EUROPE'S LESSONS FOR THE U.S. President-elect Clinton can learn a lot from this continent about . health care and how to revitalize cities. But industrial policy is another story.
By WILLIAM ECHIKSON REPORTER ASSOCIATE Jessica Skelly von Brachel

(FORTUNE Magazine) – THROUGHOUT his campaign, President-elect Bill Clinton called for a long-term, systematic plan to revive the U.S. economy. He proposed forging a partnership between government and industry, upgrading education to emphasize worker training, revitalizing cities, and revamping health care to assure access to everyone at reasonable cost. The prescriptions have a familiar ring. Europe has tried them all, with varying success. Industrial policy? Europeans are proud of their state- subsidized high-speed trains and their Airbus planes. Worker training? A majority of Germans move from school to work through apprenticeships, acquiring specific skills both on the job and in school. Urban renewal? Families still want to live in Paris, not in the suburbs, because the best schools and jobs are there, the subways work, and the streets are clean. Health care? No matter what their income or station in life, all Western Europeans receive high-quality care at about two-thirds the overall cost of the American system. Says Jean-Louis Beffa, chairman of Saint-Gobain, the French glassmaker: ''When I hear Clinton talking about investment in infrastructure, in worker training, in basic manufacturing quality, I become much more optimistic about the United States.'' But while the European model offers important lessons, it also holds perils. Along with the renewal of Europe's central cities have come high rents, which are forcing poorer families into drab suburbs that breed delinquency. The vaunted German apprentice system is being undercut as more students attend conventional high schools and universities. And for every success like Airbus, there are failures like the Concorde; although the British-French supersonic plane has generated good PR for British Airways and Air France, it has been a commercial flop. By picking and choosing carefully from the following four areas, the U.S. can learn a lot from Europe.

INDUSTRIAL POLICY When Elie Cohen was growing up in Paris in the 1960s, his family's telephone often went dead. But at least they had one. Back then, the wait for a phone could be years. France had only 20% as many lines as Sweden, per capita, and fewer than Greece. Instead of upgrading its antiquated system, the French government decided to take a technological leap and install a digital switching system developed by the state-run National Telecommunications Research Center. The government gave the technology free of charge to Alcatel, the main French telephone supplier. Next it ordered France Telecom, the state- owned phone company, to invest $80 billion in the new system between 1974 and 1990. Today France Telecom has the world's most modern phone system; 85% of its lines use digitally transmitted signals that are clearer and crisper than analog signals. In the U.S. most long-distance lines are digitized, but only about half of local lines are. A recent McKinsey report judged France Telecom twice as labor efficient as privately run British Telecom. And Alcatel, which took over ITT's European operations in 1986, is the world's largest telephone supplier. ''Telephones are a perfect example of successful industrial policy,'' says Cohen, a researcher at the National Center for Scientific Research in Paris and a France Telecom director. ''The state financed the research, used protectionism to exclude temporarily competing switching systems, and then encouraged French companies to export their products.'' Lately France and other European countries have had to modify their elixir of market-oriented, central state planning strategies. In today's GATT- regulated global market, protectionism of the kind that launched France Telecom is illegal. Moreover, under rules for Europe's unified market, state- guaranteed procurement contracts are banned. France alone could no longer afford to develop a new-generation digital phone switch. ''The factors of financing new technologies have multiplied by at least five since the 1960s,'' Cohen says. ''We must share the cost with others.'' Through persistent, long-term planning, Europeans are working to achieve some very old dreams. In 1991, after nearly two centuries of digging, the German government finished the $17 billion Rhine-Danube canal, which enables barges for the first time to cross the entire Continent. The Europeans also are planning to spend $76 billion on 19,000 miles of high-speed train tracks by the year 2000. A 1,000-mile trip from Paris to Warsaw, now 22 hours long, would take around seven. ''America could use some European-style infrastructure,'' says Beffa of Saint-Gobain. ''When I go from JFK Airport in New York to Charles de Gaulle Airport in Paris, I can't help but notice the difference.'' Modern French industrial policy has a bottom-up, not top-down, orientation. Just one example: When a French government agency recently helped finance robots at Gaston Lenotre's bakery outside Paris, it was the entrepreneur, not the state's bureaucrats, who came up with the idea of a high-tech patisserie. Says George Papaconstantinou of the Organization for Economic Cooperation and Development (OECD): ''The philosophy of picking winners is dying. Industrial policy in Europe now aims to enhance the market, not interfere with it.''

VOCATIONAL TRAINING With double earrings in each ear and a habit of hand-rolling cigarettes, Kristian Oberman may look like a candidate for an unemployment line. But the 22-year-old German will have no problem getting a good job when he graduates next year. Oberman is an apprentice at Mannesmann's Rohren factory near Dusseldorf. By the time he completes two years of training, he will have learned to repair and run the sophisticated machines Mannesmann uses to make seamless tubes for oil exploration -- and the company will assure him a well-paying mechanic's position. The joint government-industry apprentice program trains more than half of Germany's work force in jobs from baker to banker, from furniture maker to electrical engineer. Both large and small companies participate in what essentially is a modern version of the medieval guilds that passed on craft skills from one generation to the next. ''This is not something just for Germany,'' insists Karl Rudolf Gerhards, director of training and development at Mannesmann. ''Our company in the Netherlands has successfully used the model, and we are doing the same in Turkey.'' Most labor experts say that an American-style apprenticeship program would have to be run out of schools, probably the U.S.'s extensive network of community colleges. The German idea of having competing businesses voluntarily join to train workers -- without any guarantee that the workers will then join their company -- runs counter to the U.S. tradition of competition. ''When you explain the German system to American businessmen, they say, 'Wow, it looks great,' '' notes Olivier Bertrand of the CEREQ Institute in Paris, which specializes in vocational education research. ''But when you then ask them to adopt it, they complain that their company can't afford it.'' Local chambers of commerce coordinate the German program, and companies commit 2% of their payroll to the training. The apprentices can range in age from 16 to 26; most have graduated from high school. Companies hire the ''meisters'' who do the teaching and pay the apprentices between $475 and $600 a month. Mannesmann, which started its program a century ago, spends $60 million a year on the training, with a little more than half that in wages for apprentices. Mannesmann isn't doing this because it has cash to throw around. Profits have been slipping, and the company has been offering longtime workers early retirement. ''This is the only way to get skilled workers trained in new technologies,'' insists Gerhards. Despite strong corporate commitment, the German system may be entering a long-term decline. Between 1984 and 1990, the number of West German youths seeking apprenticeship positions dropped from 765,000 to 600,000, a trend experts attribute both to Germany's low birthrate and to rising interest in university education. The introduction of hundreds of thousands of East Germans has given the system a boost, but it could be temporary. ''Blue-collar work is losing its image,'' concedes Helmut Schaefer, a Mannesmann executive.

Educators and apprentices alike are concerned that the system does not give some young Germans enough general education; factory apprentices, for example, might spend four days a week working and one day a week in school. But two years ago Mannesmann started a university-level management program in which apprentices spend more than 75% of their time in the classroom. ''Here I have the opportunity to get a university degree while I do my apprenticeship,'' says Beate Albrecht, 21. ''I know so many people who just study. They have no solid work experience, and then they have nothing.''

URBAN PLANNING Painted bright green on top, covered by rubber hosing on the bottom, the space-age Paris garbage truck sweeps up everything in sight: broken bottles, paper, dog droppings. A second green machine follows, finishing the job with a spray of water. Within five minutes, Quai Tournelle is spotless. A decade ago the French capital was, in a word, dirty. Then the municipal government increased the sanitation budget six times, investing in hundreds of high-tech street cleaners, some of which cost $2 million each. ''When I started eight years ago, we had only brooms, and we were losing to the dirt,'' recalls Dominique Grillet, sitting in his street cleaner. ''Now, even though there is more garbage, we're winning.'' Paris is winning the battle not just against garbage but against general urban decay. Not since Baron Haussmann thrust broad boulevards through the mid-19th-century slums has the French capital experienced such a surge of , construction and renewal. With neighborhoods full of boulangeries and cafes, good schools, museums, and theaters, almost every ambitious Frenchman aspires to live in the city. Says Jacques Marvillet, the city's planning director: ''Paris works; it's not just a business center with empty offices at night.''

Paris offers lessons that can be exported to America. Most important is the concept of national rather than local responsibility. The central French government pays for many of the services Parisians take for granted -- everything from the multibillion-dollar monument program to the efficient suburban rail and subway system. Policemen are managed by the Ministry of Interior, not by the mayor of Paris; by enforcing tough French gun-control laws, the police have managed to keep the crime level in Paris five times lower than in New York City. Schools are financed by a central education ministry; the ministry assigns teachers to their positions, and good teachers can be placed in poor neighborhoods. In varying degrees, other European governments take similar financial responsibility for their cities. America might start by having the federal government resume block grants to cities, while regional authorities assume responsibility for transportation and law enforcement. What's crucial is that the costs be shared by city and suburban dweller alike, since both use the city. No big city, not even Paris, can escape the pressures of urban growth. Throughout the Continent, office construction has pushed the working class into grim suburbs full of shoddily built high rises. And efficient rapid transit doesn't prevent two million cars from coming into Paris every day. Instead of limiting traffic, Mayor Jacques Chirac has responded by building hundreds of underground parking garages. Other European cities are trying out new ideas to cope with the car. Stockholm and several Norwegian cities, including Oslo and Bergen, have set up electronic gates charging tolls to enter metropolitan areas. The fees in part help pay for public transport.

HEALTH CARE Janet McCormick, a 47-year-old British schoolteacher from Oldham, just outside Manchester, slipped and broke her knee two years ago. At Oldham's hospital, the doctors treating her also discovered that she had a rare gland disorder that weakened her bones. The defective gland was removed, and Mrs. McCormick spent 2 1/2 weeks in the hospital. Today she is back at work, a fervent believer in the nationalized British health system. National health systems in Western Europe not only provide coverage for everyone, but also do so at lower overall cost than in the U.S. According to the OECD, America spends more than 12% of GDP on health care, vs. less than 8% in Europe. Europeans also live a little longer, in general, than Americans, and their levels of infant mortality are significantly lower. Unlike the U.S., where cost control focuses on hospitals, the British have taken aim at doctors. The government sets the salaries of British doctors; generally they earn less than half what their American counterparts do. But the British doctors don't have to worry about malpractice premiums, since the government picks up most of the cost. Moreover, British patients -- and their lawyers -- are not nearly as litigious as American ones, perhaps because lawyers in malpractice cases get a flat fee, not a percentage of the settlement. Says Dr. Mark Zuckerman of University Hospital in London: ''I would earn more in the U.S., but I don't think I would be happier.'' Other European countries manage to contain costs in a way that might be more acceptable to Americans. In Germany the government sets overall limits on health spending but lets doctors, hospitals, and insurance companies figure out how to operate within them. The private insurers keep costs under control by negotiating uniform charges with doctors; in the U.S., insurance payments to doctors can vary widely. Doctors in each region of Germany belong to organizations that have legal authority to bargain with insurance funds over reimbursement. In the U.S. such collective price fixing could be prosecuted under antitrust laws. The German strategy, like the British system of salaried doctors, has shut off one of the main sources of health care inflation; over the past decade, incomes of German doctors have risen slower than wages in general. Uniform fees keep administrative costs down. German health insurance funds spend about 5% of premiums on administration, vs. 13.4% in the U.S. European countries also control procurement costs better. The downside is that some kinds of high-tech care are rationed. For years after CAT scanners were introduced in the U.S., they remained rare in France because the government didn't want to spend the money to buy them. When lithotriptors, machines that smash kidney stones, were developed, the French Ministry of Health limited the number as well. Says Daniel Prangle, director of the Hautepierre hospital in Strasbourg: ''The centralized procurement system has a lot of theoretical advantages, but in practice, it poses a lot of problems. The bureaucrats in Paris lack the knowledge of the needs of regions and are unable to respond quickly.'' Another common complaint by Europeans is of long waits for discretionary surgery. ''There is a general feeling that more incentives are needed to cut down waiting periods,'' says Jean-Pierre Poullier, a health care expert at the OECD. But even as the Europeans struggle to improve their systems, one thing is clear: Health care is not the divisive issue it is in the U.S. By overwhelming majorities, Europeans like Janet McCormick say they are satisfied. Adds McCormick: ''What you hear about the American system sounds so appalling.''

The main lesson to be learned from Europeans is that they are committed to sharing their burdens among all parts of society and to planning for the long term. They pay high taxes -- almost half of each pay check -- for social programs and services administrated by strong central governments. Americans not only clamor for lower taxes, they distrust almost anything orchestrated from Washington. Perhaps by voting for Bill Clinton, some recession-weary Americans are acknowledging that to get something from the government, they must also give a little.