Mitchell Leaving With a Smile, Unmet Goal : Politics: Majority leader says he doesn’t regret decision to retire. But friends say he is crushed by failure to pass health care reform.

Long before President Clinton and his wife began barnstorming across America to promote health care reform, George J. Mitchell was already toiling in the vineyards, holding public hearings and proselytizing at every turn in his studious, pedantic manner.

He even had his own plan, called Health America. But the Senate majority leader’s efforts in 1991 were soon overshadowed by the presidential campaign and the bazaar of reform proposals advanced by the major candidates, and then by Clinton.

Still, Mitchell persisted, playing a low-key, behind-the-scenes role, constantly probing for common ground where others saw no opening. He felt so strongly about seeing the issue through that he even passed up an opportunity to be named to the Supreme Court last spring.

And in the waning days of this Congress, it was Mitchell’s relentless, tortoise-like approach on which the last strand of hope for health care reform hung.

But it was not to be.

When the end came, it was again Mitchell, alone at center stage, belatedly acknowledging what most everyone already had taken for granted: Health care reform is dead this year.

For others, including the Clintons, there will be another day. But not for Mitchell.

After 15 years in the Senate, including five as majority leader, the Maine Democrat is happily calling it quits. In an otherwise somber press conference, Mitchell, 61, broke into a grin when asked if he is sorry to be leaving. “No, I don’t regret my decision not to seek reelection . . . . I think I made the right decision on the circumstances that existed at the time.”

But behind that facade, friends and confidants said, Mitchell is crushed by the failure of Congress to pass comprehensive health care reform.

“It’s got to be hell . . . for him,” said Sen. John D. (Jay) Rockefeller IV (D-W.Va.), an ally in the health care efforts. “It makes you marvel at the ache and the agony that must be under this remarkable, consistent, reasonably amiable . . . human being.”

But Mitchell never had any illusions about the daunting task that he championed.

“Reforming the health care system will be difficult. A perfect solution doesn’t exist,” he acknowledged in an interview in December, 1991, as he traveled across the country for a series of public hearings on health care reform.

“It turns out I was right,” Mitchell said Monday.

What Mitchell--and the White House--have learned is that America may be a nation of nervous nellies when it comes to the prospect of losing coverage and being squeezed by medical inflation. But even the endless stream of scare stories that reformers brought before the public weren’t enough to galvanize the middle class into support for their programs.

Mitchell said he realized that his work had gone for naught during a White House meeting last week when Republican congressional leaders threatened to hold up approval of a trade agreement if he persisted on health reform.

Mitchell conveyed his assessment to Clinton on Friday. “He listened and graciously responded,” Mitchell said, adding that both the Clintons deserve “enormous credit” for their efforts.

Mitchell exited with this prediction: “I believe it inevitable that comprehensive health care reform will be enacted . . . .”

But for now, “I’m disappointed, of course.”

Times staff writers Elizabeth Shogren and Karen Tumulty contributed to this story.