COLUMN ONE : A Lifetime of Pushing the Limits : From his summer camp days to years as a business mega-consultant, Ira Magaziner has tried to change the world. Now he’s trying to overhaul the U.S. health care system.

He arrived without fanfare, an Ivy League theorist in service to his ideals, and he quickly set out to plot big changes. He recruited an army of like-minded reformers and began dissecting the issues with missionary fervor, churning out lofty memos on how to make things better.

Twenty years ago, that was Ira Magaziner, leading a quixotic attempt to bring grass-roots democracy to Brockton, Mass., a struggling blue-collar town that was home to heavyweight boxing champion Rocky Marciano.

The youthful effort to transform a community fizzled, but Magaziner is still at it. And if his modus operandi hasn’t changed, his ambitions surely have.

Instead of trying to remake a city, he’s out to change America.

As director of the White House Task Force on National Health Care Reform, Magaziner--working closely with First Lady Hillary Rodham Clinton--has assembled more than 500 experts to help draft the Administration’s agenda for health care reform. Perhaps the most ambitious plan of its kind, it promises to transform the way every American receives--and pays for--medical care.

With delivery of a huge draft of the plan to President Clinton imminent, the moment of truth is at hand. And Magaziner has almost as much at stake as the President himself.

As a hard-driving consultant who made millions advising major corporations, Magaziner has been widely recognized for his ability to analyze and devise ways to handle the most difficult financial and strategic problems.

His devotion to hard work is such that aides who arrive for afternoon meetings toting sandwiches have found themselves still laboring--food untouched--at 3 a.m.

Yet after a series of forays into the realm of public policy--from trying to transform Brockton to a higher-profile effort to remake the entire economy of Rhode Island--Magaziner is still looking for the big win.

Producing a full-scale redesign of America’s health care system could provide it. Or the effort could go down in history as a foolhardy exercise by a man who critics say is far too steeped in academia and too naive about the workings of government.

It is clear that Magaziner, the would-be health reformer, has incorporated lessons learned from past failures. And he is apparently gambling that this, his third try in the public policy arena, will be a charmed one.

“Ira’s best trait is also his riskiest trait: He never tries to hit a single, but always a home run,” said longtime Rhode Island journalist Mark Patinkin, who spent two years writing a book with Magaziner on global economic competition.

“Ira does not think small,” agreed task force spokesman Robert Boorstin, special assistant to the President for policy coordination.

For Magaziner, a frizzy-haired, slightly rumpled, 45-year-old former Rhodes scholar now holding his first real government job, thinking big is what life should be about.

“The you-can’t-do-that attitude here is a bit demoralizing, and it can sap your energy,” he said. “But if we can get something accomplished, it’ll really be something.”

Restructuring the health care system is “very complicated,” Magaziner conceded. “But other things I’ve done were pretty complicated too.”

Cites Track Record

He is equally dismissive of skeptics who say that the system he designed for developing the health care plan, complete with a series of review gantlets he calls “tollgates,” is too complex and too academic.

“I have a successful, 20-year career in the private sector, which doesn’t take too kindly to people with ideas that don’t work. And I had one of the most successful track records as a business strategy consultant--with firms that had pretty hard folks to please,” Magaziner said in a monotone that belies his annoyance.

“So my ideas have had to be practical and to stand the test of time.”

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For Magaziner, the notion of testing himself and the system came early in life.

The gangly, shy New Yorker grew up in a household that idolized Franklin and Eleanor Roosevelt.

“There was this idealism that flowed through the household and the sense that you should be committed to doing something just beyond yourself,” Magaziner said.

As a teen-ager, he sold tickets for a Lena Horne concert to benefit the Congress for Racial Equality and joined the 1963 civil rights march on Washington.

Magaziner grew up in Far Rockaway, the son of an accountant for a small company. The family moved from Queens to a modest house that straddled the Nassau County border because the schools were better. He played basketball, ran a decent half-mile and got A’s in Hebrew school.

During high school, he was expelled from a national association of student council presidents for leading an anti-segregation boycott.

Louis and Sylvia Magaziner were not wealthy and, until their son was in junior high school, they did not own a car. The family took vacations by bus.

Magaziner remembers on a trip through Virginia when he was in the fifth grade, “seeing lunch counters that had separate seating and separate bathrooms and so on, and being affected by those odd inequities.”

At age 15, Magaziner worked as a waiter at a summer camp in the Adirondack Mountains, where he led a walkout to protest working conditions. The strike lasted only two days. Magaziner was fired, and all the other waiters got a raise.

“You need to be sure that people who are with you are really with you when you’re doing something,” Magaziner said.

At Brown University, he was class president all four years. Many classmates still recall a wildly successful spring festival he organized that featured poet Allen Ginsberg, singers such as James Brown and Dionne Warwick, and 24 hours of Marx Brothers movies.

But Magaziner’s most enduring achievement was engineering a wholesale revision of Brown’s curriculum, holding rallies and meetings with university officials, and eventually persuading the faculty to abandon course requirements and mandatory grades.

In the spring of 1969, as campus protests against the Vietnam War reached a nationwide crescendo, Magaziner, the class valedictorian, persuaded most of his classmates to stand and, literally, turn their backs on one of the university’s honorary degree recipients: Henry A. Kissinger, architect of President Richard Nixon’s war policies.

Magaziner’s speech, in which he railed against social injustice, also got national attention. Life magazine published excerpts of his address--alongside those of a student leader from Wellesley College: Hillary Victoria Rodham.

The two would not meet for another decade. Rather, it was Bill Clinton whom Magaziner first met at Oxford University.

Unlike most Rhodes scholars, Magaziner took up residence in London, where he studied political economy at the London School of Economics and continued organizing anti-war demonstrations.

Back in the United States two years later, Magaziner and some friends decided on their own to “reform” the deteriorating community of Brockton, south of Boston.

By day, they worked as clerks, librarians, bank tellers, teachers and laborers. Magaziner worked on the loading dock of a trucking company. By night, the group of 30 or so idealists plotted social reform.

They set up a food co-op, rehabilitated low-income housing, built a children’s park and fought against plans for residential construction on the edge of Brockton’s largest park. They even published a weekly newspaper dedicated to people who, according to its masthead, “feel cheated in the marketplace and frustrated in the halls of government.”

Hundreds of citizens enlisted in the movement. But after two years, the experiment lost steam and the collective dispersed.

“We didn’t really understand much about the forces that affected the economy of a town,” Magaziner said, conceding that the effort was ill-conceived.

Patinkin put it this way: “What he really wants more than anything is for his kids to have the same opportunities that he had. (But) Brockton made Ira realize that if you really want to help the needy, the path can’t be through idealistic ‘60s pursuits but through economic renewal.”

Joins Corporate World

Immediately after leaving Brockton, the newly enlightened Magaziner joined the Boston Consulting Group, a high-powered corporate strategy firm, where he was the in-house iconoclast, working for half the going salary, wearing faded blue jeans amid a sea of pin stripes.

Typically, he worked harder than anyone else, even paying secretaries out of his own pocket to work for him on weekends. Among his cohorts, Magaziner became the first to make partner.

One of his first cases involved the LTV Corp., whose steel division wanted to build a smelting plant, based on the hope of a surge in demand.

Magaziner advised against the multimillion-dollar investment, citing rising energy prices and threats from other metals and foreign competitors. But the company ignored his advice.

Eventually, it filed for Chapter 11 bankruptcy.

Magaziner claims no sense of vindication. “Maybe they would have gone bankrupt even faster if they had accepted our recommendations,” he said.

Despite the 18-hour days and seven-day workweeks, Magaziner found time to court and marry a BCG colleague, Suzanne McTigue, a graduate of the Harvard Law School and the Graduate Business School.

In 1979, they and several other BCG members left and formed their own company, Telesis, in Providence, R.I., doing corporate strategy studies for companies all over the world. In addition to consulting for General Electric Co., Black & Decker Corp. and Corning Glass Works, they also did economic development studies for the governments of Ireland, Sweden, Britain, Belgium and Ontario, Canada.

At Telesis, women were given a six-month maternity leave--with pay. But Magaziner also drove his employees hard--as he did himself. After returning from a rare Caribbean vacation with his family, he confessed to a friend that he got “a little bored.”

“What really makes Ira happier than anything in the world is working 18 hours a day on policy. No, make that 20 hours,” Patinkin said.

In 1983, he offered Telesis’ services to help Rhode Island, now his adopted home, develop an economic revival plan, shifting its industrial base from defense contracting, textiles and jewelry to assorted high-tech industries.

Magaziner’s involvement led to an 11,000-page report known as the Greenhouse Compact, named for a proposal to launch research “greenhouses” to encourage fledgling ventures.

The idea got off to a fast start, with most of Rhode Island’s political, business and labor Establishment backing the $248-million program.

Though the plan was approved overwhelmingly by the Legislature, Magaziner thought it should also obtain the public’s blessing. So he included in the plan a $110-million bond issue that went before a voter referendum in 1984.

It lost by a 4-to-1 margin.

“Ira was partly responsible for not being able to devise a strategy to make people understand it,” said M. Charles Bakst, a longtime Magaziner watcher and government affairs editor of the Providence Journal newspaper.

“I felt that if we were going to do a program this big, that it was only right to go to the people and do a referendum,” Magaziner said.

“Many people, in retrospect and perhaps second-guessing, said: ‘You shouldn’t have done it with something this complex. That’s why you have representative government.’ ”

Failed to Sell the Public

His real mistake, Magaziner says, and one he hopes not to repeat, was failing to sell the program to the public.

“I learned a lot of lessons from Greenhouse,” he said. “It taught me the need to communicate simply and to spend a lot of time on that communication.”

Magaziner says he also learned “the importance of doing things from the grass-roots level” and to “do things a little more gradually when you’re asking for a significant change.”

In 1988, Magaziner sold Telesis for $6 million.

Next he formed SJS, which takes its name from the first initials of each of his three children. The firm spent about 25% of its time doing traditional business strategy consulting and, using the income that generated, devoted the rest of its time to pro bono work on social and economic issues.

One such project was an analysis of Rhode Island’s health care system for the elderly.

In 1990, he served with Hillary Clinton on the board of the National Center on Education and the Economy, which sponsored a report on skills of the American work force.

Last year, he toyed with the idea of running for treasurer of Rhode Island but rejected it, telling friends that as a die-hard New York Yankees fan he could never get elected in a state that roots for the Boston Red Sox.

Instead, Magaziner plunged into Bill Clinton’s presidential campaign. He became a key adviser and wrote large portions of “Putting People First,” the campaign’s manifesto.

Getting Mixed Reviews

Five days into his presidency, Clinton announced the formation of the health care task force, naming his wife as its leader and Magaziner as its paid director.

As the task force puts the final touches on its recommendations to Clinton, Magaziner and the First Lady have begun intensive consultations with key members of Congress and representatives of health care interest groups.

So far, Magaziner has received mixed reviews.

“He listens, he challenges and he makes sure that all sides of an issue are heard,” said James Todd, executive director of the American Medical Assn. “He does not come with a theology of his own.”

But one Democratic member of the House Ways and Means Committee said he is worried about Magaziner’s lack of familiarity with the ways of Washington.

This member recalls a recent meeting between Magaziner and Rep. Pete Stark (D-Oakland), who is chairman of the Ways and Means panel’s health subcommittee and has his own ideas about health care reform, far different from Magaziner’s. Before long, the meeting erupted into a cacophony of raised voices.

Asked about that encounter, Magaziner simply says that he appreciates Stark’s candor.

“He’s a guy who knows a lot about health care. He’s worked at it a long time, and he’s got some opinions and is strong about them. But I appreciated his frankness,” he said.

“I’m used to company environments, where if somebody disagrees with you, they just say they disagree with you and you sort of shout it out over a table. But it’s good. You get a good discussion that way,” he added

“But here, you find a lot of people smiling, patting you on the back, and so on and so forth. But they don’t really mean it. So it’s a less direct atmosphere. Those are the kinds of things that make this more difficult, and not so much the intellectual complexities of the task.”