ROCHESTER, N.Y. -- Up here, on the shores of Lake Ontario, the president of the United States can seem far removed from the lives of everyday people.
But as John Grayko, 45, watched President Clinton outline his health care plan on television last month, Mr. Grayko felt his skin tingle and his heart pound with emotion.
"I fervently believed in what he was saying," said Mr. Grayko, who lost his health insurance for 18 months when he was laid off as a data processor. "People talk about whether health insurance for everyone is a right. The word I would use is necessity. It's an absolute necessity."
One year ago this week, this city and its suburbs, like the rest of America, put its trust -- just barely -- in the man from Hope, Ark. People do not seem to regret their votes, at least not yet.
Nationally, Mr. Clinton won with 43 percent of the vote to George Bush's 38 percent. Texas billionaire Ross Perot polled 19 percent. Those figures were replicated almost exactly in New York's 28th congressional district, which includes Rochester and most of the surrounding neighborhoods in Monroe County.
If there's one obvious pattern to people's attitudes here, it's that those who voted for Mr. Clinton are sticking by him, although with some reservations, while those who voted for Mr. Bush remain suspicious of the new president. The Perot people are still disgruntled at everyone.
"You get a lot of jokes about Clinton, but people are willing to wait," said Richard Fenno, a political scientist at the University of Rochester. "I know I'm willing to give him a break. His test is health care."
Rochester's recent typical voting patterns and its trend-setting history suggest that, if Mr. Clinton's act plays here, it will play in the rest of the country.
"It's like a laboratory," said Tom Fitzpatrick, executive director of the local Democratic Party.
Some changes in place
This city has already implemented many of the cost-cutting health care measures the president wants -- but still has tens of thousands of people without insurance.
It's the birthplace of several worldwide conglomerates -- but two of them, Xerox and Gannett, have relocated their corporate headquarters, and the largest, Kodak, plans to lay off 20,000 workers.
It is also a city with an unemployment rate below 5 percent -- and yet the welfare rolls have never been longer, and violent crime is soaring.
Rochester also has a proud tradition of progressive politics. It was home to 19th century crusaders Susan B. Anthony and Frederick Douglass -- but Mr. Clinton's Democratic ticket did not win a majority here. And the indications are that the public, while more patient perhaps than the Washington establishment, is judging him not by what he says, but by what he's able to accomplish.
"People are still angry," says Gordon Black, a national pollster based in Rochester. "And they have a right to be. This is a system that is not functioning."
Last year, with Kodak in turmoil, voters here said their primary fear was the apparent loss of jobs -- and the health insurance that goes along with them.
One year later, violent crime has forced its way onto that short list.
Top concerns: Drugs, crime
Crime and drugs. It's what you hear everywhere in Rochester, as in the rest of America, where 80 percent of the people now agree with the president's proposal to add more police officers.
Another young life was lost here last Wednesday, bringing the city's record-pace total for the year to 54. It was a scenario that is all-too-familiar in every city in the nation.
"Such a waste," said Anita Abert, a 30-year-old waitress and bartender. "The crime, the killing, the guns -- too much violence, even in the schools. It's terrible."
The other predominant issue here continues to be health care, although the talk is not all on Mr. Clinton's side.
"Clinton's health care plans are of almost an obsessive interest up here," said Mr. Fitzpatrick. "The president said, 'Let the debate on health care begin,' and Rochester took him up on that."
The reason is that the greater Rochester area -- a six-county area with a population of nearly 1 million -- has a revolutionary approach to health care that is being cited by the Clinton administration as a model.
A generation ago, the captains of Rochester industry convinced Blue Cross/Blue Shield of Rochester to use its near monopoly in the region to keep a lid on health care costs. The city's power brokers, in conjunction with the local hospital boards and physicians' groups, succeeded in blocking the construction of new hospitals, capped hospital revenues, divided up the functions of each hospital, and exerted control over the cost of medical procedures.
In January, a General Accounting Office report found that Rochester's medical costs per person were 33 percent lower than the rest of the nation -- and a whopping 45 percent lower than the rest of New York state. Moreover, with roughly 5 percent uninsured, Rochester had a lower rate of uninsured than the rest of the nation.
But that number is still somewhere between 50,000 and 60,000 people -- and for many of them the 1992 presidential election was a crusade.
Mr. Clinton "seemed genuinely concerned about the problems of people like me," said Shannon Gallagher, a 24-year-old woman whose 20 hour-a-week job as a city librarian brings no health insurance with it.
"When my daughter goes to the dentist, we pay cash, up front," said downtown bartender Marilyn Prindle, whose husband died last year, leaving her without health insurance. "That's life, I guess, but you pray nothing bad really happens. . . . If the president can change that, he'll have actually done something for people."
John Grayko, the man who got choked up when he watched Mr. Clinton's speech last month, listened to the health care debate in 1992 -- and decided the nation needed Mr. Clinton. On Election Day, he helped organize a Democratic Party get-out-the-vote effort in which some 450 voters were driven to the polls.
Mr. Grayko landed a job a month ago. But he is dismayed at what he overhears his co-workers saying: Rochester's health care is so good for those who have insurance that they are afraid the Clinton administration will louse it up.
This kind of apprehension is relatively new to Rochester.
For decades, the city was virtually recession-proof, thanks to the monopolies and worldwide markets enjoyed by its huge conglomerates, Xerox, Bausch & Lomb, Gannett, and the biggest of them all, Eastman-Kodak.
Kodak once employed some 60,000 workers in the district, giving the place the feel of a company town. But pressed in recent years by Japanese competition and by newer technologies that threaten the future of chemical imaging, Kodak has laid off 10,000 workers -- and announced plans to lay off 10,000 more.
On Thursday, Bausch & Lomb broke ground on a 20-story corporate headquarters here. Does that signify a stable economic future?
Or are Kodak's travails more indicative of what people will face in the 1990s? The company named a new chairman Wednesday. He is a popular man, but few here forget that his predecessor was forced out because Kodak wasn't cutting jobs fast enough to satisfy Wall Street investors.
Generally, Rochester's residents don't seem to blame Mr. Clinton -- or his predecessor -- for the current financial uncertainties in their lives. The most prevalent criticism of Mr. Clinton -- expressed by Republicans, Perot voters, small-business people and successful professionals -- is that Mr. Clinton seems entirely too willing to raise taxes.
"People pay enough as it is," says Peter Giamos, the Greek-born owner of an Irish bar called McGillicuty's. "And if Clinton raises the taxes on booze, he'll put me out of business."
Fred Graus, a retired railroad worker, thinks, however, that "a lot of people are bucking him too hard." He names one culprit, Senate Minority Leader Bob Dole, a Kansas Republican. "I think the guy [Mr. Clinton] is sincere in what he wants to do. I think he's trying."
Asked to name a positive political development, Mr. Graus doesn't cite any sweeping national policies -- he cites the city's decision to build a new stadium for the Rochester Red Wings, the Orioles top farm club, downtown, a la Camden Yards.
It's a healthy reminder that all politics is local.
On Tuesday, Rochester will get a new mayor -- the first African-American to hold the post. The favorite is 51-year-old Democrat William A. Johnson Jr., head of the Rochester Urban League, who ran an aggressive campaign aimed at dealing with crime among the young. Mr. Johnson's Republican opponent, Mark Dulaney, a 32-year-old chemical technician at Kodak who stresses self-reliance, is also black.
But does it matter who wins?
Calls for fundamental change
Mr. Black, the pollster who actively supported Mr. Perot in 1992, insists that, until the nation's welfare system and educational systems are overhauled, communities are going to be able to do little on their own.
"We changed faces in Washington, but nothing's changed here -- the crime rate is still soaring," he says. "Rochester is a community that should be able to solve its own problems. But it can't because many of them are imposed on Rochester by the state and federal governments."
Mr. Black is trying to help found a third party, one that would represent the vast political center.
Others are not convinced that the problems are that intractable jTC -- or that such radical change is necessary. But they, too, are coming to believe that the answers just might not be found in Washington.
"I'm starting to see this odd meeting of the minds between both Republicans and Democrats," says Ralph R. Sell, a local demographer and sociologist. "We are becoming inward-looking, all of us. People are realizing that if they want their lives to get better, they may have to do it themselves."