The MacNeil/Lehrer NewsHour

MR. MacNeil: Good evening. I'm Robert MacNeil in New York.

MS. WARNER: And I'm Margaret Warner in Washington. After our News Summary, we update the tense situation in Moscow. Then we turn to the health care debate. We get the views of four lawmakers, our regular panel of regional editors, and political analysts Mark Shields and Paul Gigot. NEWS SUMMARY

MR. MacNeil: Russia's hard-line lawmakers continued to defy Boris Yeltsin today, holed up in their parliament building behind crude barricades, but Yeltsin's stepped up the pressure on them this morning, sending troops to surround the building known as the White House. The self-appointed defenders of the White House did not withdraw, but most appeared to have put away their weapons. Both sides vowed not to use force. We'll have more on the story after the News Summary. Rebels in the former Soviet republic of Georgia reportedly launched a new offensive today against the city of Sukhumi, capital of the breakaway region of Abkhazia. Rebels fighting government forces for control of the city have shot down three airliners this week. Today, Georgian President Eduard Shevardnadze, speaking from Sukhumi, called for a mobilization of all Georgians to defend the city. The U.S. condemned the rebel assault and reiterated support for Shevardnadze's government. Margaret.

MS. WARNER: President Clinton turned his attention to crime today. Traveling in Florida, he urged support for his administration's new anti-crime bill. The bill calls for tougher criminal penalties, fifty to one hundred thousand more police for the nation's cities, and gun control. He spoke in St. Petersburg.

PRESIDENT CLINTON: There's not a person in this country that values the culture of the outdoors and the hunting, and all of that, anymore than I do. But neither those who love to hunt or who love to shoot weapons in contests, nor the framers of the Constitution, when they wrote the Second Amendment, ever envisioned a time when children on our streets would illegally be in possession of weapons designed solely to kill other people and have more weapons than the people who are supposed to be policing them. And we'd better stop it if we want to recover our country.

MS. WARNER: He also said reducing violent crime will help reduce the nation's health care costs. Elsewhere in Florida, the President continued his push for health care reform. In a town meeting in Tampa shown on ABC last night, Mr. Clinton said his plan will cover abortion, but he said he hoped the plan would reduce the demand for abortions by covering pregnancy prevention services. We'll get more reaction for the President's health care proposal later in the program.

MR. MacNeil: A federal appeals court today ruled the Clinton administration will not have to produce an environmental impact statement on the North American Free Trade Agreement. Such a review was ordered by a lower court and could have delayed congressional consideration of the agreement for months. Today's ruling said NAFTA was a political matter, and the judiciary had no role to play. In economic news, the Commerce Department reported factory orders for durable goods were up 2 percent in August. That helped offset a 2.8 percent drop in July. Increased demand for aircraft, computers, and cars accounted for most of the gain. Rescue workers in Alabama today recovered the bodies of the last three people missing in Wednesday's Amtrak crash, bringing the final death toll to 47. The victims were all crew members. Their bodies were found in the lead engine, which was pulled from the bayou this afternoon.

MS. WARNER: The United States began lifting economic sanctions against South Africa today. President Clinton called on states and localities to end their boycott, and the Senate voted to lift sanctions at the federal level. The moves followed a United Nations speech by African National Congress Leader Nelson Mandela, calling for the sanctions to end. His appeal came one day after South Africa set up an interim government council, giving blacks their first ever role in running the country.

NELSON MANDELA, African National Congress: This global struggle, perhaps without principle in the inestimable number of people, if united around the one common issue, has helped to decisively to bring us to where we are today. Finally, the apartheid regime was forced to concede that the system of white minority rule could no longer be sustained.

MS. WARNER: Mandela said the UN embargo against selling weapons or nuclear material to South Africa should remain, however, until a new government is formed after multi-racial elections next April.

MR. MacNeil: In Cambodia today, Prince Norodom Sihanouk reclaimed his country's throne after decades of exile. He was crowned king in an elaborate ceremony at the Royal Palace in Phnom Phen. His return was made possible by a 1991 UN-sponsored peace agreement that ended Cambodia's 15-year civil war. Sihanouk's first official act as king was to appoint his son as head of government. In the Philippines, Imelda Marcos was convicted of corruption sentenced to at least 18 years in prison. She remained free on bail. The government is still trying to recover some of the estimated $10 billion it claims was embezzled during the 20-year regime of her late husband, Ferdinand Marcos.

MS. WARNER: That ends our summary of the day's top stories. Ahead on the NewsHour, an update report from Moscow, and the health care debate with lawmakers, editors, and political analysts Mark Shields and Paul Gigot. UPDATE - POWER STRUGGLE

MR. MacNeil: We start tonight with an update on the tense stand- off between Boris Yeltsin and the Russian parliament. Our report is from Ian Williams of Independent Television News.

MR. WILLIAMS: They entered central Moscow this morning, trucks containing armed police and interior ministry troops. Their duty, according to the defense minister, to protect the residents of Moscow. They took up positions in roads and parks surrounding the Russian parliament, the White House. President Yeltsin having ordered the volunteer fighters inside parliament be disarmed, this decree backed up by an ultimatum from the Moscow authorities. In the square outside the White House, among several hard-line demonstrators, tension and defiance. They continued to sign up to protect the building. Inside they claimed they had locked away the arms that had so publicly been distributed yesterday but on their own initiative.

SPOKESMAN: [speaking through interpreter] On the order of our defense minister, General Achalov, the guns have been handed in for storage.

MR. WILLIAMS: But that was dismissed by the government. Indeed, when we were in parliament, guns were still evident as was a willingness to use them.

COL. VYACHESLAV SHUMILIN: [speaking through interpreter] I am willing to take up arms at any time to defend the White House till the last drop of blood. Inside the chamber of parliament, deputies had been told of 7,000 armed men at their disposal, though nobody has actually seen anything like this number. But today the speaker said he did not want to see bloodshed.

RUSLAN KHASBULATOV, Speaker, Russian Parliament: [speaking through interpreter] Our best weapons are, of course, the authority and the rule of law. If methods of force are being used, we are naturally not ready for them.

MR. WILLIAMS: The troop deployment around the White House today follows last night's attack by a group of gunmen on the headquarters of the CIS armed forces in Moscow which killed one soldier and a female on lookout. The government claimed another installation was also attacked but gave no details. It was blamed on leaders of parliament, but later police arrested Col. Stanislav Tarikoff, head of a militant, anti-Yeltsin officers group. President Yeltsin, himself, was, meanwhile, competently chairing a meeting with heads of state of the commonwealth of independence states, the former members of the Soviet Union. In a clear sign of business as usual, they announced an economic union and signed a number of cooperative ventures. Mr.Yeltsin thanked them for their support, then said that spite of the troop deployments in Moscow, he did not intend to storm the White House.

BORIS YELTSIN, Russian President: [speaking through interpreter] I would like to express to all of you my gratitude for your solidarity and your support of the measures we have taken to protect peace and democracy in Russia.

MR. WILLIAMS: It was also confirmed today that phone lines into the ministry of defense have been cut, apparently to stop certain officials being contacted by parliament. Around the White House at least, hard-line protesters are convinced they will be attacked tonight and that the barricades will have to be used. The White House is now completely sealed off, surrounded by heavy armed police and interior ministry troops. President Yeltsin is still insisting he will not use force against his opponents. But the means to do so is now firmly in place. And within the last hour, further reinforcements, elite interior ministry troops, have continued to arrive to take up positions close to the White House. FOCUS - STRONG MEDICINE?

MS. WARNER: Next tonight, Capitol Hill and the Clinton health care plan. President and Mrs. Clinton insist they want bipartisan support for their health care package. What that will take is what we explore next with four lawmakers. Sen. Harris Wofford, a Pennsylvania Democrat, supports the President's plan. Sen. John Chafee, a Rhode Island Republican, is sponsoring the key Republican alternative to the Clinton plan. Sen. John McCain, an Arizona Republican, is working on his own alternative. And Congressman George Miller, a California Democrat, is sponsoring a single payer bill in the House that would set up a Canadian style system. Welcome, gentlemen. I thought we'd start by trying to take the six objectives the President laid out and see how well you think his plan would meet them. Sen. Wofford, let me start with you. The first thing, of course, is health security for all Americans, both for the uninsured and for people today who have insurance but who are worried that they're about to lose it. Do you think his plan satisfies that criteria?

SEN. WOFFORD: That's what our present plans in this country don't give us, and that's what the health security card and the comprehensive security, health security package that the President has proposed will assure to all Americans. You'll no longer be one pink slip away from insecurity of health care.

MS. WARNER: Sen. Chafee.

SEN. CHAFEE: Yes. I agree that his plan and our plan, likewise, would provide security.

MS. WARNER: Congressman Miller, how would you rate it?

REP. MILLER: I think the President's done an excellent job on the health security issue. There's a little bit of concern about what happens to the people who are currently within the Medicaid program, the indigents, but overall, he's done a remarkable job in taking the fear out of the system and replacing it with security.

MS. WARNER: And Sen. McCain.

SEN. McCAIN: I worry about our veterans, what kind of care they expect to get, our native Americans, and I also wonder if you can possibly, if you impose price caps, provide the kind of level of benefits that people have grown to expect.

MS. WARNER: Well, we're going to get to quality later, but in terms of security, everyone having insurance, and feeling they will keep their insurance, do you think the plan does that?

SEN. McCAIN: If they get the benefits in the long run that they have been promised, yes.

MS. WARNER: And, of course, one of the most controversial elements of the plan are the savings. The President says that his plan will extend coverage to 37 million uninsured Americans without raising taxes in any substantial way, and, in fact, will reduce the growth of our nation's health care spending from its current 9 percent year, and have some money left over for deficit reduction. Sen. Wofford, is that creditable?

SEN. WOFFORD: Yes, because what is incredible is that we sit by and let this part of our economy go wildly along with inflation that's growing three times the cost of living. No one has explained to me why we can't ratchet down the increased costs each year, the growth, without cutting any programs, except cutting the fat out of them that a security card will do in terms of an electronic, single claim billing system, and other kinds of red tape and the rest, but we must stop inflation and health care, and, you know, we're increasing a hundred billion dollars a year, and if we can reduce the increases, we've got tremendous assets to apply better to extend the prescription drugs for older Americans, for example, benefits being proposed.

MS. WARNER: Sen. Chafee, is there enough fat in the system to do all this?

SEN. CHAFEE: I think it's clear that the President is overpromising here. I think that he -- we believe the savings are there. We believe that through the programs, many of the features in the President's program, in all fairness, that are in our program, likewise, will bring about savings, but we don't know. This is a very complicated area, and the Republican Senators strongly believe that we ought to pay as we save, in other words, increase the benefits, provide for the coverage of low income individuals, increasingly going up the scale for them, as we have the savings. The President's program rightfully is questioned by not just Republicans, by economists all across the nation saying it just isn't going to work and we'd better move slowly to see that there's savings there before we make the promises to individuals. They're going to seek a lot more benefits.

MS. WARNER: Congressman Miller, do you think the numbers add up, particularly the 238 billion that he's counting on getting out of the Medicare-Medicaid System?

REP. MILLER: Well, the numbers add up. Whether or not he can get that kind of savings or not within the Congress remains yet to be seen. But the -- I don't think the numbers do quite add up. I think the President's plan is still a fairly bureaucratic system. It comes nowhere close, nor does the Chafee plan or any other plan, to what the single payer system will provide you in savings. We see that the Congressional Budget Office has said that over the next five years the single payer plan would provide in excess of $300 billion in savings, some $70 billion in savings in just administrative paper work, and yet, we see managed competition or something like the President's plan, maybe 10 percent of that. So I really don't think they have gone as far as they should go in terms of the administrative savings and the health care savings that can be realized in this, in this plan that he put forth the other night.

MS. WARNER: Sen. McCain, do you think the Clinton plan can offer all this without some kind of a tax increase?

SEN. McCAIN: I do not, Margaret, and I would remind you of the words of Sen. Moynihan who said that it was fantasy, and then after he was briefed by the administration, he said it was fantastic fantasy. I don't see how you get $53 billion in savings out of health care savings which translate into hiring employees who then pay $53 billion in taxes. There has been no program in this century that was an entitlement program that hasn't far exceeded the estimated cost. The most glaring example of that, of course, is the Medicare program, which has now exceeded by some $90 billion its original estimate.

MS. WARNER: Then we turn, of course, to simplicity, which is something the American people certainly want, and doctors and hospitals all say they want. Do you think this plan, Sen. Wofford, will bring -- will create a simpler system?

SEN. WOFFORD: Well, yesterday I was with two small businesses at opposite ends of the state in Pennsylvania, and they were complaining about how the present system with 1500 different businesses in that area, each of them administering the health care plan, answering the questions, negotiating. It is taking a tremendous amount of time, paper work, and each regional health alliance will take over with the economies of scale. It will take over that huge administrative burden that is going on in every company. It is most of the employees in the United States are in companies that contribute to their health insurance. And every one of those, it is administering something. This will -- all it will require for employers now will be that they pay their 80 percent of the premium, or more if they choose to, and they won't have to be administering all these plans and all the paper work. So it takes a big step towards simplicity, not as big as a government-run program, a single payer system would do. But I don't think having built up an employer-based system, America's about to go to a government-run, single payer system, however much it would be simpler.

MS. WARNER: A simpler system, Mr. Chafee, Sen. Chafee, excuse me.

SEN. CHAFEE: He's provided simplicity in certain administrative aspects of it, and three cheers for that. We have that in our program.

MS. WARNER: Such as the single form for patients.

SEN. CHAFEE: The single form, the electronic billing, and so forth. The problem is he then gets into all kinds of complexities. If your payroll as a small business equals so much, then every employee over X dollars will receive 2.7 or whatever it is -- it's so complicated Lord knows how it's going to work -- and so I think all that is just adding complexity onto a system that hardly needs it. So we cheer him for what he's done on the administrative side and regret very much that he's gone into these complexities on the sides that I just mentioned.

MS. WARNER: Congressman Miller, of course, you'd like to see a much simpler plan. How do you think this plan does on the simplicity objective?

REP. MILLER: Well, I think clearly, as the previous speakers have said, it's certainly better than the, the existing system, but once you start calculating the invariable subsidy rates for small, small businesses and for individuals, you're going to have an awful lot of bureaucratic chatter back and forth about eligibility and what happens if you're determined to be ineligible but you are eligible, you lose your insurance. It's not seamless if you do trade employers or you do become unemployed, it's not quite as seamless as the rhetoric would suggest for you to simply stay within the system, and somebody else picks up the bill. Again, that's why we go to a single payer system. We see transactional costs in the Medicare system of 2.9 percent. We see a transactional cost of running the Canadian system of around 2 percent, and yet, we see the current system, almost 25 percent is in the bureaucracy, the paper work, the advertising, the marketing. And so we think the President has taken a step, but they got timid at the end because they, they wanted to leave too many parties involved in this, in this getting health care and getting the bill paid. He still has too many parties involved in that, and a little heavy at the top here in the bureaucratic sense.

MS. WARNER: And Sen. McCain, a simpler system?

SEN. McCAIN: Administratively, yes. As far as the enormous bureaucracies that are being set up, which I view as a massive invention into the private systems, the so-called alliances. I think it's going to be incredibly expensive. The administration estimate is about $2 billion just to set 'em up, and just one additional comment. If you put in an 80 percent tax on the small business employers in my state, they're going out of business, and you're not going to get any revenue, and it's very difficult to provide 'em with health care.

MS. WARNER: And, of course, the President also says that Americans will retain full choice of what doctor to go to. Is that the case, Sen. Wofford, or are they going to be slowly sort of pushed into HMO's here, health maintenance organizations?

SEN. WOFFORD: Well, the danger to choice right now in the present system and situation is very great. And the President's proposals, like my own bill of a year and a half ago, will increase choice. For example, more and more companies are giving workers only one choice, and more and more companies, in order to try alone to meet this inflation problem that we need together to solve are trying to get benefits and, and move people into the lowest cost plans in a sense by force. This plan will say that those workers now will have a range of choice that will include a fee for service, your own doctor, which will include new networks of doctors and hospitals, which will include HMO's, and I think we will have an increase in managed care programs, especially the good ones, but there will be a report card on these plans that will let us -- since it's a standard package -- will let us have some basis of comparing them, consumer surveys, statistical measures of the outcomes of these different plans, so that each year people can choose the highest quality plan. And I think that this is going to stop the slow decline in choice that most Americans are facing right now.

MS. WARNER: Well, does Sen. Wofford make a point here that people are losing choice anyway? How do you feel?

SEN. CHAFEE: Well, to some degree, under our plan there's a requirement that there be a variety of plans that the employee have a chance to choose from. Now, whether it's possible to have, as the President indicated, what's known as a fee for service, or where you choose any doctor you want, regardless of the cost, I think, again, he's making a promise that is going to be very, very hard to honor, because that is an expensive plan, and if he requires that every single purchasing alliance in the United States offer one of these plans, it just may not be available, and if it isn't available, he's promised that it will be, who's going to pay for it?

SEN. WOFFORD: Well, Blue Cross/Blue Shield will make it available in every region.

SEN. CHAFEE: No, no, because you're not -- if they don't have enough customers, they can't make it available. And so there is a promise that I think is going to be very difficult to keep.

MS. WARNER: Congressman Miller, do you think he can keep that promise?

REP. MILLER: No, no. There's no way that he can keep that promise, because as Sen. Chafee just pointed out, the notion you're going to have sort of unlimited fee for service plans available within the alliances or within states or regions just isn't feasible. Doctors and hospitals already today are forming alliances to get into position on a managed competition, HMO, preferred provider basis, what have you, the rhetoric of choice is so much stronger than the fine print in the plan as it was presented, at least the outlines, to the Congress during the health care university this past week. There's choice, if choice is available. If choice isn't available, you've got to go to the next option, and the next option is pretty well dictated by the alliances. Again, I go back. The single payer plan is the only one that allows the current system between patient and doctor to continue to exist based upon, based upon choice. What single payer does is streamline the system of payments, but it leaves the patient-doctor relationship in place. Each one of these other plans is a fairly severe intervention by some other mechanism between the doctors and the delivery of health care and the patients and the acquisition of that, of that health care.

MS. WARNER: Sen. McCain, do you think patients will continue to have choice?

SEN. McCAIN: I agree with George. I think this alliance concept will move the American citizens inexorably into some kind of maintenance, health maintenance organization, and I don't believe the choices will be there. I think that's why we ought to look carefully at the idea that many of us have for medical savings accounts, which would give people more choice, and which would place, in my view, what's the greatest flaw in this system, this proposal, it would put incentives into place which would want, make people not want to use health care unless they need to. If there's some reward in a system, such as through medical savings account, I think we have already seen this because other corporations have done it, there is a reduction in the use, unnecessary use of health care.

MS. WARNER: Sen. Wofford, we're getting low on time here, so let me ask you to look at two of -- the last two together. One is quality, he insisted quality will be maintained, and the other was responsibility, that this is going to force everyone from patients to insurers to just act more responsibly. Do you think it meets those two criteria?

SEN. WOFFORD: One of the ways quality will be improved is to have great emphasis and incentives for preventive care, for immunization, mammograms, many of the things that today our present plans don't often cover. That will be a key increase in quality in this system. And the universal responsibility that is a principle in this, everybody participating and paying for it and being responsible for health and making the choices, I think it's going to work. Hawaii, which had universal participation, universal responsibility, found that 55 percent of the people did choose Blue Cross/Blue Shield fee for service, choose your own doctor plans. 45 percent have chosen a variety of HMO plans but that responsibility goes to the individual. And I think that's better than having a government-run system. And I think that -- I think that we're on the right track, and I'm amazed that we have so much common ground with Sen. Chafee and his colleagues.

MS. WARNER: Sen. Chafee, quality and responsibility?

SEN. CHAFEE: I think on responsibility it does give him pretty good marks. On quality I deeply worry because, first of all, I think there's much in the President's plan that has a lot of merit, so you've just chosen us to delineate some of the specifics. On quality, I greatly worry about this proposal that somenational board is going to set the premiums that can be charged by every insurance company, every provider, in effect, in the country. Once you start doing that, it's a very slippery path you go down, and pretty soon everybody wants to lower the premiums, you lower the premiums, and pretty soon you're lowering quality. That's a dangerous aspect, in my judgment.

MS. WARNER: Congressman Miller, in our closing minutes.

REP. MILLER: Well, I think clearly what Sen. Chafee just said, that's what's going on in the current system. I think the President's done a remarkable job, and the First Lady have done a remarkable job of instilling this whole debate about quality and providing a comprehensive plan that assures that more Americans will get better quality health care than they're getting today because the squeeze and the price squeeze that's going on today is in the existing system.

MS. WARNER: Let me just give --

REP. MILLER: Hopefully, the President's plan will expand the room to, to improve quality.

MS. WARNER: Let me give Sen. McCain a very last brief word.

SEN. McCAIN: We have the highest quality health care in the world. The problem is access and inflation. Let's make sure we maintain the high quality that we have. That's why our Canadian friends are coming to our country when they really need serious help. But the fact is if you put on price caps, quality sooner or later is going to suffer. Thank you.

MS. WARNER: Thank you. Thank you, gentlemen. Robin.

MR. MacNeil: Still ahead, regional editors and Mark Shields with Paul Gigot. FOCUS - EDITORS' VIEWS - CLINTON'S PLAN

MR. MacNeil: Now, for a view of how the President's health reform package is perceived outside Washington, we're joined by our team of six regional writers and newspaper editors: Ed Baumeister of the Trenton, New Jersey Times; Lee Cullum with the Dallas Morning News; Erwin Knoll of the Progressive Magazine published in Madison, Wisconsin; Cynthia Tucker of the Atlanta Constitution; Gerald Warren of the San Diego Union Tribune; and Clarence Page of the Chicago Tribune. Cynthia Tucker, how closely do you sense the public is following this health care reform issue?

MS. TUCKER: I think the public is very, very interested in it. I think that this is one of the issues that has moved up to the top of the American agenda, second perhaps only to broader economic issues. i don't think the American people have absorbed the many complex details of President Clinton's plan so for. After all, he has just begun to present it. But I certainly think this is an issue that has become very important to many Americans, and it became more important after more white color Americans began to lose their jobs, and as they lost their jobs, they lost their health care.

MR. MacNeil: Clarence Page, right up their, close attention from the public, do you agree?

MR. PAGE: No question about it. I think what's really important is not the, the health care, itself, as it is the sense of security. We are in very insecure times. This recession is just the latest indicator of it. Young people, older people, and people in the middle, middle class, middle age, whatever, these days don't feel very secure, and for a post Cold War country that's sad, but it's true. People are worried about losing their employment and their health care. The fact that health care -- I noticed the Clinton people are playing up on this. You know, health care, that's always there. That theme seems to be ringing out with a lot of people.

MR. MacNeil: Erwin Knoll, agree, top issue?

MR. KNOLL: Oh, yes, Iagree with everything that Cynthia and Clarence said about this. I think the President deserves credit for finally putting this issue on the agenda for national discussion and debate, something that should have happened 40 years ago, and I think there is a great deal of public concern that is finally being addressed. I'm not satisfied with the solution but I think he's done a very effective job of delineating the problem.

MR. MacNeil: I -- I'll come back to some of the details of the plan. Gerald Warren, has it really got people stirred up where you are in San Diego?

MR. WARREN: I think people are interested in it, Robin. I haven't seen them stirred up yet to anything near a fever pitch, but I think Clarence was quite right when he said security is a big issue. People are worried about jobs and retaining their jobs, and if they have the security that they will be able to take their health insurance with them if they leave a job or lose a job, it'll make a big difference to them.

MR. MacNeil: Lee Cullum, top issue in Dallas?

MS. CULLUM: Yes, I think it's definitely a top issue in Dallas, Robin. I hear people who are worried about the potential cuts in Medicare. They're worried about their elderly parents and will they get the care that they need. Naturally, the elderly are worried also. I hear people in small businesses who are worried about suddenly having to pay for health insurance for their employees, and they're afraid they can't afford it, and naturally, the general consumers are worried also. We've seen company after company change health insurance every year, change providers every year, so people go looking for new obstetricians and pediatricians and all the rest, and these are professionals who aren't accustomed to this kind of thing. So they're agitated and they're very interested in this program.

MR. MacNeil: Any disagreement, Ed Baumeister, on the importance of the issue to the public?

MR. BAUMEISTER: No. But I think it's interesting to note how it became so important. It's a masterly job on Mr. Clinton's part from, from the very beginning of his administration, the formation of this group that met in secret. We didn't even know all the people at one point, the appointment of his wife, Mrs. Clinton, to head it. All these things focused attention on it. I mean, we're a medium size paper, 90,000 circulation or so, just under 90,000, and we have four people working on it. I mean, we've been stirred. Our columns are full of stuff. We've been stirred by what we've seen in Washington, and it struck me after seeing the speech that this speech was really just another element in it. It wasn't a climax. There have been all these other pieces put in place to call attention to it, to focus the attention, and now to debate it.

MR. MacNeil: And what did you think of the speech, itself?

MR. BAUMEISTER: The speech was terrific. It was a -- it almost gives rhetoric a good name again, the way he mobilized the words and, and got the ideas out through them. It was just a first rate performance.

MR. MacNeil: I see you smiling there, Cynthia. Do you agree with that?

MS. TUCKER: Yes, I did. I thought the speech was genuinely inspiring. The President was passionate, but it was also a good primer in some respects for Americans who know that there is a problem but they were not quite sure what all the problems were. And the President also challenged us, that we're all in this together. I remember, for example, when he said why it is so important that everybody is covered, because I think the inclination for some of us would be to say, well, why are we even worried about those 37 million, and he said, well, because costs will never really come down unless you cover everybody. And so I think it was a very good job.

MR. MacNeil: And Gerry Warren, what did you think of the speech?

MR. WARREN: Good speech, a tad long, but a good speech. I think he made his case very well. It wasn't long on specifics but we didn't expect it to be. I think a couple of important things in the speech, he left the way clear for accommodation with the Congress, and I think that's important. He set a deadline of the end of 1994, and I think that's wise. One of the problems he faces here is building this issue to a white heat right now, and then letting it sort of dwindle away between now and the end of next year when he expects to have a bill. I think he ought to pace himself and be a little slower with the rhetoric right now.

MR. MacNeil: What did you think of the speech, Erwin Knoll?

MR. KNOLL: I thought it was an excellent speech, and because of that speech and the other public relations efforts that Ed Baumeister mentioned, I think Americans now have a much clear understanding of, of what the problem is, of the dimensions of the problem, which I thought the President presented very dramatically, however, I find very few people have a clear understanding of what the answer is because the President really didn't tell us much about that.

MR. MacNeil: Lee Cullum, did you like the speech?

MS. CULLUM: I thought it was a masterful speech, Robin. The President looked like a hedge hog instead of a fox. He looked like a man who knows just one thing and is determined to get it done. You know, he has this amazing capacity to take in data, but all of a sudden in this speech, data had become knowledge, data had become information, and information had become knowledge, knowledge had become conviction. It was a stunning performance.

MR. MacNeil: Do you want to make it unanimous, Clarence?

MR. PAGE: I certainly do. Clinton showed us he's got the vision thing. I was impressed for a couple of reasons. One, he put this program into a context of history, putting it right up there with the New Deal, a nation that goes to the moon can conquer this problem, and he gave Americans a vision of the future. Both of those are crucially important because in order to sell this program he has got to get us Americans to think beyond our personal needs and the needs of our family and think more about national interest. That is the only way that you can sell a program that's got to apply to over 200 million people. It's a very diverse population, with very diverse needs.

MR. MacNeil: Clarence, do you get the feeling that with the way the Republicans are playing it -- you just heard Sen. Chafee sounding extremely cooperative on many parts of it -- that this Congress is going to produce, which expires in 1994, that this Congress is going to produce a health reform bill?

MR. PAGE: I'm certainly confident of it. Contrast the situation right now to that before the debate over Clinton's budget proposal. There, the Republicans knew that the American public trusted them more than the Democrats to hold taxes down and hold spending down, so they could afford to sit on the sidelines and let Bill Clinton and the Democrats try to do it on their own. The Republicans can't afford to sit on the sidelines during this health care debate. The public wants to see health care, and the polls show so far the Democrats are winning on the confidence scale, so the Republicans want to be players. At the same time, they don't want to be obstructionists. At the same time, they're very much divided among themselves as to what kind of health care plan to come up with. So Sen. Chafee has good reason to want to be cooperative right now, and the Republicans, I think, are going to try to fight to save small business from too big of a burden. But right now, at this moment, I think the Democrats have the advantage.

MR. MacNeil: And Gerry Warren, what do you think about that? Do you think with the cooperative spirit and, and the public pressure behind it, we're going to actually have health reform next year?

MR. WARREN: I think the people want it. I think that's very clear. So, yes, I think that can happen. It's not a question of whether the Democrats prevail or whether Mr. Clinton prevails over some other plan, whether it's Republican or Democrat. I think the issue is: Can Congress really deliberate? Can it compromise, come up with the best possible plan that the people will accept, and get it done by next year? It doesn't have to be a win-lose situation.

MR. MacNeil: Let me just ask you, in conclusion here, starting with you, Erwin, if health care is an issue that everyone cares about, where is NAFTA, the North American Free Trade Agreement, on their radar screens right now?

MR. KNOLL: Well, I think in the last few days, NAFTA has been eclipsed by the health care discussion. It's on the television news shows, on the newspaper pages, it's all health care. But as this debate over health care drags on for, for another year or a year and a half or maybe even longer, we can't sustain people's interest on an issue that long, and, and other issues, including NAFTA, will rather quickly come into focus again. And I find here there is a great deal of interest in NAFTA, more than I would have expected, and it's going to be a big issue even as the health care debate continues.

MR. MacNeil: Cynthia, are people paying a lot of attention to NAFTA in Atlanta?

MS. TUCKER: I think people throughout Georgia are paying attention to the issue of jobs, and many people are being told by their members of Congress and special interest groups that NAFTA will cost them jobs. There are interests in Georgia, including peanut farmers, who are concerned that the treaty will cost them. I disagree. I think Clinton is going to have to focus on NAFTA, bring it to people's attention, and focus beyond this clumsy acronym, get people to understand what it means, and what the trade-offs are, and that they need to support it. But that, that part of it, the broader understanding of what it actually means, has not drifted out to the general public yet.

MR. MacNeil: Lee Cullum, how big is NAFTA on the radar screens in Dallas, would you say?

MS. CULLUM: NAFTA is very big in Dallas, Robin. This city sees itself as the major center for this trading area for North America, particularly for the Mexico-American arrangement, so it's terribly important here. There is a lot of support for it here. Not all our citizens support it. Ross Perot is from Dallas, you'll remember, but we consider it very important here in Dallas.

MR. MacNeil: What about you, what do you think about NAFTA as something important to the public at the moment?

MR. BAUMEISTER: Well, where I'm from, it's not quite so big. We're largely a service economy. Nobody's going to take our refineries and bring them to Mexico. But I do know that crossing the political line we have a fair number of Perot supporters in New Jersey, and they adhere to his view on NAFTA because they trust him on so many other things, sort of a natural trust they have in him.

MR. MacNeil: Okay. Well, Ed, Cynthia, Clarence, Erwin, Gerald - - Gerry, Lee, thank you very much. FOCUS - POLITICAL WRAP

MR. MacNeil: Now to our weekly political analysis with syndicated columnist Mark Shields joined tonight by Wall Street Journal columnist Paul Gigot. Mark Shields, can -- you just heard what the editors have been saying about NAFTA and so on -- can the President carry both these balls at once and end up with touchdowns?

MR. SHIELDS: Certainly he can if, if everything breaks his way. I would say Erwin Knoll was absolutely right when he talked about its being eclipsed this past week. I mean, we had an overload of news this past week with everything that was happening here in Washington, but the majority leader of the U.S. House, the President's most able or probably gifted lieutenant when it comes to counting votes in the House, came out against it, and it was buried back in the truss ads so big was the, was the news about health and so dominant. So I think NAFTA, in spite of Dick Gephardt's dissent and all the rest of it, is going to be, it's going to recede as an issue.

MR. MacNeil: What do you think, Paul?

MR. GIGOT: Well, what the President has going for him in juggling two balls here is the timetables are different. NAFTA really is something that's going to come to a head this fall, and with health care we're going to begin the debate, and this week was the kickoff of that debate, and there are going to be hearings in the autumn and the President's certainly going to devote an awful lot of time trying to sell that. But the real high tension on NAFTA's going to come this year, and he can afford to wait a month, six weeks, to do that, and then get on to health care again.

MR. SHIELDS: Robin, I'd add one thing to Paul, and that is that Bill Clinton is a lot more comfortable, obviously, in his coalition on health than he is in his coalition for NAFTA. He relies upon Republican votes. Republicans are less easy as well, with a Democrat in the White House leading that fight. So just on a personal level, the chemistry of it, to have Gephardt and Foley and Mitchell and all the Democrats in the House lined up with David Bonior from Michigan, lined up on his side on health, is a lot more reassuring, and I just think there's a comfort level.

MR. MacNeil: All our editors, Paul Gigot, really liked the speech. You heard them. How would you rate it among presidential speeches, and what would you compare it with?

MR. GIGOT: Well, I thought it was the best speech I've heard this President give. And he's given a lot of good ones. I mean, I thought as a piece of political rhetoric it really was masterful in the way that it talked about big subjects, and that's what people what, I think Americans want to see from presidents. They want to see them leading on big things. And that was a quality that FDR had, that Ronald Reagan had, and I think this speech, in a way, measured up to that. The one thing I think he might be vulnerable on in the speech, as we go on in the days ahead, is that it really was the sunny side of health care reform. I mean, it was, health care reform is going to -- everybody's going to have more health care. It's going to cost less for most people. There's going to be less bureaucracy, and if it really were that easy, we'd have probably already done it. So I think he's going to -- he's leaving himself open to some critics who are going to go in and say, well, it's not that easy. There are going to be some costs, and here are the trade-offs, and his credibility over time maybe eroded.

MR. MacNeil: As presidential speeches go, Mark, how did you rate it?

MR. SHIELDS: I thought it was a good speech, Robin. I think that this is an issue in which the wind is very much at Bill Clinton's back. He is comfortable with the issue. He knows it well. He is personally very comfortable with it. He's dealt with it for more than 10 years, and most important of all, he ran on the issue. This was initially Bob Kerrey's. Of course, it was initially introduced just two years ago in the victory, the stunning upset victory of Harris Wofford in the Pennsylvania Senate race over Dick Thornburgh, but it became an issue in 1992. Sen. Bob Kerrey of Nebraska made it an issue. Bill Clinton grabbed it, made it his own, and made it his own against George Bush. He ran on it. He won on it. That provides not only a moral leverage for the winning president who does that. It also gives a political momentum, and I think that was on display the other night.

MR. MacNeil: You heard the editors on how interested the public is in this. With that mood and the mood in the Congress, are we going to have a health care reform bill passed before the congressional elections next year?

MR. GIGOT: Well, I think that the odds are that we probably will, but I would say that if this thing bogs down, and it's really going to be trench warfare, Robin, this isn't going to be one of the fights that's fought in the Guchi Gulch Halls of Washington. There are going to be massed armies out there of small business and doctors talking to people in waiting rooms and insurance brokers. Everybody's going to be engaged in this. And if this thing gets bogged down in, in that kind of fight, I think you could see this spinning perhaps into the election in 1994, and that being -- health care being the big issue in that election, and whoever wins gets to write the health care reform.

MR. MacNeil: How do you see it, Mark?

MR. SHIELDS: Well, if Paul's scenario works, then it's the best news for the Democrats, because the Democrats obviously have an advantage in most people's eyes as a party that is more committed, more conversant, with a longer tradition in advocating an expanded health care system for the people of the country. The Republicans' best hope on it, quite frankly, is to make it as they did in the stimulus package earlier this year when they defeated the President to make it into a tax and spending issue that's somehow going to cost jobs. But I think if the debate in 1994 is about health care and whether we're going to extend it to Americans to contain costs, then I think it's good news for Bill Clinton and the Democrats. I think it will pass next year.

MR. MacNeil: How much will it resemble the package the President presented to the country on Wednesday night, would you think, Mark?

MR. SHIELDS: I think its parents will be able to recognize it.

MR. MacNeil: Paul.

MR. SHIELDS: I'm not sure. I did -- I predicted that President Bush wouldn't seek a second term. No, I honestly don't -- I think the principles -- he's smart. Paul's made a very good point. He spoke in big terms. He spoke in large objectives. I think to the degree that he could avoid getting into sort of the micro issues and the dangling participles and so forth, the better served he will be and better his chance is for success.

MR. MacNeil: Paul, how much is it going to resemble the bill that passes what he's introduced, would you say?

MR. GIGOT: Robin, I think that the White House has learned something from the budget fight, and that is, announce that you're willing to compromise in advance, and construct a bill to where you think, where you know you think you can compromise. And I think there are a couple of things that they have in mind that they are not going to give on. One is the employer mandate. I think they want that very much, because what that's going to do is that, that gets coverage to the most people immediately, and that's very important to them, but there are other things, some of the regulation that they'd be willing to give on, and I think they constructed this with that kind of compromise in mind.

MR. MacNeil: Mark, Congressman Miller from California was on with Margaret a moment ago, and he's one of the eighty-nine now sponsors in the House of the single payer system. Everybody's been saying ever since this debate started a year, two years ago that was impossible, there's no political likelihood of that in this country, and yet, it continues to pick up gradually support in the House. Is it going to die and go away? What do you think?

MR. SHIELDS: No. I think the process has begun. It's hard for me to believe that people like George Miller and Jim McDermott and Pete Stark, all of whom are supporters and advocates of single payer, are going to end up voting against whatever plan does come forward. They will make their case. They'll try and change it, but I think the immediate polls, Robin, that followed right after the President's speech, where people who sought, were more impressed by the plan, more favorably disposed, gives again the President a momentum that his plan is on the table. And it's hard for me to believe it's going to be taken off the table entirely.

MR. MacNeil: What do you think of this, the pressure from the single payer people, Paul?

MR. GIGOT: Well, it's really --

MR. MacNeil: Single payer people Paul.

MR. GIGOT: [laughter] I won't try to say that. It's focused mainly in the House. In the Senate, the liberals are really very much behind Bill Clinton, and they're in favor of the employer mandate. That's their bottom line, I think. So in a way, though you have the Senators on, the politics may be the trickiest for the President and the House of Representatives, because you have the widest divergence ideologically. You have the single payer, and it's about 90 votes. I don't think they have many more than that. And then you have the Republicans in the House who, you know, well over a hundred of them would support something called "Medisage" plans which really is a much more free market system.

MR. MacNeil: If a bill passes halfway through President Clinton's term, Mark, what does that do for President Clinton politically?

MR. SHIELDS: Well, I think it does an awful lot for him, Robin. There's only three ways issues get on the national agenda in a national campaign: One is it's an existing issue -- in 1988 - or in 1968 the war was; and the second way is that your opponent puts the issue up there, that he's running on it, as Ronald Reagan did on tax cuts in 1980, if you were Jimmy Carter; and the third way, of course, is you put it there, yourself. Bill Clinton put this issue on there, and that gives, that gives him an advantage if, in fact, it can prevail. I thought the other night he did something that he hadn't done earlier when you asked about the speech. He brought to it, I felt, the rhetorical tradition of the Democrats that was positive, optimistic, confident. It was more in the tradition, far more in the tradition of Franklin Roosevelt and John Kennedy rhetorically than it was if sometimes the President had been in sort of a naysaying and crepe hanging earlier of Adlai Stevenson or Jimmy Carter, and I think that's an important -- it's an important theme for any Democrat. The message has to be that this is for everybody, not that we're a special interest party, that it's for all Americans. And I think that came through.

MR. MacNeil: All right. Mark and Paul, thank you. ESSAY - LOST CAUSES

MS. WARNER: Finally tonight, essayist Roger Rosenblatt looks at 25 years to a presidential campaign that sparked a generation of political activists, including Hillary Rodham Clinton and Vice President Al Gore.

MR. ROSENBLATT: Recently, at Georgetown University in Washington, alumni of the Eugene McCarthy presidential campaign of 1968 convened to talk politics. Twenty-five years ago, these people licked envelopes, worked door to door, and cheered, and wept for a man who would be President against monumental odds. Now, suitably aged, they joined with their candidate to commemorate and assess that political movement's effect on their lives, country, and perhaps principally to recall a time when politics had passion. There have been campaigns since McCarthy's when politics had passion, Reagan's a lot, Clinton a little.

DEMONSTRATORS: We want peace! We want peace!

MR. ROSENBLATT: But no recent presidential campaign has had the special fire of McCarthy's, because McCarthy's campaign was a lost cause. It's hard to know if people at the time of McCarthy's run for the Democratic nomination really knew it was a lost cause. There was, after all, that one, unthinkable moment when McCarthy finished the New Hampshire primary so close a second to Lyndon Johnson you would have thought he'd came in first. Of course, that was the one and only moment in the campaign when dreams appeared as facts. But even during those heady weeks, the idea that the enigmatic Eugene McCarthy was going to be President of the United States seemed awfully remote, almost as remote as McCarthy, himself, who preferred to talk poetry with Robert Lowell, or to write some of his own, than to go on the stump, and who was in temperament probably the most unlikely sort of man to lead a world, even the one inside his likeable head. McCarthy was, nonetheless, the leader of a lost cause. And lost causes have a strange, almost victorious power, which is why they are so rare, almost nonexistent these days. An uphill battle is not a lost cause. Ross Perot in our last presidential election was not a lost cause, though he lost. Compare the Perot campaign to McCarthy's, not just the money spent, or the size of the political organization, but the attitudes of the candidates. Perot was Texas, McCarthy the Alamo. What a lost cause does for the individual's soul is to free it from everything but principle. One does something because one believes it is right, there is no other reason for doing it. The fact that the cause is doomed clarifies matters because there's no prize at the end of the battle but principle. Yet, when you've lost, you have lost everything but principle too. Someone else walks off with victory. You walk off, if, indeed, you are still able to walk, with yourself. There was more to the McCarthy campaign than the good old college try, though to a great extent the campaign was born and sustained in colleges. There was the fact that McCarthy's finish in New Hampshire demonstrated like nothing before it the depth of anti-Vietnam War sentiment, and so probably deterred our further escalation of that war. Lyndon Johnson, whose weakness was shown more than McCarthy's strength, eventually chose not to run for a second term. Most of all,it provided a kind of reckless purity one misses in a presidential campaign. There has been nothing reckless or pure about any of the campaigns since, which may be all to the good. Deep under every reckless pure heart lies the wish for moderation, a little compromise, a little order. Of such blander stuff are winners made. Yet, who would not have at least one time in a life when the leader was the lost leader and the followers the lost followers, and all things being impossible were possible? I'm Roger Rosenblatt. RECAP

MS. WARNER: Again, the major stories this Friday, Russia's hard- line lawmakers remained barricaded in their parliament building as Boris Yeltsin ordered troops to surround them. Both sides have promised not to use force. And the U.S. began lifting economic sanctions against South Africa minutes after African National Congress Leader Nelson Mandela called on the International Community to do so. Good night, Robin.

MR. MacNeil: Good night, Robin. That's the NewsHour tonight. Join us Monday night for a consumer's view of the Clinton health care plan. I'm Robert MacNeil. Thank you, and good night.