The NewsHour with Jim Lehrer

RAY SUAREZ: Good evening. I'm Ray Suarez. Jim Lehrer is off. On the NewsHour tonight: Our summary of the news; then, an update on the latest violence in Iraq from Robert Worth of the New York Times; as the House of Representatives opens hearings on Social Security, a look at the political state of play; a push to revitalize labor unions; and minorities lagging behind whites in getting health care.

NEWS SUMMARY

RAY SUAREZ: Iraqi officials announced the discovery of dozens of corpses at sites in western and central Iraq. The latest numbers from the country put the total at 41. Twenty-six bullet-riddled bodies were found today in a field near the Syrian border. Iraqi troops found 15 headless bodies yesterday in a building south of Baghdad. In Baghdad today, gunmen opened fire on the planning minister's car. He was not hurt, but his bodyguard was killed. A suicide truck bomb in the capital killed two policemen. The American military said at least 30 American contractors were among those injured in the blast. A roadside bomb, also in Baghdad, killed one U.S. soldier and wounded another. Italian Prime Minister Silvio Berlusconi today told his country's Senate the U.S. must recognize its responsibility for the killing of an Italian intelligence agent in Iraq. Nicola Calipari was killed at a U.S. security checkpoint Friday as he escorted a just freed hostage to the Baghdad Airport. Berlusconi said Italy had a duty to demand the truth. Lebanon's parliament today nominated its pro-Syrian former prime minister to form a new government. Omar Karami resigned last week in the face of anti-Syrian demonstrations. Today's action came one day after a massive pro-Syrian rally in Beirut organized by the militant group Hezbollah. Thousands turned out in Damascus today to support Syrian President Assad. And Syrian troops continued to redeploy to eastern Lebanon in a phased pull-back. In Washington, President Bush insisted again all Syrian troops and intelligence services must leave Lebanon ahead of elections in May.

PRESIDENT GEORGE W. BUSH: One of the things a lot of people don't understand is that Syrian influence is heavy-handed through the involvement of intelligence services throughout the government. And they must remove both in order for the election to be free. And we're working with friends and allies about steps forward, what to do. Right now, the president, Assad, has said he's removing to the Bekaa Valley. That is a half-measure. It is a measure, but it's a half-measure.

RAY SUAREZ: Syria has some 14,000 troops in Lebanon. Chechen rebels vowed to continue their fight for independence a day after their leader was killed in a Russian military operation. A posting online predicted more violence to come. "A new period has begun in the modern history of the Russian Chechen military confrontation. It allows for no negotiations, no end to the war." Russian officials said the killing of Aslan Maskadov would reduce future attacks. The Senate moved closer today to overhauling the nation's bankruptcy laws. The bill would have made it harder to erase medical bills, credit card charges and other debts by declaring bankruptcy. Democrats said average Americans would find it more difficult to escape from their debt. Republicans said the measure preserves a fresh start for everyone.

SEN. DICK DURBIN: For a lot of people, you'd say, well, if you can pay back something, you ought to pay it back. But for many people, it means the debts that they've incurred that they can't pay back will be dogging them and burdening them for the rest of their natural lives. And so many of us have said when you take a look at this bill, at least be sensitive to some people who go into bankruptcy court through no fault of their own.

SEN. CHUCK GRASSLEY: If people have the ability to repay some of their debt, shouldn't they have to repay some of their debt? It seems to me to be fair to those people who do pay their debt. So we preserve the principle of a fresh start, but we also establish a principle that if you have the ability to repay some of your debt, you're not going to get off Scott free.

RAY SUAREZ: The House is expected to take up the bill next month. The House Ways and Means Committee took its first official look at proposed changes to Social Security. The comptroller general of the U.S. testified there is no immediate crisis, but he pushed Congress to act "sooner rather than later," arguing the remedies only become more painful the longer action is put off. We'll have more on the political state of play in the Social Security debate later in the program. There were elections in California yesterday. Democrat Doris Matsui easily won a special election to succeed her late husband, Congressman Robert Matsui. He died in January after representing a Sacramento district for more than 25 years. In Los Angeles, the crowded mayor's race narrowed to two, and it's a rematch of the 2001 runoff. City Councilman Antonio Villaraigosa, who received 33 percent of yesterday's vote, will face incumbent James Hahn, who received 24 percent; the runoff is in May. In economic news, the Federal Reserve reported the nation's economy grew at a "moderate pace" in January and February. Steady consumer spending and continued expansion of factory activity contributed to that boost. On Wall Street today, the Dow Jones Industrial Average lost 107 points to close at 10,806. The NASDAQ fell 12 points to close at 2,061. That's it for the News Summary tonight. Now it's on to: An Iraq update; the state of play on Social Security; pushing for change within labor unions; and examining disparities in medical care.

UPDATE - STRUGGLE FOR SECURITY

RAY SUAREZ: First tonight, the continuing violence in Iraq. We get an update from Robert Worth of the New York Times in Baghdad. He spoke earlier today by phone with Jeffrey Brown.

JEFFREY BROWN: Robert Worth, welcome. There were two gruesome discoveries announced today of bodies in different parts of Iraq. What can you tell us about those killings and who might have been behind them?

ROBERT WORTH: Yeah, 20 bodies were found northwest of Baghdad near the Syrian border. Those included civilians and women. And then the other discovery was south of Baghdad where 15 people -- and these were headless bodies -- were discovered yesterday. The ones discovered today near Syria, it's not clear --some of them had been shot in the head -- it's not clear whether they had been decapitated. But certainly it's pretty grizzly stuff. It's reminiscent of December, when over 100 bodies were found, many of them decapitated in Mosul in the North. You know, we believe that some of the people that were discovered south of Baghdad were, in fact, Iraqi police or army soldiers. Most of the bodies that were discovered in the North back in December were soldiers. It's part of the insurgency's campaign against the Iraqi army and police so presumably this is a continuation of that.

JEFFREY BROWN: Today, in fact, was a particularly bloody day there, including a large truck bomb where you are in Baghdad this morning. Tell us about the area where that took place and what's known about who might have been behind it.

ROBERT WORTH: Yeah, the truck bomb was just outside the Sadeer Hotel, which is a couple blocks east of Fardus Square, which is the square where the statue of Saddam Hussein was pulled down famously on April 9, 2003. It's known as a place where western security contractors stay, so presumably that was why it was targeted. It was unusuallyearly this time. It was at 6:30 A.M. In fact, the hotel was quite close to where we stayed here, and it was a massive car bomb, it was inside a garbage truck. There was some shooting first. And what we were told is that that was some of the insurgents who were firing or blasting their way in to the parking lot by the hotel. And then the explosion went off. It's actually very lucky what happened in the sense that only one person was killed, an Iraqi policemen, we're told. There may have been a couple other killed. But right now we think it's just one. About 30 Americans were injured, but it was in a big parking lot. And we're told that as many as 30 cars were completely destroyed. There was a huge black cloud that rose over that part of Baghdad. And as often happens in these kinds of attacks, Abu Musab al Zarqawi, the militant who takes responsibility for a lot of these things, issued a statement on Islamist Internet sites saying that he carried it out.

JEFFREY BROWN: There were several other bombings today. There was an assassination attempt against an Iraqi minister. Given this spate of violence what are the authorities now saying about the strength of the insurgency?

ROBERT WORTH: It's clear that they still have the power to launch attacks pretty much at will. One surprise today was that there actually was an attack where two people were killed in Basra in the South. That hasn't happened much recently. It's mostly been in Central and Northern Iraq. It's pretty risky to say how strong the insurgency is. But one thing we can say is that there have been a lot of announcements from Zarqawi's group on the web, and some of them sound a little bit defensive. Certainly ideologically anyway the elections which went pretty peacefully were a blow to these people. And they feel that it's up to them to sow a lot of confusion and havoc before a government is actually formed. As you know, negotiations are happening right now to form a government and to appoint a prime minister, a president. In the meantime, they're clearly -- the insurgents are doing their best to try to disrupt that process.

JEFFREY BROWN: Now, finally Robert today, Italian Prime Minister Silvio Berlusconi said that the U.S. must take responsibility and challenged once again the U.S. version of what happened when an Italian intelligence officer was killed and journalist was wounded. The U.S. yesterday promised a quick inquiry. Can you tell us anything about that inquiry, how it will take place, what they're looking at exactly?

ROBERT WORTH: We can't tell you much about it because they're being pretty tight lipped about it. But we can certainly say that a lot of things remain unclear about what exactly is happening that night. The questions are: Was it, in fact, a checkpoint? The Americans have said that it was a checkpoint. But the Italians are suggesting that it wasn't really any kind of formal checkpoint. It may have been just a couple of Humvees there. And then perhaps most importantly, did the soldiers, as they say they did, flash lights, give hand signals, all kinds of gestures, shooting in the air, to warn the Italians to stop? As you know, Berlusconi and his foreign minister have said that the car stopped immediately when a light flashed. So those are pretty starkly different versions. I think this investigation is trying to answer those questions.

JEFFREY BROWN: Okay, Robert Worth of the New York Times, thanks very much.

ROBERT WORTH: Thank you.

FOCUS - STATE OF PLAY

RAY SUAREZ: Now, to those members of Congress who could make or break the president's planto change Social Security. Kwame Holman has our report.

KWAME HOLMAN: House Ways and Means Chairman Bill Thomas had hoped to limit discussion at today's hearing to Social Security's financial outlook, why it's facing long-term insolvency, and the importance of doing something about it soon.

REP. BILL THOMAS: Clearly the current program, because the American population has changed, is not sustainable based upon the old method of financing.

KWAME HOLMAN: What Thomas was hoping to avoid until a later date was a discussion of the various Social Security remedies that have been circulating around the capitol of late.

REP. BILL THOMAS: President Bush is clearly committed to strengthening Social Security, and has agreed to expend significant time and energy with the American people so that there will be a receptive audience when this committee examines options to change the system.

SPOKESPERSON: Thank you, Mr. Chairman.

KWAME HOLMAN: But New York's Charles Rangel, the committee's top Democrat, jumped at the mention of the president and the campaign he has launched to get Americans behind his plan to create private or personal retirement accounts.

REP. CHARLES RANGEL: Why is privatization and the private accounts placed on the table if in fact it has little or no relationship to do with the real problem that we face, and that is solvency? And so there's two ways to handle this: To come to the table, take off the one thing that deals -- that doesn't deal with solvency, take it off the table so we can work; or to go around the country to political groups, 60 cities in 60 days, tightening up and separating our ability to work together.

KWAME HOLMAN: The committee's witness, David Walker, comptroller of the Government Accountability Office, did his best to stay out of the partisan crossfire. He ran through a slide show, hitting the key dates he said would lead to Social Security's eventual insolvency.

DAVID WALKER: Social Security is expected to run a negative cash flow starting in 2018. That means in that year, there's not enough money going to be coming in to pay benefits and expenses, and what will have to happen is we'll have to start cashing in some of these bonds that have accumulated over time. To cash in these bonds, you'll either have to increase taxes, cut other spending, or increase the debt held by the public. 2042 is the date that the trustees estimate, by their best-estimate intermediate assumptions, that the trust fund will become exhausted. In 2042, if their estimate is correct, then benefits will have to be cut precipitously and dramatically across the board by 27 percent, and they will have to be cut gradually more as time moves on.

KWAME HOLMAN: But one Democrat after another argued the president's plan for private accounts would only speed up insolvency because they would be paid for with money carved out of the current system. Maryland's Ben Cardin:

REP. BEN CARDIN: If you take what the president suggested in his state of the union address, 4 percent of the payroll tax, or about one-third, that in and of itself, out of Social Security, Mr. Levin suggests, pointed out in his opening comment, that in and of itself would accelerate the insolvency by about 11 years, using the actuaries' assumptions. I assume that you agree with that. Is that correct?

DAVID WALKER: That by itself...

REP. BEN CARDIN: Itself.

DAVID WALKER:...But I don't think even the president is talking about doing that by itself.

REP. BEN CARDIN: I'm trying to isolate the point-- I'm going to come right back to it-- but that by itself accelerates the insolvency by 11 years. By itself.

DAVID WALKER: It would accelerate it. I don't know about the 11 years, but it would accelerate it.

REP. BEN CARDIN: That change then makes it more complicated and difficult, and more changes are going to be needed in order to deal with the insolvency issue, if we just dealt with it directly.

DAVID WALKER: It will mean that your... that the sense of urgency... well, not only will the negative cash flow increase, but it also means that potentially the insolvency date would get closer, depending upon what other reforms there are.

REP. BEN CARDIN: I understand that. Other reforms mean more revenue coming into the system or benefit cuts?

DAVID WALKER: Or some combination thereof.

REP. BEN CARDIN: Or some combination thereof. Thank you.

KWAME HOLMAN: Louisiana Republican Jim McCrery didn't let that argument go unchallenged.

REP. JIM McCRERY: I don't think you meant to say that under no circumstances can personal accounts funded by a carve-out contribute to the solvency of the system. I believe you said earlier in your response to a question that it depends on how those accounts are structured and how they are tied to the ultimate benefit pay-out of the Social Security system.

DAVID WALKER: Carve-outs by themselves, with no other reforms, will exacerbate the solvency staying in force.

REP. JIM McCRERY: Absolutely.

DAVID WALKER: Depending upon what other reforms you have with a carve- out, they may or may not cause A... contribute positively or negatively over the long term, depending upon what the other reforms are. However, irrespective of what the other reforms are, they will accelerate negative cash flows because most of the reforms...

REP. JIM McCRERY: In the short term.

DAVID WALKER: Correct. Correct.

REP. JIM McCRERY: But as part of the solution, personal accounts can contribute to the solvency of the system because of the compound interest those funds that are put... real cash in a real account in the real market will grow over time faster than this imaginary trust fund does.

DAVID WALKER: It's very, very important to... for people hopefully to agree that we have a problem; it's prudent to solve it now. It's also important that entire packages of proposals get on the table, because there will be pluses and minuses to any package.

KWAME HOLMAN: At this point, the Ways and Means Committee has not scheduled any further action on overhauling Social Security. However, a small number of Republicans have made formal proposals that include personal accounts, and are trying to enlist the support of Democrats to help get them passed.

RAY SUAREZ: And Gwen Ifill has more.

GWEN IFILL: So how is the debate over Social Security playing out in Congress and around the country? For that, we turn to: Amy Walter, an analyst with the Cook Political Report, a non-partisan publication that covers U.S. politics; and Andrew Kohut, president of the Pew Research Center, an independent public policy research organization.

So, Amy Walter, with all that talk of pluses and minuses we understand again why Social Security is considered the third rail of American politics. What's really happening on the Hill?

AMY WALTER: I think that what you're watching there is an internal struggle among members as much as it is about a partisan back-and-forth. Look, I think it's only natural in a second-term presidency that there is a tension between a president who is looking to establish a legacy and members of Congress who are looking for their own immediate legacy which is getting re-elected the next year. Clearly this is an issue that many members are very wary about touching and being associated with something that's called a cut or anything that looks like a tax hike. This is something that I think many members would rather not have to deal with coming into election, absolutely.

GWEN IFILL: So much of the debate seems to be, especially on the Senate side, seems to be happening within the Republican Party. Is that a fair assessment?

AMY WALTER: Well I think that is true because what we're seeing right now is this idea... we see it a little bit between the Senate and the House too about whether or not we're going to be able to do something that conservative and moderates can agree on. One of those things is raising the cap. That's something that conservatives have said out loud we're not going to be able to do something like that because our conservative members will see this as a tax hike. There is no way we're going to get it through the House.

GWEN IFILL: Andy Kohut as we watched it in Washington, politicians and interest groups are consumed by this back and forth. Is the American public, according to your polling, following this?

ANDY KOHUT: Oh, yeah. This is an issue that engages the public. They care about it. We've got two-thirds of the public saying that they think that Social Security will run out of money as it is now constituted unless something is done, two-thirds saying something should be done either immediately or within the next few years. Now there are other issues too. Medicare gets the same kind of rating. And health care more generally gets a higher rating. But, you know, the president has sold this as a problem. His problem and the GOP's problem is that he hasn't sold the solution. In fact, the public is rejecting the proposals that he's made according to our tracking poll.

GWEN IFILL: So those people who are paying attention aren't necessarily buying at least this first issue of private accounts which has seemed to consume so much of the debate?

ANDY KOHUT: Absolutely not. If you look at the trend back in September, 58 percent have said they favored the idea of private accounts for allowing younger people to put a portion of the payroll taxes into private accounts. That fell to 54 percent in December as more people heard about it. It fell further to 46 percent as even more people had heard about it by February. In fact our survey showed when we divided the poll into people who had heard a lot about this or said they heard a lot about it, a plurality of them disapproved of private accounts while people said they heard only a little, most of that group said they liked the idea so the more people have heard, the less they've liked it.

GWEN IFILL: Amy Walter, let's talk about this. The private accounts debate in particular because it seems Sen. Lindsey Graham told the Washington Post that this is a side show, a huge fight over a side show was his way of putting it. And what you were hearing just now in the House was a lot of people saying we should be focused on the bigger question of solvency. How big a distraction has this debate over private accounts been?

AMY WALTER: Well it looks like it's clearly the road bump that Democrats have united in opposition to any sort of private or personal, whatever we're going to call this account. There is absolutely no work that's going to be done on a bipartisan basis and nothing can get through the Senate with just Republicans unless this private personal account is taken off the table and something else is added. Whether it's something, now we're hearing about these add-on accounts that don't actually carve out from the Social Security fund -- whether that is acceptable to other Republicans we will soon see. I think what Democrats are hoping and this is the battle for them too, they're having their own internal struggles which is do we go ahead and try to use this as an issue in 2006 to bang Republicans over the head with or do we look like we actually have our own plan or look like we're reaching out to Republicans to solve something that as Andy pointed out they see as a problem?

GWEN IFILL: Is there any way to know at this stage which party is more guilty of overreaching, the Democrats who are saying, you know, heck no, or the Republicans who are saying, our way or the highway on private accounts?

AMY WALTER: Well, what I've seen in looking over the different polls is that Democrats have a slight advantage when you ask who do you think will do a better job in handling this issue? You know what? I think that Democrats might have cried wolf few too many times in campaigns on this issue. It was an issue brought up in '96, and '98, and 2000. They always made this argument that Republicans were going to cut the Social Security. At some point I think voters became very wary of that argument. And they are willing at least to listen to the Republicans. So I think they have a little bit of a gamble if they're going to put all their eggs in this basket in 2006.

GWEN IFILL: Andy there's a generational split here. We're not talking about everybody feels the same way, the way older voters feel is pretty starkly different from the way younger voters feel; that's who the president at least has been trying to appeal to. Has it been working?

ANDY KOHUT: 25 percent of the people over 65 years of age like this idea. 62 percent of the people under 30 years of age like this idea. Now part of the problem -- part of the issue here is that younger people haven't thought about this; they don't care about it as much as older people do and even middle-aged people, the baby boomers. And when people begin to think about this, the Democrats may have overplayed this or they may have been talking about this for a long time but the fear factor is very high. People who say they oppose this, which is now most people in these polls, or a plurality of people or a large percentage of people in these polls say they worry that the investments will be risky and they worry that ultimately down the line the guaranteed benefits won't be covered. One of the most important things about Social Security is it's an anomaly. 80 percent of the public told us that they like this program. Very few government programs where 80 percent say I like it, and the aspect that they like especially among older and middle aged people is the social safety net, that this is a form of protection; anything that threatens that, even if it's appealing like an opportunity society or getting a better return, people are very wary about that.

GWEN IFILL: If that's true then why is it the more the president seems to talk about it, the more the public approval of his handling of the issue seems to go down?

AMY WALTER: Because what they're doing is they're more concerned about the down side than they are appreciative of the up side because they like the fact that Social Security is a form of protection. And the president obviously has not sold that aspect. Even though he's made the point that it's not going to affect older people, (a), they probably don't believe him and secondly even middle aged people are increasing wary of the stock market. You know, we asked this same question back in 2000 when the market was booming and we had 70 percent thinking it was a good idea. Things have changed. People look at the stock market differently than they did.

GWEN IFILL: Amy Walter, is there any sense of a turning point that's coming up in the next few weeks or so that's everyone is aiming for to make this move off the dime, this partisan split?

AMY WALTER: I really don't see that. I think we'll come down to this issue of this private account and whether there is some wiggle room on this issue from one side or the other. Democrats, as I said earlier, seem very, very unified.

GWEN IFILL: Solvency is not going to become part of this debate?

AMY WALTER: Well, solvency has become part of the debate. And I think that is really where the public has started to also be educated on that issue as well is that the issue of private accounts in and of itself is not going to solve the problem. I think that that is the one thing actually that Democrats have done well to sell as much as the president has done well selling there is a problem.

GWEN IFILL: Briefly to you too do you think there is a turning point coming up, Andy?

ANDY KOHUT: I think at some point the public will demand some action. And whether it will be a turning point in this period, I don't know. But somewhere down the road that's going to be the case.

GWEN IFILL: Andy Kohut, Amy Walter, thanks a lot.

RAY SUAREZ: Still to come on the NewsHour tonight: Labor unions struggling to change, and gaps in health care for different ethnic groups.

FOCUS - LABOR PAINS

RAY SUAREZ: Now, the struggles of organized labor. Jeffrey Kaye of KCET-Los Angeles has that story.

JEFFREY KAYE: To understand how the economy and the strength of labor unions have changed, go back to August 1992. A mariachi played a Mexican farewell tune as workers ended the last shift at the last automobile factory in southern California. The employees at the General Motors plant, all of them unionized, earned paid vacations, health and pension plans and averaged what today would be $21 an hour. Today, the plant on the site of the old factory is a shopping center, where non-union workers make barely more than minimum wage, with few fringe benefits. "This block is a metaphor for our times," says labor analyst Kent Wong.

KENT WONG: What we see has happened to the GM plant right here in Van Nuys is a reflection of the shifts in the economy, where we've gone from a manufacturing or an industrial-based economy to a service-based economy.

JEFFREY KAYE: With the rise of a service economy, union membership has plummeted, and labor leaders are arguing over how to revitalize their movement. The debate was prompted in large part by this man, Andrew Stern.

ANDREW STERN: It is time! It is so long overdue that we join with our union allies and either change the AFL-CIO or build something stronger that can really change workers' lives! (Cheers and applause)

JEFFREY KAYE: Stern is president of the 1.7 million member-strong Service Employees International Union, the fastest growing union in the country. The SEIU's success has come mostly from organizing poorly paid, often immigrant workers in the service economy, such as security guards, health care employees and janitors. The union is the AFL-CIO's largest affiliate, but Stern has threatened to pull out of the federation unless it makes dramatic changes.

ANDREW STERN: We've made the decision that if nothing changes in the AFL-CIO, we're leaving.

JEFFREY KAYE: The AFL-CIO is a shadow of its former self. 50 years ago, when the American Federation of Labor merged with the Congress of Industrial Organizations, labor was among the most powerful political forces in America.

KENT WONG: Unions back in the '50s represented about 35 percent of the U.S. Workforce, so fully one-in- three workers was a member of a union. Today, the percentage is under 13 percent. And in the private sector, meaning in the non-governmental sector, only 9 percent of workers in the U.S. are organized.

JEFFREY KAYE: To help workers regain economic and political power, Stern says the AFL has to change its structure and financial priorities.

ANDREW STERN: It's about providing a vision to workers about how they can win. That's what we did in our union. We gave them a vision about how they can win.

JEFFREY KAYE: In its battles with employers, the SEIU has favored national and industry- wide strategies. That's what it did five years ago to win a contract and wage increases for striking janitors in Los Angeles.

ANDREW STERN: And all of our members from all around the country actually struck buildings in different cities, poured resources into the strikers, because we understood we needed to be coordinated where in the past we would have let each local union, each market, you know, make it or break it on their own.

JEFFREY KAYE: Similarly, says Stern, the labor movement would be stronger nationally and globally with better coordination. He wants to force the federation's 58 unions, which often compete with each other, to merge into around 20. Stern also wants to slash the AFL-CIO's budget by returning 50 percent of dues money to individual unions for labor organizing drives.

ANDREW STERN: We're actually talking about trying to get unions focused, you know, on an industry, have a strategy for the industry and then have the resources to accomplish that. That's what the AFL has to do, have to get people focused on the right industry, make sure of their plans and make sure of their resources.

JEFFREY KAYE: Stern's brash critiques have put him at odds with his former mentor, John Sweeney, who headed the SEIU before Stern.

SPOKESMAN: I turn this gavel over to the next president of the AFL- CIO, John Sweeney. (Cheers and applause)

JEFFREY KAYE: Ten years ago, Sweeney won the presidency of the AFL-CIO with Stern's backing. Sweeney's reform slate ousted the old guard with promises to reinvigorate the labor movement. But union membership dropped. And today, with his own leadership under assault, Sweeney says he wants change as much as Stern.

JOHN SWEENEY: Andy's very bright, he's a visionary, but it's one thing to have the vision and promote change; it's another thing to get majority support for those changes. And I have always strived for consensus to build positive programs, and Andy doesn't have as much patience.

JEFFREY KAYE: The stage for a showdown was set last week in Las Vegas when union leaders gathered for their annual winter meeting. Closed-door sessions turned into a debate about labor's priorities. Sweeney came with a plan to direct more funds to political activity rather than labor organizing, which Stern advocates.

JOHN SWEENEY: Workers are squeezed and hurting. We're making a long-term plan to build a majority for working families in state houses and city governments, as well as the Congress and the White House.

JEFFREY KAYE: Sweeney said Labor's political priority should be a campaign to fight the president's privatization plans for social security.

JOHN SWEENEY: This will be the labor movement's biggest issues mobilization ever.

JEFFREY KAYE: As Sweeney mustered his forces, Stern and SEIU leaders worked to build alliances with other unions. And in a public show of unity, leaders of four major unions-- Teamsters, food and commercial workers, laborers and the union representing hotel and garment workers-- joined Stern in calling for reform. Teamsters' president James Hoffa read their joint statement.

JAMES HOFFA: We believe that a massive shift in resources and focus to organizing and growth in our unions' core industries and sectors is the only path to rebuilding worker power in the workplace and in the political process.

JEFFREY KAYE: The alliance tempered Stern's threat to pull out of the AFL-CIO

ANDREW STERN: First thing, it was lonelier in November than it is now. And I feel well supported by having three of the four largest unions in the federation at this table, along with the most -- two of the most dynamic unions. So I think we are now in the middle of an enormously important discussion, and we're going to keep evaluating things, you know, as this discussion continues.

JEFFREY KAYE: These union leaders lost the first round. Their push to direct more funds to labor organizing was turned down.

ANDREW STERN: The AFL's proposal will put less money into organizing than the AFL's currently spending today. That's not a plan to win. That's fake change.

JEFFREY KAYE: And the threat to leave, is that still on the table?

ANDREW STERN: You know, if the policies that the AFL-CIO's passed at this meeting become the ultimate policies that are successful, that's not the kind of AFL-CIO we would want to be part of.

JEFFREY KAYE: Stern's most radical proposal, to force unions to better coordinate and to merge, didn't come to a vote at the Las Vegas meeting. Sweeney says he has facilitated mergers and welcomes more, but not with a heavy hand.

JOHN SWEENEY: There's such a thing as democracy. The workers themselves have to participate in a merger. This is not about just banging heads together and forcing them to merge.

JEFFREY KAYE: In July, the AFL-CIO will hold its next convention, and delegates will be asked to vote on proposals designed to reverse organized labor's downward slide.

FOCUS - UNEQUAL TREATMENT

RAY SUAREZ: Now, racial and ethnic disparities in health care. That subject is the theme of the latest issue of the journal Health Affairs. It's also the focus of a conference here in Washington sponsored by the Robert Wood Johnson Foundation, which underwrites the NewsHour's health unit. Among the findings in Health Affairs: There's a significant gap in mortality rates between black Americans and white Americans, a gap that accounts for 80,000-plus excess deaths annually among African- Americans.

For more on the disparities and what can be done, I'm joined by Dr. Adewale Troutman. He's a co-author of that study and director of the Louisville Metro Health Department. He also serves on the faculty of the University of Louisville School of Public Health.

And welcome.

What did you find in your overall assessments of health among different Americans?

DR. ADEWALE TROUTMAN: Well, the first thing is that we did find that there's been an increase in improvement in the health of all Americans if you look across the board over the past 40 years. But the gap in mortality rates between blacks and whites in particular, which is the group that we studied, remain constant. In other words, as everyone's health has improved, but the gap between those two groups has not. And, in fact, in some instances, it's gotten worse. It's gotten worse for black babies. It's gotten worse for African- American men. It's improved slightly for African-American women, but then has leveled off. So we're seeing a continuation of the excess death gap that has been in existence for at least 100 years and probably more based upon the availability of good literature and statistics going back several centuries.

RAY SUAREZ: Well, you note that everybody's health has gotten better.

DR. ADEWALE TROUTMAN: Correct.

RAY SUAREZ: But black Americans have had a significant decrease in their poverty rate, a significant increase in the amount of education, a very large number have moved into the middle class, and yet this tremendous gap persists. Why?

DR. ADEWALE TROUTMAN: I think it has a lot to do with several factors, including what has recently been discovered as an issue of discrimination, potential racism, stereotyping and bias within the health care delivery system as defined by the institute of medicine report published in 2002. In other words, if you take... if you balance out for everything else... not income, by the way, because income is another factor that has remained constant -- the gap in income, the gap in asset wealth, specifically, has remained constant over the years, as well. And there was a specific connection between asset wealth and health outcomes. And that may be a part of the answer as to why the black-white mortality gap has continued over these many years. But that particular aspect of healthcare that says that when you go into a provider, whether it's a hospital or an individual practitioner, and you happen to look a certain way-- and there is a belief based upon the IOM report that there is provider attitude, whether it's conscious or unconscious and/or whether it's institutionalized racism that, in fact, dictates the kind of care that an individual is going to get-- there's good evidence to shows that there is, in fact, poorer health outcomes based upon the kinds of referrals that are given to individuals, and it's believed that there's an association with those referrals and provider attitudes and potentially bias and stereotyping and discrimination in the health care delivery system.

RAY SUAREZ: Give me an example. If someone shows up in a hospital and they're both being treated for similar maladies, what's going to be different about the kind of care that one person gets as opposed to another?

DR. ADEWALE TROUTMAN: There's an excellent study that was published in I believe in JAMA a couple of years ago - it's called a chest pain study, where they took eight actors-- four black, four white, four male, four female. They were all dressed exactly alike. They were all very articulate. And their persona appeared to be "all middle income," the same, you know, educational level, et cetera. They were given instructions. These were all actors, by the way. They were given instructions to present with a series of symptoms that was typical of chest pain that was probably cardiac in origin. These videotapes were then shown to practitioners. And the practitioners were asked to determine what they would do in the way of referral. Now, the right answer was: These individuals should all have been referred for coronary artery angiography or some aggressive cardiac intervention because they were probably, based upon the presentation, having a heart attack or having severe unstable angina. Well, the white males were referred appropriately. Black males, black females and even white females from a gender standpoint were referred more often for GI work-up, as in, "this is not a cardiac problem. You know, take some Maalox and call me in the morning." And that was not the right referral. And there are lots of other instances and studies that are documented in the IOM report where there have been differences in referral patterns or access blocked for HIV medication, more likely to have certain kinds of surgery performed or more likely not to get certain kinds of surgeries based upon the need. And these have been analyzed down to the point where the only thing different was provider attitude or perhaps an institutional bias on the part of that particular organization that was providing care.

RAY SUAREZ: Well, if, as you say, this is a factor largely due to race or ethnic origin and not social class, how do you counteract it? What do you do to start closing this gap and start taking away some of these maligned factors that you're talking about?

DR. ADEWALE TROUTMAN: Let me also say I'm not saying that social class is not a factor. I'm saying that this particular study demonstrates that there is a bias that probably is a racial and ethnic bias not based upon socioeconomics, because all these individuals looked the same. You must include in the formula, in the equation, income disparities and income gap disparities, asset wealth disparities. And you still must include occupation, education, housing, the social milieu in which someone lives, the availability of good social capital or not; safety in the community. The way the community is constructed as it relates to access to good nutrition, fruits and vegetables, exercise opportunities. All of these are factors in determining what differences there may be that continue to exist in terms of the various populations that we've talked about. Now, to get back to the question, this conference today-- as a matter of fact, it's actually going on right now-- is looking at health care and seeing where we can connect the question of disparities, health gaps and quality of care. In other words, the IOM suggests very strongly that this issue of continued disparities in health care-- remember health care is not the same as health; it's a part of health but not the overall umbrella-- that if there is discrimination, if there is bias, if there is provider attitude that negatively affects the kind of care someone gets, that is a quality of care issue. So now, all of the experts in health care are looking at how can we monitor this quality of care issue and what kinds of parameters can we put in place to eliminate the potential bias or the potential inappropriate referrals based upon race and ethnicity and tie it to quality of care? And that is, in fact, what's being discussed at this very moment of the conference.

RAY SUAREZ: And very briefly, we've talked mostly about black and white Americans.

DR. ADEWALE TROUTMAN: Yes.

RAY SUAREZ: But you're seeing similar effects with Asians, with Latinos and others?

DR. ADEWALE TROUTMAN: Yeah, absolutely. And we looked at the black-and- white mortality gap. The most... the data that's most readily available over time has been comparisons between the African-American community and the white community. But since 1985, when there's been a very intensive effort to look at the health of the nation's "minorities," the same patterns have been found between... within Latinos, Native Americans, Pacific Islanders, Asian-Americans, et cetera. There are some very, very basic commonalities that cut across all of the racial/ethnic groups, with some additions, obviously. The Latino that is not speaking English necessarily will have other issues than an African-American population will not. An Asian-American population that has a different set of cultural values and mores will have some different factors, perhaps subtly, that an African- American community will not. But when you look at all the nation's minorities, they're similar issues.

RAY SUAREZ: Dr. Adewale Troutman, thanks for joining us.

DR. ADEWALE TROUTMAN: My pleasure.

RECAP

RAY SUAREZ: Again, the major developments of this day: Iraqi officials announced the discovery of 41 bodies at sites in western and central Iraq. A suicide truck bomb in Baghdad killed two policemen and wounded at least 30 U.S. contractors. And Lebanon's parliament nominated its recently resigned pro-Syrian former prime minister to form a government as Syrian troops continued their phased pull-back. We'll see you online and again here tomorrow evening. I'm Ray Suarez. Thanks and good night.