Does America have a social policy deficit?

I just noticed that Francis Fukuyama sorta joined the blogosphere -- he's occasionally posting over at The American Interest's blog. In this post from last month, he issues a provocative question that remains relevant: What is it that leaders like Iran?s Ahmedinejad, Hezbollah?s Nasrullah, and Venezuela?s Hugo Chavez have in common that vastly increases their local appeal? Anti-Americanism and an aggressive foreign policy are of course components. But what has really allowed them to win elections and cement their support is their ability to promise, and to a certain extent deliver on, social policy?things like education, health, and other social services, particularly for the poor. Hugo Chavez has opened clinics in poor barrios throughout Venezuela staffed with Cuban doctors; Hezbollah has offered a complete line of social services for years and is now in the business of using Iranian money to rebuild homes in the devastated south of Lebanon. Hamas in Palestine, the Muslim Brotherhood in Egypt, and Evo Morales in Bolivia all have active social agendas. Organizations like Hezbollah and Hamas do not merely lobby the government to provide social services; they run schools and clinics directly while out of power. The United States and the political groups that it tends to support around the world, by contrast, have almost nothing to offer in this regard. Washington stresses democracy and human rights?that is, procedural safeguards that institutionalize popular sovereignty and limited government?as well as free trade, with its promise of economic growth. This is a good agenda in line with American values, and it has worked well in Eastern Europe, East Asia, and elsewhere. But it tends to appeal to middle-class, educated constituents. In those parts of the developing world that suffer from deep social cleavages and inequalities, free elections and free trade have relatively little resonance for the great majority of the population that is poor.... Washington has lots of advice to give developing countries on economic policy, in terms of deregulation, privatization, reduction of tariff barriers, and the like. But there is no equivalent of the ?Washington Consensus? on how to help Bolivia or Pakistan or Egypt improve its primary education system, or how to get health services delivered more efficiently in poor neighborhoods. The United States and its liberal democratic friends around the world need to start thinking seriously about a social agenda that will appeal to the poor if they are ever to compete successfully with the Islamists and populists of the world. This is not a call for a return to the old social democratic agenda of the 1950s and 60s.... But all governments have to provide social services, and it is important to figure out how to do this well rather than poorly. I do think Frank is overstating the problem here. First, it shouldn't be that shocking that local leaders have the ability to craft social policies that resonate better in the short run than the United States. Second, all you have to do is read Bill Easterly to become immediately wary of anything that smacks of a "Wasington Consensus" on health and education in the developing world. I'm pretty confident that such an animal does not exist. Third, and most important, the one element that would belong in anything resembling a Washington Consensus on social development would be an intensive focus on educating women and providing them with greater health choices. How many conservative societies in the developing world are going to be truly receptive to that kind of program? Finally, one of the few Bush administration policy innovations that does get kudos across the ideological spectrum is the Millennium Challenge Corporation. No one pays attention to it, however. Why? Well, it's been a bit slow in dispensng aid, and, oh, yes, there's Iraq. That's the thing about big foreign policy screw-ups -- unfortunately, all the soft power in the world can't erase them.