The MacNeil/Lehrer NewsHour

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

MR. LEHRER: And I'm Jim Lehrer in Washington. After our summary of the news this Wednesday we have two reports from and about the war in Bosnia. Spencer Michels reports on the health care option called "managed competition," Secretary of Labor Robert Reich is here for a Newsmaker interview, and Charlayne Hunter-Gault tells the story of the women of Somalia. NEWS SUMMARY

MR. LEHRER: A protest strike in South Africa turned violent today. It was called because of the weekend assassination of Communist Party and African National Congress figure Chris Hani. Black leaders had urged the strikers to keep their protests peaceful but it did not work. Jeremy Thompson of Independent Television News reports.

MR. THOMPSON: This was everyone's worst nightmare, chaos in the heart of Cape Town, fires burnt outside the city hall. Crowds of youths went on the rampage, looting shops, smashing windows, torching property. Vehicles were set alight. Security forces struggling to maintain control fired volleys of warning shots. Several people were injured, including a policeman. Even a peace monitor was hurt, led away after being stabbed. The men at least tried their best to hold the line. A distressed Archbishop Tutu blamed militant elements for trying to ruin Hani's Memorial Day.

ARCHBISHOP DESMOND TUTU, Cape Town: There are elements who are undisciplined and use, have used this occasion, or abused the occasion.

MR. THOMPSON: The biggest labor stay away in the country's history had started calmly in those towns but later deteriorated into several angry confrontations with the police. Before a huge crowd in Soweto, Nelson Mandela had repeated his call for restraint.

NELSON MANDELA, ANC: As members of a government in waiting you have the responsibility to behave orderly and with dignity.

MR. THOMPSON: But the greatest test of the ANC's credibility was being undermined as youths mobbed a Soweto police station. Suddenly the police opened fire. Live rounds scattered the demonstrators. The police, who'd been told to act with restraint, claimed they were just enforcing order, the result, three dead, five critically wounded and scores more injured, among them a PDC camera crew. The day of mourning for Chris Hani turned into mayhem.

MR. LEHRER: President DeKlerk ordered three thousand more troops and police on the streets. He said what happened in South Africa today cannot be tolerated in any civilized country. Robin.

MR. MacNeil: U.S. special envoy Reginald Bartholomew stepped up the pressure on Bosnia's Serbs today. He said if they did not sign a peace plan, the U.S. would back lifting the arms embargo on Bosnia's Muslims. Bartholomew met with the Bosnian Serb leader in Belgrade and afterward told reporters what he'd said.

REGINALD BARTHOLOMEW, U.S. Envoy: Military and humanitarian horrors have to stop now and that the Bosnian Serbs have to come to an agreement in the Vance-Owen process now and that this involves, this involves in the first instance the line of marks that we are on to impose tougher sanctions and we are all aware of this, and it does involve the prospect of pursuing the lifting of the arms embargo should that prove necessary if, in fact, the Bosnian Serbs do not come to terms, come to a settlement in the Vance-Owen process quickly.

MR. MacNeil: Victims of Monday's Serb shelling of the besieged town of Srebrenica were in the relative safety of a North Bosnian hospital in Tuzla today. They were evacuated by a U.N. convoy yesterday. Many of the evacuees were children suffering from shrapnel wounds. According to U.N. officials the Serbs unleashed another artillery barrage on Srebrenica after the convoy left. It brought the two-day death toll to at least 64. Bosnia's Serb leader today denied his forces were responsible for the attacks. We'll have more on Bosnia later in the program.

MR. LEHRER: President Clinton continued the campaign for his economic stimulus package today. He said it would create 700,000 summer jobs and help cut the nation's unemployment rate by 1/2 percentage point. He spoke to business leaders at a conference on summer jobs put together by the Departments of Commerce and Labor in Arlington, Virginia.

PRESIDENT CLINTON: The jobs program that I have presented to Congress with the summer jobs, with the money for the cities and the counties through the community development program with the infrastructure money is a small part of a big budget. It is an attempt to engage in an experiment to see whether or not with the economy recovering in terms of corporate profit we can give a little duce to it, give opportunities to young people, create 1/2 million jobs and maybe get the engine going again.

MR. LEHRER: House Republicans rejoined the attack on the stimulus package today. It passed the House but was stalled by a Republican filibuster in the Senate. House Minority Leader Bob Michel said House Republicans would hold town meetings around the country this Saturday.

SEN. ROBERT MICHEL, Minority Leader: Our role and responsibility is educating the American public to what really is in these specific proposals, and when they get to understanding it, reading the fine print like you have to in an insurance policy, you get a very different view. When you get beyond simply accelerating public works as an item or summer jobs, beyond that you tell me where there's one additional job created, but additional spending, and that's the difference that has to be pointed out to the American people, what really is a job creator.

MR. LEHRER: White House officials said today a national sales tax was being considered as a way to pay for health care reform. Spokesman George Stephanopoulos said the idea had not yet been presented to President Clinton but his health care task force was considering a wide range of options, including a so-called "value added tax."

MR. MacNeil: There was still no verdict today in the federal trial of four Los Angeles police officers accused of violating Rodney King's civil rights. Deliberations ended early after the judge called all parties to the courthouse to announce that one juror was sick and being taken to a doctor. Deliberations are expected to resume tomorrow morning. The governor of Ohio deployed 500 National Guard troops to the Lucasville prison today. Rioting prisoners there have been holding eight guards hostage since Sunday. The move came hours after inmates hung a banner out a window threatening to kill one of the hostages unless their demands were met. Seven inmates have been killed by other prisoners since the uprising began.

MR. LEHRER: Officials of the seven largest industrial nations met in Tokyo today on aid to Russia. The United States wants the group to put together a $4 billion fund to privatize Russia's state run factories. An overall package of about $30 million is expected to be worked out during the two-day meeting.

MR. MacNeil: That's our summary of the news. Now it's on to Bosnia, managed competition in health care, Labor Secretary Reich and the women of Somalia. UPDATE - WAR WITHOUT END

MR. MacNeil: First tonight an update on the Bosnia story. Serb shelling of the Eastern Bosnian town of Srebrenica continued today, and so did international diplomatic efforts to stop the fighting. Yesterday a United Nations convoy managed to evacuate nearly 700 Muslim women and children from Srebrenica to Tuzla. Jane Bennett- Powell of Independent Television News has a report. We caution that it includes strong material.

MS. BENNETT-POWELL: Last night's convoy brought civilians, women and children, with the kind of wounds soldiers get in battle. Of the 700 people evacuated from Srebrenica yesterday, 27 were brought to Tuzla's hospital. Surgeons operated through the night and were still in the operating theater this afternoon. These were the first eyewitness accounts of the intense shelling Srebrenica's been subjected to over the last few days. By today the medical staff were better able to assess the scale of the injuries, though some children like Assad still bore the number of his place in the truck on his unwashed face. He's in intensive care with internal bleeding from a shattered breast bone and a deep skin wound from shrapnel. He's six. Sadat, who's 16, was playing football on Monday when he was hurt. He came out with his mother, but his father and brother are still in Srebrenica. He has broken ribs, internal bleeding.

SADAT: [speaking through interpreter] I was in the school playground playing with a ball and one shell landed. There was a huge bombardment from the direction of Serbia and Brachina.

MS. BENNETT-POWELL: Said was also playing football when the first shells fell. Overnight surgery failed to save his sight. He'll never play football again as the nurse explained.

NURSE: [speaking through interpreter] Shells hit the school. We heard 50 people were killed there. He came alone. The doctor who had examined him said that these are serious eye wounds.

MS. BENNETT-POWELL: There was more shelling last night and today. Eight more people died and three times that number were hurt. A U.N. aid worker described Monday's bombardment as intensive and systematic in its targets with bursts of three or five shells at a time. Radovan Karadzic, the Bosnian Serb leader, said that after inquiries, there was no evidence it came from Bosnian Serb positions.

MR. MacNeil: In Europe both proximity and heavy news coverage have produced political debates over Bosnia more passionate than those in the United States. And in Britain, some of the strongest language has come from Lady Thatcher, the former prime minister. Yesterday on British television, Margaret Thatcher said that Europe has become an accessory to massacres. Today there was an angry response from the government of her successor, Prime Minister John Major. We have a report from Eleanor Goodman of Independent Television News.

MS. GOODMAN: Lady Thatcher today went on the American breakfast shows to make the case for greater Western intervention in Bosnia.

BARONESS MARGARET THATCHER, Prime Minister 1979-90: [CBS, "This Morning"] We can't pass by on the other side and see those terrible things going on to innocent people. I suggest, therefore, that we revive what was a previous policy talked about but not implemented of arming the Bosnian Muslims who've been prevented from getting arms to defend themselves by a United Nations resolution.

MS. GOODMAN: The British government is firmly opposed to lifting that embargo but that opposition could lead to a rift with the new American administration. Today Reginald Bartholomew, President Clinton's special envoy to former Yugoslavia, said on a trip to the region that the U.S. would back the lifting of the U.N. embargo against Bosnia unless the Serbs signed a peace agreement soon. And he made it clear that American patience with the diplomatic route was running out, given the atrocities being committed on the ground. In Britain, where MPs returned to Westminster after the Easter recess, Lady Thatcher's intervention infuriated ministers. Some loyal Tory back benchers were privately going round saying that their former leader had flipped her lid. But other MPs on both sides of the House clearly shared her frustration at the impotence of the West to stop the killing. In an attempt to counter her arguments, the government agreed to make a statement. Using rather more measured terms than yesterday, the defense secretary said the government shared the sense of outrage about the attack on Srebrenica.

MALCOLM RIFKIND, MP, Defense Secretary: Madame Speaker, the government fully shares the widespread frustration that diplomacy and military pressure have not yet succeeded and that the suffering still continues.

MS. GOODMAN: He stressed that the sanctions noose was being drawn tighter. Then without mentioning Lady Thatcher by name, he rejected her call to lift the arms embargo on Bosnia.

MALCOLM RIFKIND: Removal of the United Nations arms embargo would certainly result in the Bosnian Muslims being free to acquire all the weapons that they needed. Presumably, the Bosnian Serbs for their part would also seek more arms from other countries. The result would be to prolong the conflict and to make it even bloodier and more vicious than it is today.

MS. GOODMAN: Turning to the calls for air strikes against Serbian positions, he did leave open the possibility that at some future point they might be justified, but he warned that they would fundamentally change the role of the U.N.

MALCOLM RIFKIND: The clear military advice received by the government is that air strikes unsupported by substantial numbers of troops on the ground would be unlikely to be effective, given the nature of the conflict, the weapons deployed, and the terrain.

MS. GOODMAN: Mr. Rifkind was broadly supported by the opposition front benches.

DAVID CLARK, MP, Shadow Defense Secretary: Madame Speaker, the secretary of state is right when he says that we cannot lift the arms embargo to the Muslims. It has always seemed to us rather crazy to try and douse a fire with petrol. It never works.

MENZIES CAMPBELL, MP, Lib. Dem., Defense Spokesman: Although the right honorable gentleman and I disagree about a number of elements of this matter, may I say to him that I believe him to be fundamentally right in resisting calls for the relaxation of the arms embargo.

MS. GOODMAN: Mr. Rifkind was also backed by a majority of Tory back benchers.

HAROLD ELLETSON, MP, Conservative, Blackpool North: Would my right honorable friend not agree with me that the quickest available short cut to a general Balkan war and an escalation of the conflict far beyond the borders of Yugoslavia would be to bomb the Serbian positions?

MS. GOODMAN: But Lady Thatcher's frustration was shared by a significant minority on both the Labor and Tory back benches.

WINSTON CHURCHILL, MP, Conservative, Davyhulme: Does the government not see that it is the inevitable consequence of the present policy that ethnic cleansing will continue its course and genocide will continue because there is nothing whatsoever being done by the international community to stop it?

FRANK FIELD, MP, Labor, Birkenhead: How many more millions of people must be driven from their homes and tens of thousands of people killed before the government comes before that dispatch post with a policy commensurate with the genocide which we're witnessing here?

MS. GOODMAN: And in the Lords this evening Lady Thatcher showed that the government's attempts to counter herarguments had in no way changed her mind.

MARGARET THATCHER: The government have left the people, although they have a right to self-defense, without the means of implementing that right against a vicious aggressor.

MR. MacNeil: On the diplomatic front today, Russian officials proposed a meeting of foreign ministers of the five permanent members of the U.N. Security Council to discuss Yugoslavia. The Russians suggested the meeting take place after their presidential referendum on April 25th. Still ahead, managed competition in health care, Labor Sec. Reich, and Charlayne in Somalia. SERIES - OPTIONS FOR CHANGE

MR. LEHRER: Now another in our series on options for health care reform. A new survey of medical doctors found that two-thirds of them favor a fundamental overhaul of the current medical system and 58 percent of them in that Times-Mirror survey said they support a so-called "managed competition" approach. President Clinton's task force on health reform may include that in its recommendations so what exactly is managed competition? They already have such a system in California, and Spencer Michels of public station KQED-San Francisco tells us all about it.

[DOCTOR EXAMINING LITTLE GIRL]

MR. MICHELS: Four-year-old Lisa Jackson and her baby sister, Michelle, are showing signs of retardation. Dr. Ronald Bachman, a pediatrician and geneticist at Kaiser Hospital in Oakland, California, suspects that these young patients may have a complicated hereditary disorder.

DR. RONALD BACHMAN, Geneticist: One of them has already had chromosome study, cytogenetic studies. That's the test that's close to $1,000. And then we'll do molecular testing, DNA testing, for something called fragilex, which is one of the newer diagnosed retardation syndromes, as well as doing some other chemical testing or metabolic testings as we call it.

MR. MICHELS: Such state of the art procedures like most new medical technologies are expensive. And their increased use is one reason health care costs are spiraling out of control. They currently make up nearly 15 percent of Gross National Product. In California, even Kaiser, the nation's largest health maintenance organization, which prides itself on quality, low cost care, is now being pressured to hold the line. Some health care planners believe that cutting cost is a simple matter of market economics, where price is king. Welcome to Price Club, one of a growing number of discount warehouse stores. True, the frills are few, selection is limited, and the packages give the term economy size new meaning, but shoppers are lured by bargain prices, kept low by the outlet's enormous buying power. That principle may work elsewhere. Health care, physical examinations, vaccinations, operations, they don't bear much resemblance to the products on these shelves. But in California, the people who manage a health care system for public employees have figured out that they can buy health care the same way that Price Club buys toilet paper or dog food. And then they can pass the savings along to their members.

TOM ELKIN, CalPERS: Volume purchasing is an excellent idea that's been used throughout the American economy in every other sector that I can think of and it's about time we start using it in the health care business.

MR. MICHELS: Tom Elkin buys health insurance for nearly 900,000 government workers in California. They are members of Sacramento- based CalPERS, the Public Employee Retirement System, which manages health benefits for active, as well as retired employees, of hundreds of public agencies throughout the state. In 1991, fed up with ever escalating premiums and constrained by a tightening state budget, Elkin got tough with insurers. CalPERS sought volume discounts from about 20 companies and then let its members choose their coverage from among those competing plans. This system is as close to a model of what President Clinton calls "managed competition" as exists in the nation.

TOM ELKIN: The idea of getting hundreds of employers together to purchase health care using purchasing power and spreading the cost of administration over lots of employers, from our experience, is a pretty good idea.

MR. MICHELS: Benefiting from CalPERS' clout are the seven employees of the Castro Valley Sanitary District who clean and maintain the sewers near Oakland. Average health insurance premiums for CalPERS members will go up just 1.5 percent this year, far below the national average of 10 to 15 percent. That's why district manager Mary Fredette recommended a change from the county insurance plan.

MARY FREDETTE, Castro Valley Sanitary District: The last year that we were with the county our fee for service plan, which is Blue Cross, had increased or was projected to increase 44 percent.

MR. MICHELS: What kind of savings did you get under the CalPERS plan?

MARY FREDETTE: The first year that we were there our fee for service plan, which was roughly comparable to the Blue Cross that we had had under Alameda County, decreased between 22 and 33 percent.

MR. MICHELS: You mean the amount you were paying, that the district had to pay, went down that much?

MARY FREDETTE: The amount that the district had to pay went down that much.

MR. MICHELS: Such savings convinced Stanford Business School Professor Alain Enthoven, one of the originators of the managed competition theory, that CalPERS is on the right track.

ALAIN ENTHOVEN, Economist: I think as a model of a purchasing cooperative it is excellent. It works very well.

MR. MICHELS: Does that make it managed competition?

ALAIN ENTHOVEN: Not yet.

MR. MICHELS: Enthoven believes that health care costs will come down only if individuals who want more than minimum care have to pay for additional insurance themselves. CalPERS has taken a first step in this direction. Realizing that its members had trouble comparing various health plans, CalPERS required all providers to come up with a standard benefit package. Here at Kaiser, I learned that the CalPERS plan was a little more generous than my own.

SPOKESPERSON: We have V coverage which means that you pay $5 for your visits when you see the doctor. Also, if you need an X-ray or a lab test, there's no charge for that. Free prescriptions. You pay $1 in the pharmacy from a Kaiser pharmacy. And basically that's what you're covered for.

MR. MICHELS: What kind of benefits to CalPERS members get?

SPOKESPERSON: They have the S coverage plan, and they, I can look it up exactly and tell you. The S coverage, which is no charge for visits, they pay $1 for prescriptions, as on your plan, no charge for X-ray or for lab tests or for allergy testing.

MR. MICHELS: Those benefits have proven too expensive and last year they provoked a major battle between Kaiser and CalPERS. In 1991 and '92, Kaiser's premiums jumped a total of nearly 30 percent and CalPERS demanded a better price or else.

TOM ELKIN: We spent many hundreds of hours trying to convince the Kaiser management to reduce their premium increases. They never reduced 'em at all, and in return for that, the PERS board, since Kaiser has 40 percent of our members, decided they would freeze their enrollment for a year as a sanction for them not complying with the request.

JERRY FLEMING, Kaiser Health Plan Manager: I have to say this probably the most aggressive thing I ever went through.

MR. MICHELS: Jerry Fleming and Dr. Francis Crosson represented Kaiser in the negotiations. Fleming said CalPERS strategy of blocking new enrollments in Kaiser sent a strong message.

JERRY FLEMING: Clearly, your second largest customer comes to you and says, we're very dissatisfied with your rates and we go through a process and they decide to punish us by freezing us. We can't help but notice that. At the same time, we knew we needed to get our costs down, and so we just redoubled our efforts in some sense.

MR. MICHELS: This year, Kaiser got reinstated by CalPERS when it came in with a 2 percent drop in premiums. That was achieved in part by charging patients $5 a visit and raising the co-payment for drugs from 1 to $5, an unpleasant surprise for CalPERS members who had joined Kaiser before the enrollment freeze.

MR. MICHELS: You know that on August 1st you're going to start paying $5 every time you go for an office visit? That's the new CalPERS contract.

WORKER: No. We had no idea.

MR. MICHELS: You didn't know that?

SECOND WORKER: We didn't know that.

MR. MICHELS: Is that all you can say?

SECOND WORKER: That's new to us.

MR. MICHELS: Is that going to bother you?

SECOND WORKER: Well, any time anything goes up in price it bothers us.

THIRD WORKER: Especially if you've got families and stuff.

MR. MICHELS: Kaiser expects the co-payments to discourage unnecessary visits and, therefore, cut costs. In addition, Kaiser says CalPERS forced it to become more efficient, for instance, finding new ways to reduce hospital stays.

DR. FRANCIS CROSSON, Kaiser Medical Director: There's a new technique now for taking out your gall bladder which is done instead of with a large incision across your abdomen a very small incision and a special tube with a laser on it which allows the gall bladder to be taken out with a smaller incision and with a lot less pain. As a consequence also, patients get to go home much more quickly.

DR. BARBARA NEWMAN, Family Practitioner: [Discussing Case with other Medical Person] Were you telling me you weren't able to get verbal authorization for this?

MR. MICHELS: But some cost cutting measures draw the ire of physicians, who resent it when they feel insurers and bureaucrats are interfering with their medical judgment.

DR. BARBARA NEWMAN: This woman has flagrant hypothyroidism and she's got to get this iodine treatment.

MR. MICHELS: Dr. Barbara Newman practices family medicine with a small group in San Francisco. She believes all this emphasis on cost cutting can reduce the quality of care.

DR. BARBARA NEWMAN: I think you're perverting the whole idea of, of healing. A marketplace system would have me trying to do the least I can for this patient and get the most money I can from that patient. No. 1, that's not rewarding. It's very alienating. I mean, I'd be terminally depressed if that's how I had to practice medicine. And it just doesn't fit. We're not selling shoes.

MR. MICHELS: Prof. Enthoven counters that cost cutting doesn't hurt medicine, it helps.

ALAIN ENTHOVEN: I think people should understand when you talk about the low-priced plan that's not a put down. That's not el cheapo. That's often the best quality care. Doctors who do it right the first time and don't make mistakes cost a lot less than doctors that are not very good.

MR. MICHELS: Enthoven believes that large HMO's like Kaiser, where patients pay a flat yearly rate, encourage efficient care. His theory of managed competition promotes HMO's over the old system where the more visits a patient makes, the more money the doctor gets. Critics have long contended that HMO's skimp on tests and procedures to stay in the black. But Dr. Bachman says that's just not so.

DR. RONALD BACHMAN: This is no Mr. Kaiser watching over me. Four geneticists that actually make the decision as to what testing is medically appropriate and then we have to go to our administration and show them why we think that, and if we are able to show them that it's a test that should be done, no one stops us from doing it.

MR. MICHELS: There are other objections to the CalPERS model. Author and health consultant Peter Boland alleges that managed competition isn't fair to those not enrolled.

PETER BOLAND, Health Care Consultant: Because what we're doing on squeezing price, somebody else is going to get caught with the rest of the bubble.

MR. MICHELS: Who?

PETER BOLAND: Those who don't have access to these large purchasing groups.

MR. MICHELS: Is that, in fact, happening? If CalPERS is bringing down the prices are other people paying more?

PETER BOLAND: You and me and everybody else who doesn't have access to CalPERS.

TOM ELKIN: The only thing that I could suggest is that you need to join a purchasing cooperative as well and use that power like we have to hold down prices.

MR. MICHELS: Prof. Enthoven is emphatic is emphatic. For managed competition to work, everyone should be in a purchasing pool like CalPERS, including the 37 million Americans now uninsured.

ALAIN ENTHOVEN: For those people who can afford it, they have to be required to participate, to buy coverage. Those people who can't afford it, they have to be subsidized by government so that we get everybody in.

MR. MICHELS: But Dr. Newman, an activist who favors a Canadian style national health system where the government pays all the bills, thinks that managed competition perpetuates waste.

DR. BARBARA NEWMAN: Why do I have to go through an intermediary HMO or Blue Cross with all the administrative expense? I mean, these places employ huge numbers of people. They have a lot of salaries, a lot of paper work, a lot of marketing. All that money is wasted. It could go just to patient care.

MR. MICHELS: Unfortunately, for advocates of Canadian style health reform, managed competition seems to be winning politically. In California, the CalPERS model is already being copied. The state is bringing together small businesses to bargain collectively for employee health benefits.

SPOKESMAN: Price and service are competitive factors --

MR. MICHELS: One recent morning this new state agency was negotiating with Kaiser in one room, while down the hall, Blue Shield executives were arguing that their health plan should also be offered to employees of the small businesses in the pool.

SPOKESPERSON: Are there other specific diagnostic categories that you try to target for cost management and risk assessment besides pregnant women?

JOHN RAMEY, California Insurance Board: We think we're the wave of the future.

MR. MICHELS: As agency chief, John Ramey is the key negotiator for the pool of small businesses. He thinks the concept of purchasing cooperatives like his and CalPERS will fly nationally.

JOHN RAMEY: It has the components of a possible political solution. It retains traditional relationships between patients and providers. It retains the function of the health benefits industry. It retains free choice, which is really critical to the electorate, and for those reasons, I think that it's going to be tried.

MR. MICHELS: The rising costs of modern medicine make major change inevitable. Managed competition appears to be the reform of choice today. But while various parts of that concept, like the purchasing pools, have been implemented, no one has ever put all the elements together to find out if the theory works. The test may be soon at hand. NEWSMAKER

MR. LEHRER: We go now to a Newsmaker interview with the Secretary of Labor, Robert Reich. He took part today with President Clinton in a special conference on summer jobs. Mr. Secretary, welcome.

SEC. REICH: Thank you, Jim.

MR. LEHRER: In the $16 billion economic stimulus package that is now stalled in the Senate how much of that would go to summer jobs?

SEC. REICH: Only about a billion dollars, Jim. We're talking about a $16 billion stimulus package that has $4 billion of extended unemployment insurance, a lot of roads and bridges, child immunization, summer jobs, a variety of things that have to do with both rebuilding foundations of the country but also in the short-term stimulating the economy, getting jobs back.

MR. LEHRER: Now the summer jobs part of that is how many, 700,000 jobs, is that right?

SEC. REICH: Seven hundred thousand jobs in addition to 600,000 jobs that the government was planning to support, and in addition to a lot of jobs that hopefully the private sector is going to come up with. And this summer the government is asking the private sector to come up with an equal number of jobs because it's not just the public sector responsibility. Getting those kids into structured work environments, giving them some, some pride in what they're doing, getting some work habits is something that both the public sector and also the private sector need to do.

MR. LEHRER: The government approach, yours and President Clinton's approach, is that based on the idea that there's a lot of work out there that needs to be done or is it there are a lot of young people out there who need jobs?

SEC. REICH: Well, it's both. Look at any major city, and when you look around the city in terms of parks, playgrounds and places for people to stay who have no place to sleep, there's a lot of work to be done, there's no question about that, child care facilities and so on. But a big part of the goal obviously is to give young kids, teen-agers who are in urban areas, who are in deprived areas, a structured work environment. Get them off the streets, give them a sense of pride in getting a paycheck, make sure that they show up for work on time, that there's little discipline and order in their lives, and also this summer give them an educational enrichment, a little expert tutoring during the summer so they don't fall back and they don't forget by September a lot of what they learned by June. This is a problem particularly in some of our urban areas where a lot of kids just simply are not exposed to any stimulating environment during the summer, and they do forget during the summer a lot of what they learned.

MR. LEHRER: House Minority Leader Michel said today the same thing that many critics of the stimulus package said before, which is, okay, fine, no problem, if you want the summer jobs program, you have the summer jobs program, it's all that stuff that is not needed. Is the President so anxious to get this summer jobs program that he will make a deal along those lines?

SEC. REICH: Remember, there are two purposes being served here with regard to the jobs program, not only summer jobs, but -- one is to have a down payment on the long-term investment we have to make as a society, roads and bridges and all kinds of things that have to be done anyway. We want to do them a little bit earlier so that, No. 2, we can get the economy back on track. Now, granted, $16 billion is not very much. It's a drop in the bucket in a huge economy like ours, but it is at least a small kick in the right direction, and it's our judgment that the economy is not yet picking up speed. In fact, even in yesterday's news we saw a drop in consumer spending and we have a problem with unemployment. We're still stuck at 7 percent unemployment or more for the sixteenth month in a row.

MR. LEHRER: Well, if this program is so small compared to the overall thing, why has it been -- why has it become such a huge thing to the President?

SEC. REICH: Well, again, it's small but it's necessary. I think that there's almost a psychological gridlock out there right now, Jim. It's not just a political gridlock. It's also you see firms are not hiring. They're going on overtime but they're not actually bringing on new workers. Consumer spending, as I said, is down. There's a fear out there that this economy will not really recover in terms of jobs. If you don't have jobs coming back, you don't really have a long-term recovery. So, granted there is a psychological element. The government is going to do everything it possibly can to get us back on track. If it takes more than $16 billion, well, it takes more than 16 billion. But the notion is we've got to at least move forward. We've got to try. And this is what I find, and I think other members of the administration find a little bit frustrating, because Bill Clinton was elected for change, to get things moving. Let's experiment. Let's try something. If it's not exactly the right thing, let's try something else, but here we have a situation in which the economy is flat on the jobs front. We've got to at least begin.

MR. LEHRER: But even using your term "psychological thing here," the critics of this say, well, if that's what you really want to do, if you really want to give the economy a kick, you want to give it a real kick, in other words, with permanent jobs, help the private sector and not just go create a bunch of government jobs that are going to eventually run out, they're not going to do that much.

SEC. REICH: But, remember, part of the stimulation program or the jobs recovery program is an investment tax credit that would be retroactive right through right now. Now, again, there are opponents who are saying we don't want the investment tax credit, we don't want those business incentives, but the administration's point of view is that you want to stimulate both public and private investment. After all, not only the short-term to stimulate the economy but also in the long-term. One of the big problems we've had in this country if you look at, where you're looking at the debts, where you're looking at the disintegration of roads and bridges or our schools is that we simply are not investing in the future. And this is for the down payment immediately on a long-term investment.

MR. LEHRER: Some people have noticed, it's appeared in print, in fact, that the presidential rhetoric about the economic stimulus stifling in the Senate thus far has become, his rhetoric has gotten tougher and tougher. Is this -- the Congress comes back on Monday. Do you expect this thing to become a really bloody fight before it's over with? Is it that important to the President?

SEC. REICH: It's certainly important to the American public that jobs come back, and I think the President's going to do everything he possibly can to make sure. I mean, he was elected because the economy was so bad. Now there are some indicators, Jim, that the economy is bouncing back in terms of, in terms of profits, a little bit in terms of productivity, but again let me come back to this jobs issue. We are not yet out of the woods on jobs and unless people feel more secure we are not going to be out of the woods on jobs. In fact, large firms are now continuing to slim down. We have 10 million people who are unemployed, a couple of more million people who are working part-time, would rather be working full- time. We have discouraged workers, another million or more who are too discouraged even to look for work. This is not what the Clinton administration was elected to do.

MR. LEHRER: Let's go on to some other things that are related to your job as Secretary of Labor. You said that Labor should have a louder voice in government policy on the economy. Do you mean organized labor, all of labor? Define what you mean.

SEC. REICH: I mean the work force in the United States. It's very important. In fact, if you look at companies in this country, the most successful, most productive, what you find is that they have a collaboration between workers and managers. Workers are very actively engaged, they're involved. Workers and managers are -- you know, the mathematicians have this expression, a zero sum game in which one side wins and the other side loses. That's not the way these companies are organized. They're organized in positive sum games. It's win/win. Workers take an active role in making the country more productive. They're involved in quality control. They're involved in increases in productivity. The managers are concerned about the health and safety of their workers. In fact, if you made a list on the best companies in this country in terms of long-term productivity and then you made another list of the companies that were really engaged in investing in the training of their workers, and listened to their workers, you'd have the same list.

MR. LEHRER: If you made another list of which ones were unionized and which of them were not, how would it come out?

SEC. REICH: Well, it's a mixed, it's a mixed list, Jim. A lot of unionized companies like Xerox or National Steel or the Saturn plant at GM, Chrysler, LH is another example, the new Chrysler, I can give you countless examples of unionized plants in which you have win/win bargains. The unions are essentially saying, okay, we'll give up rigid job classifications, work rules, cost of living adjustments that are unrelated to productivity improvements, but in exchange, management says, okay, we'll give you a piece of the action, we'll give you some profit sharing, we'll give you more job security, we'll give you a greater say in quality and productivity. Well, again, it doesn't matter whether it's unionized or non-unionized. Those are the essence, the essential features of that new compact. This kind of loops back in a way to the beginning part of our conversation because you see we can do everything right on the macro economy. The administration, the Federal Reserve Board, we can get interest rates exactly where we want. We can get spending, we can get the deficit down, but if our business units are not productive enterprises, if management and labor are not working constructively together, we're not going to be a productive society.

MR. LEHRER: I think it's the last figure I saw, in fact, saw today was that about 15 percent of the American work force is unionized. Is it the Clinton administration's position that more of the work force should be unionized? Is that a matter of policy and belief on your part?

SEC. REICH: No. The position is that we don't want to load the deck in either direction. The National Labor Relations Act of 1935, the Wagner Act, set some basic boundaries with regard to collective bargaining. It established a frame work for peaceful resolution of disputes. We want to make sure we go back to that. The 1980s, you know, if you look at everything from Greyhound to Eastern Airlines were littered with the residues of a very, very bitter labor/management conflict, and that conflict, itself, is an outcome of labor and management just at loggerheads, not really adhering to the spirit of that, of that original compact.

MR. LEHRER: But you as the Secretary of Labor of the United States if there's an individual worker out there or a group of individual workers who feel they've got a problem at the work place, your recommendation to them is not automatically go organize a union or join a union?

SEC. REICH: My first recommendation, my first recommendation to management and to workers, in fact, I've made this recommendation over and over again, and interestingly, the Chamber of Commerce of the United States, the National Association of Manufacturers, Jim, a lot of the business groups where you would expect this message would resonate are saying, yes. My message is come up with ways of working together constructively. Managers, labor, you can only do it together. We as a nation are only [never] going to be productive unless you do it together. If it's, if it's one against another, we're finished, we're dead. I don't care whether you're unionized or non-unionized, labor is going to have a voice. I mean, again, if you're talking about employee participation and involvement, you have to have some sort of system for giving it a voice. I don't care again whether it's a traditional organized system. Some of the most innovative companies in America have come up with different ways of providing workers with a voice. But that involvement is absolutely critical.

MR. LEHRER: Finally, just personally, you came from Harvard into the cabinet.

SEC. REICH: Please don't hold that against me.

MR. LEHRER: I won't hold you that against you. That's just for reference purposes that I say that. Is it, is it what you expected, being a member of the cabinet of the President of the United States?

SEC. REICH: Well, it is in many respects what I expected, but I have to tell you that it's an odd experience in one very fundamental respect. The President, I've known the President for 25 years. I know him in ways that the public doesn't know him. The public knows him as a very eloquent, articulate man, a man who has extraordinary passion about public ideals and public principles, but I also know him as one of the kindest and most decent personal friends and individuals I know with regard to his family, his friends and others. Getting those two images to overlap, that wonderful person and that President, has been a little bit difficult for me.

MR. LEHRER: I hear you. Mr. Secretary, thank you.

SEC. REICH: Thanks, Jim. FINALLY - RETURN TO SOMALIA

MR. MacNeil: Finally tonight, on her return visit to Somalia, Charlayne Hunter-Gault looks at the dual roles women have played in that tragedy. They are both victims and peacekeepers.

MS. HUNTER-GAULT: It was a scene that captured attention around the world, as much as the faces of starvationin Somalia, the stoning of this woman. It is said that there was a misunderstanding that caused this beating. Someone accused the woman of consorting with French soldiers, a rumor now widely discredited but not before the damage was done by a crowd out of control. But this woman was not the only victim of crowds out of control. All over the country, Somali women have been the victims of brutal rape and beatings at the hands of soldiers and warring factions out of control. There are, in fact, many who say that it is the Somali women who've paid the highest price and have borne the greatest burden of Somalia's tragedy. And in many cases, it is the women who have come to the rescue. Here, for example, in Northern Mogadishu, one of the most battle-scarred areas of the city across the green line, the last refuge of scoundrels and snipers. It is here that Aabshiro Abtidon, an economist, had taken on the role of volunteer social worker, turning one of the two houses she owns into a safe haven for displaced people, women she didn't know until tragedy threw them together, women like these.

AABSHIRO ABTIDON, Somali Volunteer: She was a virgin and they destroyed her virginity and she get pregnant.

MS. HUNTER-GAULT: Tell her to tell me what happened to her.

[AABSHIRO ABTIDON TALKING TO GIRL]

AABSHIRO ABTIDON They came -- the soldiers -- and they rape her.

MS. HUNTER-GAULT: In her house?

AABSHIRO ABTIDON In her house, yeah.

MS. HUNTER-GAULT: How many soldiers were there?

[AABSHIRO ABTIDON TALKING TO GIRL]

AABSHIRO ABTIDON Four.

MS. HUNTER-GAULT: And what about her? What happened to you?

[AABSHIRO ABTIDON TALKING TO GIRL]

AABSHIRO ABTIDON When she came out from her house where she used to live before, she came from her house, when she came about two meters, she meet the men with the guns, and they put them like that, they took her hands, and they took her to a small place to rape her.

MS. HUNTER-GAULT: Just right out on the street?

AABSHIRO ABTIDON Small corner. They put her in small corner and then they rape her.

MS. HUNTER-GAULT: And did they hurt you?

AABSHIRO ABTIDON They hit her. They beat me, beat me very much.

MS. HUNTER-GAULT: Ask her how hard has this been for her to have this baby.

[AABSHIRO ABTIDON TALKING TO GIRL]

AABSHIRO ABTIDON We can't throw it away, we have to keep it whether we survive or not. You know we have to support the child.

MS. HUNTER-GAULT: What does she think should happen to the men who did this to her? If they can be found, what should happen?

[AABSHIRO ABTIDON TALKING TO GIRL]

AABSHIRO ABTIDON If I could know him, and I could see him, I could have killed the men who gave me the problems.

MS. HUNTER-GAULT: She feels that she could kill them?

AABSHIRO ABTIDON Yes, to kill him if she knows actually who is he. Unfortunately, she says, I don't know who.

MS. HUNTER-GAULT: And what about her, what does she think who should happen to the men who did this to her?

[AABSHIRO ABTIDON TALKING TO OTHER GIRL]

AABSHIRO ABTIDON She says, "No, I never kill him even if I see him."

MS. HUNTER-GAULT: What does she think should happen to him if he could be caught? Should he be punished? Should he go to jail?

[AABSHIRO ABTIDON TALKING TO OTHER GIRL AGAIN]

AABSHIRO ABTIDON She would like to take him to the court and lock him up but not to kill him.

MS. HUNTER-GAULT: And this baby also, his mother was raped?

AABSHIRO ABTIDON His mother, she was.

MS. HUNTER-GAULT: She was raped also?

AABSHIRO ABTIDON Yeah, raped.

MS. HUNTER-GAULT: Are there many women like this in Somalia?

AABSHIRO ABTIDON: So many. You cannot even count. So many ladies, so many women.

MS. HUNTER-GAULT: Somalis tell me that this is something very unusual, that it never happened like this before.

AABSHIRO ABTIDON: Never before, never happened, never, ever before, you know. But this two years, the civil war, during the civil war, it happened a lot, but before now it was very rare.

MS. HUNTER-GAULT: What do you think happened? Why do you think all of a sudden this kind of thing started to happen?

AABSHIRO ABTIDON: I can't tell you my dear.

FADUMA AHMED ALIM, IIDA Women's Group: My mother gave me one explanation. They said this is the nature of, the chauvinistic nature of man.

MS. HUNTER-GAULT: Faduma Ahmed Alim is a member of the women's organization IIDA. It means Woman Celebrating Her Liberty. They are almost all professionals, teachers, nurses, accountants, doctors. Faduma was once a member of Somalia's parliament. Most of them have been brutalized one way or another by the war and have come together for mutual support and to help other women like the young woman who was stoned by the mob.

FADUMA AHMED ALIM: It is a senseless war. Nobody understands what they are fighting for because they are destroying the country, destroying the people. Then too they are going to, you know, to rule, so the thing is to go back to my premise that the Somali men motivated by this tribal bashing, whatever they call, they think the whole thing is in score -- now that tribe -- then I must make them pay and set the score. So they think well they are raping women, they're actually raping the men to whom that woman, you know, are --

MS. HUNTER-GAULT: But even as these women try to provide some solace to others, they must also deal with their own pain.

WOMAN: One night, happened in the evening, 9 o'clock, there was a gunman came into the house and then we tried to, you know, to get help but unfortunately all these gunmen, they were my neighbors, so nobody came and help us.

MS. HUNTER-GAULT: You knew them?

WOMAN: Yeah. Because we never get help, when we shout and shout nobody was coming out because they were scared in the house. So everyone, the gunman took one position in the house so no neighbors can come and help us. And then they took all the things in my house. When they finished, they tried, you know, to have ourselves, and they took two of our, my sisters, in the yard but they were very fortunate because they were very drugged or this or -- we saved our lives but they tried everything.

MS. HUNTER-GAULT: Despite the stories of sadness though, there is a sense of renewal and hope in this place.

MS. HUNTER-GAULT: What's happening here?

SPOKESMAN: This is what they are given, the raw material when they come.

MS. HUNTER-GAULT: This is what comes out of that?

SPOKESMAN: This comes out of that and that also comes out of that. All these things come out of that.

MS. HUNTER-GAULT: This comes out of that.

MS. HUNTER-GAULT: Many of these women were widowed by the civil war. Others, along with their families, were forced out of their villages because of the fighting. But IIDA, with the help of GOAL, the Irish relief agency, provides these women with a bit of straw and a chance at a new life.

MS. HUNTER-GAULT: Sterlinga Rush is a member of IIDA. She tells us through our interpreter, Abdul Kadir, about the work here.

INTERPRETER: They take this to the market to sell and this, they give it out for settlement of the people.

MS. HUNTER-GAULT: Oh, for resettlement of the people, so that they have something to do and then they can sell wherever they are. Cover his head. Most of the women who work here live in a refugee camp next door. Where does she come from? She's from 300 miles away. What you see mostly is women here, is that right? Is it the women who are suffering so much?

INTERPRETER: It's the women who have been really affected by this war. The men sometimes go to fight or they go on their own. They run away for their own security, and it is the women and the elderly and the children who are left, and those are the people that concern us most.

MS. HUNTER-GAULT: Will women have more of a say in the future of the country do you think?

INTERPRETER: The persons have already been asked by women themselves, although they are now concerned strictly on the basic domestic care, domestical living, is that they now realize the role they have played during war, and they are beginning to ask the question that come peace time they must be ready to play a more important role in the running of the country.

MS. HUNTER-GAULT: Because they've struggled so much during this war, they feel they've learned.

INTERPRETER: Yes.

MS. HUNTER-GAULT: If there were any doubts about the new determination of Somali women, this demonstration went a long way towards erasing them. In one of the largest protests since the end of the war, women were in the forefront here as they were at the recent national reconciliation conference in Addis Ababa, demanding for equitable treatment for their group of so-called "Bantu" Somalis. Women comprise some 60 percent of the Somali population and some 60 percent of its productive work force in both the rural and nomadic sectors. For these women and many like them it is the dawning of a new day. The fear that kept them locked in their houses is a thing of the past. They are now ready to be seen, to be heard, and to make a difference. RECAP

MR. MacNeil: Again, the main stories of this Wednesday, violence erupted during a strike by millions of black workers in South Africa protesting the slaying of a popular black leader. At least four people were killed. US Envoy Reginald Bartholomew told the leader of Bosnia's Serbs to stop committing atrocities and sign a peace agreement or face a possible lifting of the arms embargo on their Muslim enemies. Good night, Jim.

MR. LEHRER: Good night, Robin. We'll see you tomorrow night. I'm Jim Lehrer. Thank you and good night.