the role of a state-security sector. There are signs of progress, including the existence of an elected government (and the prospect of another round of parliamentary elections in January 2010); progress in advancing the sovereignty of the Iraqi state, and in judicial and other institutions; the development of the Iraqi economy; and greater participation of its citizens in governance. 

But violent attacks continue, as in Baghdad itself on the 19 August anniversary; the potential for further outbreaks persists (in contested cities such as Kirkuk, and elsewhere); and many Iraqis who fled abroad during the nightmare years are reluctant to return. It has been a longer and much more painful road than might have been travelled if wiser policies had been followed.

Out of the rubble

The perspective of six years also highlights the importance of the improved relationship between the United States and the United Nations that are the result of the election of Barack Obama in November 2008. The new US president has outlined "a new era of engagement" in US foreign policy of which multilateralism is a cornerstone. It is a change that has profound implications for the UN, and is worth considering on this anniversary.   

Some remarks by the US's permanent representative to the UN, Susan Rice, are in this respect a revealing indicator of the future direction of US diplomacy:

"When the United States joins others to confront these challenges, it's not charity. It's not even barter. In today's world, more than ever, America's interests and our values converge. What is good for others is often good for us. When we manifest our commitment to tackling the threats that menace so many other nations; when we invest in protecting the lives of others; and when we recognise that national security is no longer a zero-sum game, then we increase other countries' will to cooperate on the issues most vital to us...We build will by pursuing pragmatic, principled policies and explain them with intelligence and candour. And in the broadest sense, we build will when others can see their future as aligned with ours...All of this helps explain why so many of America's security interests come together today at the United Nations."

The UN general assembly will convene for its sixty-fourth session on 15 September 2009. President Obama's address will be an opportunity to reaffirm both the US's renewed support for multilateralism and the continued vitality of the ideals of 1945: commitment to a strong international legal order, and to the universality of UN membership as the key source of legitimacy of the whole organisation's decision-making power. These commitments are both right in themselves and in America's own best interests, a combination that reflects secretary of state Hillary Clinton's emphasis on the need for the US to pursue a "smart power" approach.

Indeed, US and UN interests are set to align in the 2009-12 period on a host of issues: among them threats to peace and security, climate change, global health concerns and managing humanitarian operations. That alignment will be reinforced if the US takes a leadership role in promoting reform of the UN where it is most needed, including in improving the secretariat and its agencies.

A principled and effective multilateral policy by the Barack Obama administration is crucial to United States's rebuilding of its reputation in the community of nations, at a time of great fluidity and complexity in international relations. A strong US-UN relationship will be a vital part of this effort. As both institutions seek to match the needs of this challenging new era, the best of the tragically brief first UN mission in Iraq - the willingness to listen and as well as the need to be heard, the emphasis on cooperation, the instinct to engage - can be an inspiration.

The members of the United States Congress have gone home without approving Barack Obama's healthcare plan. The president has given the issue so much salience, and the case for reform is so urgent, that it is likely that some more or less satisfactory healthcare reforms will be passed between September 2009 (when Congress reconvenes) and the end of the year. But even if this happens, it is now plain that the result will fall far short of what Obama promised as a presidential candidate and what so many hoped for; it will be rather an intricate complex of compromises, cobbled together to meet the conflicting political and financial needs of  dozens of special interests.

Godfrey Hodgson was director of the Reuters' Foundation Programme at Oxford University, and before that the Observer's correspondent in the United States and foreign editor of the Independent.

Godfrey Hodgson's most recent book is The Myth of American Exceptionalism (Yale University Press, 2009)

His earlier books include The World Turned Right Side Up: a history of the conservative ascendancy in America (Houghton Mifflin, 1996); The Gentleman from New York: Senator Daniel Patrick Moynihan (Houghton Mifflin, 2000); More Equal Than Others: America from Nixon to the New Century (Princeton University Press, 2006), A Great and Godly Adventure: The Pilgrims and the Myth of the First Thanksgiving (PublicAffairs, 2007)

Among Godfrey Hodgson's openDemocracy articles:

"Barack Obama: at the crossroads of victory" (11 June 2008)

"A game of two halves" (15 July 2008)

"Welcome to the party: American convention follies" (18 August 2008)

"America's foreign-policy election" (28 August 2008)

"America's economy election" (17 October 2008)

"Yes he can!" (6 November 2008)

"Change?" (2 December 2008)

"An end and a beginning" (5 January 2009)

"Barack Obama: don't waste the crisis" (6 February 2009)

"Barack Obama's reality gap" (27 February 2009)

"Barack Obama: end of the beginning" (30 March 2009)

"Barack Obama's hundred days" (29 April 2009)

"Barack Obama: a six-month assessment" (10 July 2009)

"Barack Obama's world" (16 July 2009)

The exact lines of that package of reforms is not yet clear. But already it has offered a highly instructive look at three matters of great importance:

* Obama's growing political difficulties

* The current mood of American politics

* How very different American politics are from the style and substance of politics in other developed democracies.

The magnified madness

The inherently ridiculous affair of the professor, the policeman and the president revealed that, contrary to the "bliss-was-it-in-that-dawn" mood at the time of President Obama's election in November 2008, the United States is still very far from being a "post-racial" nation.

On 16 July 2009, A (white) neighbour observed what seemed to her to be two black men breaking into a house. The two turned out to be the best known African-American scholar in the country, the Harvard University professor Henry Louis Gates Jr, and his driver; they had gone round the back of Gates's home because the front-door was jammed.

Sergeant James Crowley of the Cambridge, Massachusetts police, was sent to investigate and arrested Gates, who - understandably, since he was in his own house - used some unprofessorial language. When asked about the episode at a press conference, President Obama, a personal friend of Gates, said that the local police had acted "stupidly". This is a president who, like most non-white people in America, has personal experience of being "racially profiled", the euphemism for discriminatory harassment by police (see Darryl Pinckney, "Henry Louis Gates Jr: Every black man's nightmare", Independent, 4 August 2009).

With some grace and political style, Obama invited both the tactless policeman and the touchy professor to the White House to have a beer with him in the rose garden.

So much for a silly-season story. What is of lasting significance is the storm of blogs, tweets and other responses the affair provoked, and what they reveal about the political mood. The great majority were furious, not with the policeman, but with the president. The incident has even given new life to the truly mad minority who insist that Barack Obama, a devoted Christian, is a Muslim; or that he is disqualified by foreign birth from the presidency, though he was born in Hawaii; and even that he is a "Manchurian candidate", sneaked into the United States by some Muslim conspiracy to undermine its constitutional-liberties system and Christian faith.

The public illness

What, it may be asked, does this have to do with healthcare reform?

No one, I think, who has read both the bloggers' response to the Gates affair and the chorus of incoherent rage about healthcare could fail to struck by the similarity of their stridency and irrationality.

True, there is one significant difference. On Gates, the great majority were hostile to the president: it looked very much as though only African-Americans and a thin sprinkling of liberals spoke up for Obama. On healthcare, the spluttering rage and wild indifference to the facts have come from both the president's assailants and his defenders.

There is now some evidence that support for both Obama's healthcare policy and his personal popularity are falling. Obama's own standing has (according to a Quinnipiac University poll) fallen from 66% to 50% between early July and early August 2009 (and by a similar margin, albeit to a higher total, in a CNN survey.

Obama's political circle fear that time is against him, and they may be right. They pushed to get Congress to pass a healthcare-reform proposal before Congress adjourned, and failed. The health-insurance industry and the Republicans will used the congressional vacation to bombard vulnerable politicians with even more fear-inducing material. Already the heaviest advertising spending has been in the districts of key members of relevant committees. The closer the 2010 mid-term elections approach, the more congressmen will be reluctant to expose themselves to this barrage.

The political mood in the United States is nervous, edgy, uncertain. In foreign policy, a number of events - the re-election (albeit dubious) of Mahmoud Ahmadinejad in Iran, the return to power of Binyamin Netanyahu in Israel, the continued frustrations in Afghanistan and Pakistan - have shown that Obama has less power to change the world than he, or at least those who voted for him, imagined.

In the domestic arena, against the background of a deep economic recession there is a strange political situation as the president seeks to push healthcare policy forward. A substantial majority of Americans still say they want serious change in this area. But on this as on other issues, Obama's wish to "reach across the aisle" and overcome the sharp political dichotomy (as well as to convince elements of his own side) has not worked; Republican politicians still caricature healthcare reform as "socialised medicine", even if as yet they have derived little political benefit from this stance.

The media story, however, is more sharply defined than the political one. Conservative publicists and pundits, especially on radio and on Fox TV, have recovered their confidence. They shamelessly travesty Democratic policies, and a surprising number of their readers and listeners seem to agree. Senator Charles Grassley, the senior Republican on the finance committee and a relatively responsible figure in the healthcare debate, asserted that Senator Ted Kennedy - the veteran champion of healthcare reform, who has had surgery for a brain tumour - would have died by now if he had lived in Canada or Britain.

The interest effect

The United States is a democracy. Its citizens have the right if they wish to spend twice what any other countries spend on healthcare, and receive in return an overall inferior service. But it is worth asking why - since Lyndon B Johnson's introduction in 1965 of Medicaid (for the poor) and Medicare (for the elderly) - the clearer failures in the delivery of healthcare have been so hard to remedy.

An important factor is undoubtedly the extraordinary influence of special interests at several points in the political system. "Interests" - in this case health insurance, pharmaceuticals and private hospitals on one side, and trial lawyers and trade unions on the other  - are able to exert three kinds of pressure (see Joe Klein, "Will Special Interests Stymie Health-Care Reform?", Time, 3 August 2009).

First, they target politicians directly with massive campaigns of televised political advertising of a kind that would not be permitted by law (on account that it skews public debate) in most other developed countries.  

Second, they lean on politicians by contributing large sums to their re-election campaigns, or to those of their opponents. The fact that elections for the House of Representatives are held every two years increases the temptation and vulnerability of congressmen.

Third, the interests can support a vast network of advocacy-groups, foundations, lobbies and  public-relations operations which all strive to frame the debate. This includes the often explicit aim of influencing media reporting. The success here is most blatant in the resulting distortion of Americans' perception of how healthcare works in other countries (for example, the canard that people in Britain or Canada are not allowed to choose their own doctor).

The federal lesson

Most Americans believe that their system is more "democratic" than others, especially than parliamentary systems. There is some truth in this. It is certainly true that "interests" in the United States - special or routine, benign or selfish - have greater opportunities to stall or avert change, even when there is evidence that large majorities desire such change. Many Americans (and others) also believe that the spread of new media in America has introduced an enviable online "people's democracy". The quality of much online debate in the US makes this questionable.

Because the United States has a federal system, there is a wider range of geographical variation. In other respects, too, the American constitutional system makes quick and effective action by central governments more difficult. The weakness of the two parties means that a new coalition has to be negotiated for each major legislation.

The constitution enshrined two principles:

* the balance of powers between the three branches of government (the executive, the legislative and the judicial)

* the distribution of "checks and balances" between them, and between the federal government and the states, in a manner that was intended to defend against a tyranny of the majority. This it has done effectively.

The American constitution has worked well on the whole, and - even if William Ewart Gladstone's description of it as the "noblest work ever struck at one time from the mind of man" may be hyberbolic - it is respected to the verge of veneration in its homeland. Like any human creation, however, it has imperfections. A serious failing is that the constitution makes it harder to reach consensus on the need for change, or on the precise form that change could take, than do the (equally imperfect) political institutions of other nations. When in addition the political atmosphere in the United States has become so febrile and partisan, the result is that the fate of Barack Obama's flagship policy is in the balance.

What has been described as the "democratic recession" around the world is prompting some serious reflection by the "stewards" of democracy - among them civic forces, agencies, think-tanks, pressure-groups and media in a host of countries. The evidence that democracy is in trouble is by no means overwhelming, as peaceful elections in Indonesia and Lebanon in mid-2009 alone indicate. But the trends often cited for the "recession" - the resurgence of authoritarian rule, populism, corruption, and even (as in Mauritania and Honduras) military involvement - are clear enough.

Nicholas Benequista is research and communications officer in the Development Research Centre on Citizenship, Participation and Accountability (Citizenship DRC) at the Institute of Development Studies, University of Sussex

John Gaventa is director of the Development Research Centre on Citizenship, Participation and Accountability (Citizenship DRC) at the Institute of Development Studies , University of Sussex

This article draws on discussions at a conference on Promoting Political Freedom and Deepening Democracy at Wilton Park on 22-25 June 2009There is an even deeper concern, that the effect of George W Bush's "freedom agenda" and the way it was pursued has been to discredit the very ideas of democracy and democracy-support in the eyes of many around the world. This makes the change of rhetoric and outlook under Bush's successor as United States president all the more welcome. Indeed, there are signs that Barack Obama is breaking with the approach of his predecessor in a more than rhetorical way.

His speech on 11 July 2009 in Ghana - where the December 2008 election is another positive entry in democracy's global balance-sheet -  was significant in this respect. "America will not seek to impose any system of government on any other nation - the essential truth of democracy is that each nation determines its own destiny", he said then. The words are deceptively simple, for they might finally mark a break from a much longer tradition of treating democracy as an exportable commodity. 

This new understanding at the heart of the power echoes developments taking place at grassroots level in many countries.

An ebbing tide

True, this understanding has only come on account of democracy becoming a tougher sale. Freedom House has marked a third continuous year of decline for global freedom; the countries that spend approximately $9 billion every year to promote fair elections, government transparency and public participation find themselves on the defensive for the first time since the collapse of the Soviet Union. That wave of democratisation has now begun to recede, most notably in Russia itself, but also in several African nations that have adopted democratic procedures in merely theatrical ways.

"It is, I think, fair to say that the heady optimism of the early 1990s seems to have ebbed", says Anwar Choudhury, the director of international institutions at Britain's foreign office. "The belief in the inevitable march of democracy has been shaken. The 21st century has seen the emergence of a different, altogether more complex, dynamic around democracy."

The ebbing tide of democracy has left a few dispirited - but it has also inspired new thinking. Thomas Carothers of the Carnegie Endowment for International Peace (CEIP) writes in the Journal of Democracy that democracy-support is diversifying away from a one-size-fits-all strategy, with approaches that can be grouped into two camps: the political and the developmental (see "Democracy Assistance: Political vs Developmental?", Journal of Democracy, January 2009).

President Obama's speech confirms Carothers's hypothesis, but it also raises a question of whether democracy-support might need a third perspective - a societal approach - if it is to truly allow each nation to determine its own destiny.

Thomas Carothers says:

"The political approach proceeds from a relatively narrow conception of democracy - focused, above all, on elections and political liberties - and a view of democratization as a process of political struggle in which democrats work to gain the upper hand in society over nondemocrats. It directs aid at core political processes and institutions - especially elections, political parties, and politically oriented civil society groups - often at important conjunctural moments and with the hope of catalytic effects". 

He contrasts this with a developmental approach, which tends to measure the quality of a democracy based on how well it delivers equality, welfare, justice and other socioeconomic outcomes: 

"The developmental approach rests on a broader notion of democracy, one that encompasses concerns about equality and justice and the concept of democratization as a slow, iterative process of change involving an interrelated set of political and socioeconomic developments. It favors democracy aid that pursues incremental, long-term change in a wide range of political and socioeconmic sectors, frequently emphasizing governance and the building of a well-functioning state."

President Obama's speech in Ghana clearly expounds a developmental approach to democracy-promotion in Africa, emphasising the instrumental role of good governance in delivering socio-economic development in the continent:

"(We) must first recognise a fundamental truth that you have given life to in Ghana: development depends upon good governance. That is the ingredient which has been missing in far too many places, for far too long. That is the change that can unlock Africa's potential. And that is a responsibility that can only be met by Africans."

The European Union too is moving toward a more developmental approach to promoting democracy, with a concerted push emanating from Sweden to better integrate the work carried out by the agencies of international development and institutions that have traditionally been tasked with spreading democracy. There appears to be a consensus in Sweden between its development organisation, the Swedish International Development Cooperation Agency (Sida), and its foreign office. Both organisations are now working to influence the EU's policy of democracy-promotion under its six-month presidency of the EU (July-December 2009).

A rare opportunity

In this rare opportunity for a paradigm-shift, advocates of democracy may also want to consider how they might better support the ways that collective action contribute to strengthening the legitimacy and effectiveness of democratic institutions. 

None of this suggests that the Washington-based National Endowment for Democracy or the European Partnership for Democracy will (or should) stop funding electoral processes or sending electoral observers. But especially in countries where leaders have been able to imitate the form of democratic institutions, while avoiding any of the substance of democracy, a more nuanced approach is clearly necessary. It is unclear, however, that there is enough innovation to be had in developmental approach to democracy-promotion.

Barack Obama, as a former community organiser in Chicago, should understand why. Indeed, his speech in Accra again suggests that he might: 

"Across Africa, we have seen countless examples of people taking control of their destiny, and making change from the bottom up. We saw it in Kenya, where civil society and business came together to help stop post-election violence. We saw it in South Africa, where over three quarters of the country voted in the recent election - the fourth since the end of apartheid. We saw it in Zimbabwe, where the Election Support Network braved brutal repression to stand up for the principle that a person's vote is their sacred right."

These cases highlight that states are not built through institutions alone. Organised citizens also play a critical role by articulating demands for new rights, mobilising pressure for policy change and monitoring government performance. A societal approach to promoting political freedom recognises the limits of institution-building with support for intensive, long-term, organised collective action (see Andrea Cornwall ed., Spaces for Change? The Politics of Citizen Participation in New Democratic Arenas [Zed, 2006]). 

An end to promises

Two researchers, Vera Schattan P Coelho and Bettina Von Lieres, have collected examples of when citizens mobilise around democracy itself (see the project on "Deepening Democracies in States and Localities", Development Research Centre on Citizenship, Participation and Accountability [DRC]). One of the cases included in their work is Nigeria, Africa's largest democracy, where huge amounts of funding have gone into government-appointed commissions to oversee "fair" elections (a strategy seen by some as "paying the fox to guard the chicken-coop"). Little external money went to support civil-society organisations, which mobilised members across the country to monitor the election process themselves, with many risking their lives to do so. 

Two years since the election, the public uproar has become both vociferous and well organised. Two organisations are at the helm: Coalitions for Change, a programme that helps civil-society organisations come together with a coherent platform, and the Nigeria Labour Congress, the national umbrella group for Nigeria's trade unions, boasting 4 million members. While Coalitions for Change has enabled the cacophony of civil-society groups to articulate a more coherent voice, the National Labour Congress has mobilised its members in massive rallies across the country; the largest to date, in Kano, attracted tens of thousands. 

These organisations hope to force the congress to adopt reforms such as a much-needed law to make electoral fraud a criminal offence, rather than merely an issue for civil litigation.

"The key question is: why would the parliament accept this if they rigged themselves into office?" says Jibrin Ibrahim, director of Nigeria's Centre for Democracy and Development. "We have a political class that is complicit in the history of electoral fraud. Given this context, our position in civil society is that at the end of the day, it is direct citizen action that can make the difference." 

The power of grassroots campaigning of this kind, allied to principled encouragement from democracy-support practitioners and wise political leaders, could yet make the coming era one of democratic innovation rather than recession.

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Almost exactly six months after the inauguration of Barack Obama as the president of the United States, twenty-two politicians and intellectuals from nine countries in central and eastern Europe addressed an open letter to him and his new administration, published in the Polish newspapar Gazeta Wyborcza and in openDemocracy (see "East-central Europe to Barack Obama: an open letter", 22 July 2009).

President Obama has completed his first in-depth engagement with the Russian leadership during his Moscow visit. From an outsider's perspective, he gets a B-plus for substance but no better than a C on form. On balance, then, a B-minus. The new American administration's relations with Russia are a process, adjusting the policies of the previous Bush administration to its own goals. The main areas of change are three:  

• treaty-based strategic nuclear arms control
• Afghanistan
• a structure for other bilateralcooperation.

This process began with the meeting of the two presidents in London. The Moscow summit represents progress on their first meeting in each area, but each is a shell waiting for real achievement. In each case, the serious work is still ahead.

On strategic nuclear arms control, both sides want to preserve the treaty-based system of the Reagan-Gorbachev period, but without even the facade of real parity between the two powers which then existed. The Russian strategic nuclear force is aging rapidly, will continue to shrink regardless of arms control, but represents for Russia one of its few remaining grounds to claim great power status (the others being geography and oil/gas exports). 

The U.S. nuclear force is much more modern, but plays far less importance in either the American military posture or its international role in general.  Both sides agree to smaller arsenals, but for different reasons. Moscow is less concerned with the traditional measures of nuclear power (missiles, warheads, throw weight) than with American dominance in non-nuclear strategic weaponry and its lead in ballistic missile defence. The Russians see a prospective environment in which they would cease to have a credible deterrent in face of American technological progress. Thus, the asymmetry facing the treaty negotiators on both sides.

Obama and Medvedev agreed again on the need for a replacement treaty (or treaties) for START which expires in December. On the American side, a complication is the on-going Nuclear Posture Review (NPR) in the Pentagon because, in principle at least, the U.S. negotiating position should reflect the outcome of the Review. In practice, the two proceed hand in hand, but the negotiations cannot get out in front. This is more a matter of White House relations with the Senate than with the Kremlin, as Senators of both parties can be both prickly and independent of the President in matters of treaty ratification.

Other complications are the Bush Administration's efforts to deploy ABM systems in Poland and the Czech Republic, the nature of future non-strategic systems on the U.S. side, counting stored versus deployed warheads, and other issues beloved of the arms control experts. The Obama team's efforts to square the circle on the ABM issue through a collaborative programme with Russia will fail. Washington tried this before in more favourable circumstances, and got nowhere. The simple reality is that the Russian leadership regard any U.S. ABM as directed against their security.  Deploying an ABM close to their borders is additionally an affront they feel they must reject. Interestingly, the Russian military have given some indications that a sea-based system would not be an insuperable negotiating problem, but Moscow is holding firm on systems in Poland.

The Obama team has said all along it will evaluate those planned deployments in terms of technical capacity and cost effectiveness. The latter quality is a loophole through which any system can be judged worthy or worthless.

Given the complex issues involved and the limited time remaining, a reasonable expectation would be for an interim treaty before the end of this year to commit both sides to substantial reductions in their nuclear ceilings (in fact, both are already well below their existing treaty limits). This is important before next year's review conference of the Non-Proliferation Treaty.  Work will likely then start between Washington and Moscow on a broader treaty aimed for ratification on the U.S. side before the next presidential campaign.

The Moscow summit agreement on transit of US supplies and equipment to Afghanistan is more important than it may appear. The logistics lines through Pakistan are under greater peril than most Americans realise, and could even be cut altogether. Effective northern supply routes are not just important now, they may become essential soon. The Russians served their own interests by signing a wide-ranging deal on transit because using the Russian route will make transit through/over Georgia and Azerbaijan that much less important to the United States. Moscow is serious about Afghanistan, though it certainly wants the US to depend on its support to avoid failure there.  The big question is how the transit deal will work in practice.  Anyone with experience of air
travel in and through Russia knows that problems with authorities are the norm, even when the Kremlin actually wants things to go smoothly.

This will bear close watching.

The third summit agreement was to establish a mechanism for other bilateral cooperation under the immediate supervision of the two foreign ministers. According to many reports, in London Obama proposed a commission headed by Vice President Biden and Prime Minister Putin, along the lines of the old Gore-Chernomyrdin Commission of Clinton-Yeltsin days. This, predictably, was rejected outright. Many ex-Clinton administration people look back on the Clinton-Yeltsin years as a golden age, whereas the Russians (leadership and man on the street) see the Nineties as a period of humiliation and national disgrace never to be repeated. This ill-judged proposal communicated to the Russians that the Obama team thinks of a "reset" as a return to the Nineties, rather than starting a new type of relationship. In addition, the proposal equated Putin with Chernomyrdin -- a slap in the face for the dominant figure in the current Russian leadership.

Thus, in Moscow the agreement was for a commission run by Secretary of State Clinton and Russian Foreign Minister Lavrov. The problem is that foreign ministries everywhere are weak players within their domestic governing machines. Hillary Clinton brings greater power to her role by her own political status, but Lavrov does not. He is a top-notch professional diplomat, one of the smartest around these days, but not a heavy hitter at home. It remains to be seen who will be assigned on both sides to make this new commission setup actually work. The two governments are not symmetrical, so in Washington the White House and NSC must be engaged, while in Moscow many of the ministries concerned fall under Prime Minister Putin's chain of command rather than under Medvedev's presidential staff. A likely major figure on the Russian side will be former ambassador in Washington Yuri Ushakov, now Putin's chief foreign affairs aide.

Each of the three areas of titular agreement at the Moscow summit -- arms control, Afghan resupply and transit, and the bilateral commissions -- are works in progress at early stages of development.  Any or all could get bogged down due to inherent difficulties or because of an erosion of the broader bilateral climate. Others remain on the table, where there is not even the tincture of agreement. For example, Vice President Biden's trip to Ukraine and Georgia will be a delicate diplomatic mission, designed to convey to both countries that their interests have not be compromised by the United States but also to communicate to the leaderships in Kiev (if there is one) and Tbilisi (if its president can be called a leader) that Washington has major equities with Moscow that they should not compromise - as Georgian President Saakashvili did in spades last summer.

On form, President Obama did not perform as well on this foreign venture as on previous ones. Granted, Moscow was the toughest foreign house where he has yet performed, with his charisma making nary a dent in Russian scepticism toward the United States. Still, he did not handle things as well as he should have. Obama's clumsy effort before the summit to drive a wedge between Medvedev and Putin was, bluntly, the act of a neophyte on the world stage. He had to backtrack on the
issue repeatedly while in Moscow, looking ineffectual from a Russian perspective.

Obama also did not use his limited time well. Taking his family to Ghana was a public relations coup, but in Russia achieved nothing. A single breakfast meeting with Putin was a missed opportunity. Putin is the leading figure in the Russian leadership, and may continue to be throughout Obama's tenure. Given the historical precedents, it would not be a surprise if Putin were in power long after Obama is retired. Not to engage Putin in depth and with full courtesy was a mistake.

Again, Putin is not Chernomyrdin.

Finally, Obama's speech to students received only polite applause for a good reason; it was not an effective speech. True, there is precious little good feeling among the younger Russian elite toward the United States at this time, but still Obama's approach was poor. In common with similar speeches by Bill Clinton and George W. Bush, Obama condescended to the Russians, making sanctimonious tributes about their history and culture not likely to persuade a youthful audience. A speech dealing candidly and directly with issues such as nuclear proliferation, the economic crisis, global warming, or other problems these young Russian will have to live with might have earned their respect. To talk down to these Russians, as Obama did, could not. No one likes being talked down to, least of all educated Russians by an American who is a newcomer to their country. The speech was definitely a missed opportunity for a change of tone in communicating with Russia.

In sum, the relationship is more or less on track on substance, but within the context that American-Russian relations are narrow and mostly zero-sum, especially for Russia. Moscow's foreign policy experts fear a successful Obama presidency will come at Russia's expense, because Russia succeeds in the world largely where America fails (as in Venezuela). Only a few months of Obama in office demonstrate again that the world, in bad times as in good, is centred on the United States, while Russia's global standing is a shadow of what it was two decades ago and much removed from the fantasies of only two years ago. The days when Russia could think of itself as shoulder to shoulder with America are long gone, and with China already a thing of the past. As the G-8 gives way to a G-20, Russia's place at the global top table will be below the salt.  Investors are now saying that instead of BRIC, one should think in terms of BRIM (Brazil, Russia, India, Mexico), reflecting the comparable size of the four economies. For Russians of the new elite to watch China join a new superpower status with America while they are paired with not one but two Latin American countries is simply unendurable. This is the psychosis American diplomacy must reckon with in trying to manage those issues with Russia where America's national interests are engaged. Not an easy task, and one requiring the new U.S. administration to perform better than it did in Moscow.

Barack Obama is a nice man, with rare charm and humour. Anyone who doubts that should see the picture of him reading to a White House children's party from Where the Wild Things Are. He is a shrewd and daring politician. If he wasn't, he wouldn't now be in the White House. He is a thrilling speaker. Listen to any of his set-piece speeches, from Philadelphia to Denver, and from Berlin to Cairo.

Also in openDemocracy on Barack Obama's presidency:

Simon Maxwell, "Global development: Barack Obama's agenda" (20 January 2009)

Pervez Hoodbhoy, "Obama's triple test" (21 January 2009)

Fred Halliday, "The greater middle east: Obama's six problems" (21 January 2009)

openDemocracy, "Barack Obama: hope, fear... advice" (19-23 January 2009) - reflections from thirty-seven of our worldwide authors

Simon Critchley, "Barack Obama and the American void" (22 January 2009)

Ruth Rosen, "American women's stimulus: voice, agency, change" (18 February 2009)

Jim Gabour, "The redemption game" (20 February 2009)

Gideon Levy, "Barack Obama: Israel's true friend" (25 May 2009)

Robert G Rabil, "Barack Obama's middle east: pragmatism and hope" (1 June 2009)

Nader Hashemi, "What Obama must say (and do) in Egypt" (3 June 2009)

Plus - regular comment on openUSA

Tens of millions of Americans desperately want him to succeed. So do perhaps even more people elsewhere.

But is he an effective president? Will he be a successful one? We are coming up to the time when that will be decided.

In a few days, he will have been president for six months. That's not a long time, just the beginning of what should be a long march of eight years. But this is the moment when both his friends and his enemies will look at what he has done and what he has tried to do, what he has begun badly, and what he has begun well.

The political context

The president is reported by a leading columnist to have said something typically intelligent, and characteristically both cautious and enigmatic: that he would rather have seventy votes in the Senate for 85% of what he wanted than fifty-two voters for 100% (see David Broder, The ‘Rock' in Health Reform, Washington Post, 11 June 2009).

What Obama  probably meant is that he wants to pass legislation that will have enough cross-party backing to be secure against future reversal. That is all of a piece with Obama's general bipartisan approach. It is arguable, though, that it sounds wiser than it is. Bill Clinton's administration, after all, fell short of expectations, its own and others', at least in part because of an excessive readiness to "triangulate", a polite way of saying compromise.

There is so much emphasis on the personality of the president in the way American politics is perceived, and not least with this president, that it is easy to forget that Obama's political reputation, and therefore his effectiveness, is far more in the hands of Congress than might appear. Obama is a Democrat. The Democrats have a majority in both houses of Congress. So why can't he get whatever he wants?

That is not how it works. A president brings a stock of political capital with him to the White House. Then he trades with it. If he is skilful, and lucky, he conserves his original capital, and even adds to it. Especially, if he trades with the Congress.

Since the comedian Al Franken was finally declared the winner of a super-close election in Minnesota, the Democrats now (in theory) have sixty votes out of 100 in the Senate. That should, (in theory) gives the president sixty votes there, and sixty votes are needed for closure, to end debate and pass a bill.

In practice, the Democrats will find it hard to clear that threshold. They will pick up some liberal Republican votes on major issues like healthcare reform and climate change. But Edward Kennedy of Massachusetts is desperately ill with a brain tumour. Robert Byrd of West Virginia is not well, at 91. Joe Lieberman of Connecticut is a Republican in all but name.

There are other independent-minded, usually conservative Democrats like Mary Landrieu of Louisiana. She voted for the oil interests on drilling on wildlife reserves in Alaska. On the other wing of the party there are more progressive senators who might balk if they felt the president and the Democratic leadership in the Senate were too timid and vote against what they saw as unnecessary compromises.

Harry Reid, the Nevada senator who is the Democratic majority leader, understands this very well. "We have sixty votes on paper", said Senator Reid after he learned that Franken had finally made it. "But we cannot bulldoze anybody; it doesn't work that way. My caucus doesn't allow it. And we have a very diverse group of senators philosophically."

Exactly. The other thing that cannot be forgotten is that senators, and congressmen, are confronted with a baffling array of votes on every subject you can think of, studded with "earmarks" and sundry special favours, for their own constituents and for the constituents of other legislators who might be available to vote for a pet project of their own. They, too, are traders.

If we look just at domestic issues - and I propose to look at the president's international record and prospects in a second article next week - there are three key areas on which he can and must be judged. They are the economic crisis, healthcare and climate change.

The numbers game

The first key area is Barack Obama's handling of the financial and economic crisis he had to deal with even before he was inaugurated. Immediate disaster was prevented. But great damage was done, and the Obama administration cannot truly claim either to have prevented a recurrence of the crisis, or to have healed the harm.

In spite of the administration's huge expenditure and guarantees and all its efforts to reassure the public, the banks' books are still stuffed with toxic assets. The stock-market has recovered, then stuck on a plateau. The bankers are already poking their heads above the trenches. They are expecting big bonuses again. But great psychological and political harm has been done by the contrast between the avidity with which the administration bailed out the banks, and its comparative reluctance to help workers who have lost their jobs in the automobile and other manufacturing industries.

President Obama understandably sought to reassure sceptics that he was not prejudiced against Wall Street. Unfortunately he did this by handing over the financial side of his new administration to be run by people like his treasury secretary Tim Geithner, who was a protégé of the very Wall Street titans who had caused the trouble in the first place.

It is too early to say whether the president will get away with this mistake, either economically or politically. But it is already time to look at the prospects for his own chosen domestic priorities.

There are many, many tasks he cannot shirk. But there are two other pre-eminent issues which as a candidate Obama awarded high priority in his campaign - reform of America's failing but passionately controversial healthcare system, and climate change. He cannot run away from them, and to do him justice he shows no sign of wanting to do so. He will however be judged by how he frames what he asks from Congress, and how he responds to what Congress hands him on these questions.

In each case, the president's 100% option is not known for sure. But in each case the 85% he seems to have in mind would simultaneously infuriate the right and leave a significant minority on the left deeply disappointed.

The climate calendar

The question of climate change is already at the heart of the legislative process. On 26 June the House of Representatives passed by a vote of 219-212 a bill whose essence was the idea of "cap and trade". Corporations, that is, would be handed permits to pollute, which they could trade; polluters who would not or could not meet a given standard would be able to buy the right to break that standard from those who did not need or want to do so.

There are a number of worrying, some would say disgraceful, aspects of this result. In principle, for one thing, this is not to control pollution, but to allow it. The standard, for another, is low. The House called only for a reduction of 17% from 2005 levels, with a safely future aspiration of an 83% reduction by 2050. By that time most members of the present House will be dead. Most environmental experts think the bill is far too little, far too late.

Second, the Republican opposition still seems not to have accepted the case for doing something about the danger of climate change. Henry Waxman, the bill's Democratic sponsor, said there was now a consensus that the scientists were right about climate change. If so, the consensus has not reached the other side of the aisle.

John Boehner, the Republican leader in the House, called the proposal "the biggest job-killing bill" in history. One of his colleagues said industry would be driven back to 1910 levels of pollution, as though 1910 was a vintage year for the air over Pittsburgh.

Worse, no fewer than forty-four Democrats voted with these Republican dinosaurs against the bill, which passed only with the help of less Jurassic Republicans. Now the Senate will come up with its own bill. The Obama administration will do what it can to pressure the Senate to improve on the House bill.

The good news here is that the Obama administration has tackled what many believe to be the most urgent issue before all of us. The bad news is that it has met more resistance than seemed believable.

The question of care

On healthcare, the prospect is even less clear. The system is in chaos. Americans spend, as a proportion of national income, roughly twice as much as people in other developed countries on healthcare, but by such measures as life-expectancy and child mortality they are not especially healthy. At its high-technology best American medicine can be superb: the problem is access. Almost 50 million Americans, one in every six, have no health insurance. Many more have insurance that will not protect them against all of the risks they are likely to encounter (see James A Morone & Lawrence R Jacobs, "American sickness: diagnosis and cure", 16 October 2007).

Two trends make it likely that the situation will get worse not better. First, for the well insured, the quality of care does get better and better, and more and more expensive. So already "managed care" by insurers and "health maintenance organisations" has steadily chipped away at the benefits available under policies, in terms of the quantity and expense of medication allowed and for example of the length of hospital stays.

Second, many Americans have health insurance as part of their contract of employment. This is particularly true of trade-union members (a dwindling band) but also of, for example, government employees, military personnel and employees of universities. But now unemployment is rising. Many of these people will lose medical coverage for themselves and for their families if they lose their jobs.

Experts, therefore, believe that the only cure adequate to the scale of the problem is to go to a "single-payer" system like those in Britain or northern Europe. For fifty years and more, however, Americans have been told that anything of the kind, whether a nationalised healthcare system or a universal insurance system, is "socialised medicine", to be shunned at all costs.

In 1993, President Clinton proposed a fairly cautious reform, strongly advocated by his wife, now President Obama's secretary of state. It was laughed out of existence by the notorious "Harry and Louise" TV advertising campaign. A worried couple talk health insurance over in the kitchen. They don't like the Clinton plan. "They chose we lose!"

Now once again an army of lobbyists is descending on Washington like the locusts that plague the city every seventeen years. Already ads are running on TV retailing horror stories of the failings of Britain's National Health Service. They are not, you can be sure, scrupulously careful to show the best of the NHS. 350 former members of congressional staffs, officered by defeated Republican congressmen, have been hired, money no object, to make congressmen shiver with fear.

In the face of this army - recruited by insurance companies, pharmaceutical companies, hospital companies and the rest of an industry whose turnover exceeds 15% of the national income - no wonder if President Obama is retreating from anything that could be represented as "socialised medicine".

Instead, it is thought that he will leave healthcare in the hands of the commercial insurance industry, but make insurance mandatory and perhaps set up a government health-insurance plan to compete with the existing companies. In principle, that would keep the "managed care" brigade honest. In practice, it would need massive government investment and might not succeed.

The interim calculus

Already, therefore, on all three of the most important issues he must confront, Obama seems to have rejected the more daring solutions and settled for, well, 85% of what he might want.

Perhaps that is unfair. Perhaps he will stand in front of the nation like a great teacher, and persuade the people that this is the moment to throw caution to the winds.

Perhaps he will insist on strict limits to pollution, not create a market for it. Perhaps he will bring the American healthcare system into line with other developed countries that, by statistical measures, do substantially better in providing good health care for a fraction of what Americans pay. Perhaps he will stop the same old Wall Street crowd from starting back on the old road of perverse motives, bonuses for reckless leverage, toxic greed sold as "innovation".

That would be nice. But then again, he may be right. His calculus may be the only realistic one. Perhaps the American political system really has been so captured by the special interests of private healthcare, corporate polluters, reckless bankers, that there is nothing even the most idealistic and gifted president we have seen for a generation can do about it.

Let us hope not.