The MacNeil/Lehrer NewsHour

MR. LEHRER: Good evening. Leading the news this Tuesday, White House Chief of Staff John Sununu resigned, American hostage Alann Steen was freed, and there were reports Terry Anderson, the last American being held in Lebanon, will be released tomorrow. We'll have the details in our News Summary in a moment. Robin.

MR. MacNeil: After the News Summary, the whys and wherefores of John Sununu's resignation. Then a documentary report on Hawaii's attempt to provide universal health care for all its residents. Next, Charlayne Hunter-Gault talks to Nelson Mandela, and the second in our week long series of essays on Pearl Harbor. Tonight, Roger Rosenblatt. NEWS SUMMARY

MR. MacNeil: White House Chief of Staff John Sununu resigned today. He said he thought it was in the President's best interest that he leave. He officially informed Mr. Bush of his intentions in a five-page handwritten letter which he presented aboard Air Force One en route to Florida this morning. The President accepted the resignation, saying he did so with reluctance, regret, and a sense of personal loss. Later, Sununu spoke with reporters at a stop in Mississippi.

JOHN SUNUNU, White House Chief of Staff: It's been a great three years. I told the President in his letter I couldn't have had three better years. I've enjoyed it. I knew the rules of the game when I came to town. I'd always told them that if I could serve them best by being in the job, I wanted to be in job, and if I became a political burden, I'd be willing to leave. And he's going into a campaign. He doesn't need an extra political target that folks would be shooting at, and I think it's best for the President that I move on.

MR. MacNeil: The resignation will take effect December 15th, but Sununu will remain as a counselor to the President with cabinet status until March 1st. We'll have more on the story right after the News Summary. Jim.

MR. LEHRER: Now only one American remains hostage in Lebanon. The next to last one, Alann Steen, went free today after nearly five years in captivity. Several reports, including one quoting Iran's U.N. ambassador, said Terry Anderson, the last American held, would be released tomorrow. Steen arrived at a U.S. military hospital in Wiesbauden, Germany, a short while ago. The 52-year-old college journalism professor will undergo medical examinations and debriefings there. He flew to Germany from Damascus, Syria, where he was taken after his release. He spoke with reporters there.

ALANN STEEN: It's great to be out. I don't think I can find words right now to express all that I feel, except that it's wonderful. Five years is no party.

REPORTER: What kept you going? Did you ever despair?

ALANN STEEN: I exercised every day for two hours to keep my mind off of what was happening to me.

REPORTER: Did you have access to newspapers, radios?

ALANN STEEN: No, no.

REPORTER: Any message to your wife?

ALANN STEEN: I love her. I miss her.

REPORTER: Are they going to release Terry Anderson?

ALANN STEEN: Are any of my students here? All right. All right.

MR. LEHRER: Doctors said today Joseph Cicippio suffered permanent frostbite from being chained outdoors during his captivity in Lebanon. He was released yesterday. American doctors in Germany also said Cicippio was knocked unconscious when he was kidnapped and still suffers from dizzy spells. Cicippio's expected to spend several more days at the U.S. military hospital in Wiesbauden before returning to the United States.

MR. MacNeil: The Israeli government today approved a new military post in the occupied West Bank. The facility is similar to others which have been used to protect the building of new civilian settlements. Two Israelis were killed at the site in October by unknown gunmen. The Israeli defense minister said the troops were being dispatched to guarantee security in the area. The second round of Middle East peace talks are scheduled to begin in Washington tomorrow. The Israelis have been trying to delay the start until next week. They're not expected to have a delegation in place when the meetings begin. The Palestinian delegation arrived last night. Today at a press conference, their spokeswoman criticized the Israelis.

HANAN ASHRAWI, Palestinian Delegation: We come here with a back- drop of more Israeli settlements, an escalation of settlement activity. We have had new settlements established since Madrid. We have had new settlements established, old settlements expanded, extensive lands expropriated, infrastructure expanded, and at the same time restrictions of land use around settlements, which means that this stepped up activity is another way in which Israel is trying to predetermine the issues, is telling you unilaterally to create facts on the ground that were prejudiced and pre-judge the outcome. And we view this with tremendous alarm and seriousness.

MR. MacNeil: U.S. and Soviet officials today announced that the two countries will sponsor an international foreign ministers conference on Middle East issues. The meeting is scheduled for January 28th and 29th in Moscow. Representatives from about 35 countries are expected to attend. State Department Spokeswoman Margaret Tutwiler said today the Bush administration will push in the next two weeks for the repeal of a 1975 U.N. resolution equating Zionism with racism. President Bush first called for the repeal in a speech to the United Nations in September.

MR. LEHRER: Soviet President Gorbachev said today the break up of the Soviet Union could ignite a civil war. He said he believes officials of the military or the former Communist Party may be plotting a new coup against him. He predicted any attempted takeover would fail. His comments came one day after the Ukraine announced its overwhelming vote for independence. We have a report narrated by David Simmons of Worldwide Television News.

MR. SIMMONS: A desperate plea to preserve what remained of the Soviet Union. The Ukraine's overwhelming vote for independence was his latest and most serious setback, made worse by the republic's reelected president's refusal to sign any union treaty. Gorbachev warned that a society without a union would mean a society without structure, hinting it could lead to a catastrophic civil war. He promised that his proposed confederation would in no way resemble a return to the old Kremlin's style of authority. Meanwhile, officials of now sovereign republics, including Russia, the Ukraine and Kazikhstan, met to discuss details of an economic treaty signed in October. The chairman of the Economic Council, Yvonne Silayev, led the meeting which focused on price policy, the banking system, and debt sharing, part of a widespread move to a market economy. To help with that transition and the economic instability caused by decades of Communism, the European Community has begun delivering badly needed food and other goods as part of its promised aid package. This shipment is targeted for needy children in hospitals and in schools. In Kiev, Ukrainian foreign minister Anatoly Zalenko celebrated his republic's newly won independence with Hungary's official recognition. He declared the Ukraine would become a neutral, nuclear free state and would not join any military alliance.

MR. MacNeil: African National Congress Leader Nelson Mandela told the United Nations today that sanctions against South Africa must not be lifted. In a speech, he said negotiations with the government on sharing power with blacks were moving forward, but not enough progress had yet been achieved.

NELSON MANDELA: Precisely because we have not as yet reached the goal of liberation towards which all of us have striven, we believe that there is need for continued international pressure to encourage a speedy movement forward towards ending the system of apartheid. Sanctions, therefore, continue to be important.

MR. MacNeil: Charlayne Hunter-Gault will interview Mandela later on the program. A new United Nations Secretary General was sworn in today. He is Buttress Galle, an Egyptian. Galle is the sixth secretary general but the first from an Arab nation. The career diplomat helped work out the Camp David Accords between Egypt and Israel in 1979. He officially takes office January 1st, succeeding Javier Perez DeCuellar.

MR. LEHRER: The government's Index of Leading Economic Indicators was released today. It was up slightly, .1 percent in October. The Commerce Department also reported new home sales rose 2.2 percent in October. That's the seventh increase since last January. President Bush today said much more needs to be done to get the economy back on track. He made the remarks to workers at an orange juice plant in Bradenton, Florida. He said he would fight to get an economic growth package through Congress next year. Pan American Airways could be forced to stop flying in a matter of days. Delta Airlines today backed out of an October agreement to finance Pan Am's remaining operations. Pan Am sold most of its routes and now flies mainly to Latin America. It is operating under federal bankruptcy protection. The airline could be permanently shut down if it fails to find a new investor this week.

MR. MacNeil: That's our summary of the news. Still ahead on the NewsHour, the Sununu resignation, health care in Hawaii, Nelson Mandela, and Rosenblatt on Pearl Harbor. FOCUS - RESIGNED

MR. LEHRER: The going of John Sununu is our lead story tonight. His resignation as White House Chief of Staff was announced today. It came after several very intense days of very intense speculation that his departure was coming. The how and why of his going is what we are going to discuss now with two White House reporters, Maureen Santini of the New York Daily News, and Dan Goodgame of Time Magazine, and with our own political analysis team of Gergen & Shields, David Gergen, editor at large of U.S. News & World Report, syndicated columnist Mark Shields. Maureen, why? What happened? Was there a chain of events that led to it?

MS. SANTINI: Yes, I think there was. I talkedto several Republicans today who said this story has been going on for eight or nine months. I think the reason it culminated this week was there were two big errors by Sununu in the last few weeks, one having to do with the credit card fiasco when he went on television and said it was Bush's fault, not his, and the other having to do with civil rights legislation. And there were a few other things too. At that point, just about everybody recognized this man is a political liability, but what do we do? And I think the sequence of events started in earnest last Wednesday night when the President's son, eldest son, George W. Bush, met with Sununu and we are given to believe informed him that he had become a political liability and hoped that Sununu would volunteer to step aside. As far as I can tell, that did not happen. On Saturday, Mr. Bush met with his most trusted adviser, Sec. of State James Baker. We can only presume that they discussed this matter. And I know for a fact in-between these days the President was on the phone with longtime Republicans who were telling him almost using words that we can't say on television, throw the rascal out. On Sunday, Mr. Bush came back from Camp David and met with Sununu and that night, significantly, he had dinner with Sam Skinner, the Secretary of Transportation, who, by the way, my sources say will be offered the job tonight to replace Sununu. In any event, one Republican told me today they thought they had an agreement for Sununu to resign on Monday. That did not happen. I don't exactly know why. On Tuesday, there were front page stories in the New York Times and the Washington Post saying that George Bush was trying to get Sununu out, recounting --

MR. LEHRER: George W. Bush, the son, was trying to get him out?

MS. SANTINI: Right. And recounting the conversation that had happened last Wednesday, I am told the conversation was very, very closely held. In fact, one very high ranking Republican told me they had been speed dialing the entire Western world to find out what happened and couldn't. What I'm saying I guess is that I believe the story leaked today for a very specific reason. I believe they were trying to send him a message. And I think they did send him a message and by --

MR. LEHRER: They being.

MS. SANTINI: The White House. And by the end of the day today he had resigned after Bush, himself, today was put in the awkward position of not supporting him, reporters asked him, I think at that point he was in Florida, do you want your chief of staff to resign, and he said, I'm here to talk about orange juice.

MR. LEHRER: Yeah.

MS. SANTINI: And I think that was the final straw and he resigned this afternoon.

MR. LEHRER: Dan, anything you want to add or subtract to that?

MR. GOODGAME: Well, I think it's important to understand that John Sununu has not changed so much as events have changed. John Sununu's been through this before during the 1990 budget agreement when people thought that he should be ousted then, particularly a number of conservative Republicans did. Also, during his difficulties with the use of government aircraft for personal business, people thought that he would be gone then, and he wasn't. What's brought him down is the decline in the economy and the decline in the President's poll numbers.

MR. LEHRER: So no matter what foul-ups may or may not be attributed to him, correctly or incorrectly, he would still be chief of staff tonight if the President was doing terrifically well in the polls?

MR. GOODGAME: Correct. One of the things that's always been overlooked about John Sununu is the good job he's done for President Bush as a lightning rod, because when people don't like the President's economic policy or environmental policy, they say, oh, it's that nasty John Sununu again.

MR. LEHRER: They did that on civil rights.

MR. GOODGAME: Right. And it's a role that was specifically designed for John Sununu. Looking at the letter that Sununu handed to the President today, handwritten, it says, "I assure you that in pit bull mode or in pussycat mode, your choice, as always, I am ready to help." This is John Sununu's way of saying I always did just what you wanted me to. George Bush watched Jim Baker for years as Ronald Reagan's chief of staff, blamed Ronald Reagan when anything wrong, take the credit when anything went right. George Bush didn't want that kind of chief of staff and he didn't get it in John Sununu.

MR. LEHRER: But listening to Maureen, Dan, the idea that the President of the United States had to send a signal through his son to his own chief of staff, hey fellah, it's time to go, seems kind of weird to me.

MR. GOODGAME: Well, they'd been through it twice before, and, you know, George Bush has a saying from his Navy pilot days, you don't pull away from your wing man when he's under fire. And that's been an article of faith for John Sununu up until now. Now, I guess the new version of that around the White House is you don't let the whole squadron go down because one plane's, you know, using fuel and losing altitude.

MR. LEHRER: Yeah. Yes.

MS. SANTINI: Also, we have to remember this isn't so terribly dissimilar from other cases in other White Houses. Remember Don Regan and the role Nancy Reagan played to oust him. Presidents have traditionally been very loathe to simply cut and run and in this case I think we can assume that George Bush tonight is very, very pained over what happened. And someone told me today he never would have fired this man, it was up to him to resign.

MR. LEHRER: Yeah. David, you said here on this program Wednesday, a week, almost a week ago, that Sununu was probably, well, you said definitely he was going. So your scenario probably jives with Maureen's. It just took him a week to get rid of him, is that what you're saying, is that correct?

MR. GERGEN: Both with Maureen's and with Dan's. I think Dan has - - the larger point here is that John Sununu was the master of the President's political fortune. When the President dropped 40 points in the polls, it became inevitable that the man would be fired. It's like a baseball manager who's lost 20 of his last 25 games. At some point you lose your job. And the President has just experienced his worst month in the history of his Presidency. So I think the dynamics are there. Now John Sununu contributed to the accelerating process not only through his past escapades on travel but through the recent miscues in the White House. There have been a lot of flip flops over the last four weeks, as we all know, and I think that they have been laid on his doorstep so that that's added weight.

MR. LEHRER: You mean if he had not had the problems with his airplane, the air Sununu problems, if he had not made this remark that the President ad libbed on the credit cards, it would have been a little more difficult to get rid of him?

MR. GERGEN: Yes, and also if he'd been a more popular figure in Washington, if he'd been a Howard Baker kind of figure I think it would have been harder. But given the fact that the President is going through this difficult period, they're just going into a campaign, they can't get anything else done till they get this resolved, I just -- just one brief historical footnote, Jim.

MR. LEHRER: Sure.

MR. GERGEN: You said it's sort of an odd way to fire. It is an odd way to fire your chief of staff, but it's worth remembering the last time that New Hampshire sent a man to be chief of staff was Sherman Adams, who had this same imperious quality about him when Dwight Eisenhower was President, and Eisenhower had to go to his Vice President, Richard Nixon, to be an intermediary to Sherman Adams to say it's time.

MR. LEHRER: So what's the message there?

MR. GERGEN: The message is you might not want to go to New Hampshire to find your chief of staff. [everybody laughing]

MR. LEHRER: I was afraid you were going to say that. We're going to get a lot of calls from New Hampshire.

MR. GERGEN: I think the real message is the imperious quality of the man.

MR. LEHRER: Mark, everybody has commented on this man's personality. He's been here three years now. Everybody knew what his personality was and everybody's commented on it, mostly negative. How important is his personality to, a factor has that been in his demise today, do you think? If he'd been a terrific guy, do you agree with David, if he'd been Howard Baker or somebody or James Baker, forget the friendship thing, but that kind of personality, could he have survived this, even the difficult times that Bush is in right now?

MR. SHIELDS: He may have been able to, at least a little bit longer, Jim. I think, you know, if you're talking about who gets good press in Washington, nobody gets better press than moderate Republicans, I mean, Howard Baker being the perfect example. I mean, it isn't liberal to get great press. It's moderate Republicans. Everybody, Democrats really have to like a moderate Republican and moderate Republicans --

MR. LEHRER: Encourage them to --

MR. SHIELDS: They're so damn reasonable. And so John Sununu wasn't that. I mean, John Sununu what you saw was what you got. Here's a guy who got his job because of one campaign and lost it because of another. He got his job because in the 1988 campaign George Bush flew into New Hampshire from Iowa and those of us who were there, he was dead meat politically. He had finished behind Pat Robertson. He had finished third in the Iowa caucuses, and if he lost New Hampshire, it was over, forget firestorms, forget the South or anything, and John Sununu was there, and he said, you're going to win. And Barbara Bush said, John, don't tell us that unless it's the truth. He said you're carry the state by eight points. And John Sununu picked that campaign up. He really did. He was a pain in the neck then. He was abrasive. He was imperious. He was all of those things and he was in the White House. And he lost his job for the very reason that's been stated here, because George Bush is dropping like a rock, and it's a lot easier to change personnel than it is to change policy.

MR. LEHRER: Maureen, I know there's no universal list that you would give to rate chiefs of staff, but just forget personality, forget politics. Was John Sununu a good chief of staff for George Bush?

MS. SANTINI: Oh, gosh, I suppose it's hard to say that a President who had unprecedented popularity for most of his first three years was at least initially ill served by this man, but what happened was his personality became such a dominant factor, he alienated so many people who really wanted a pipeline to George Bush.

MR. LEHRER: Like who?

MS. SANTINI: A lot of Republican Congressmen on the Hill, and then they started having things leak out that they didn't want, for instance, some letters that some Republicans were writing that were embarrassing the President. I talked to one Republican today who said, you know, we used to have a group of Congressmen who would meet and iron these things out before they became public, and where is that group? And the same thing lately, I think lately he's not been a good chief of staff because all these things would happen to the President and you'd say, where was the guy who was supposed to be watching out for the President's best interest, on the flip flop on civil rights, on credit cards and things like that, so in the end, no, I don't think so.

MR. LEHRER: Dan, Maureen said that her sources say that Sam Skinner's going to be offered the job tonight. Is that what you said?

MS. SANTINI: I'm given to believe he'll be meeting with the President tonight.

MR. LEHRER: What do sources close to Time Magazine say?

MR. GOODGAME: I think her sources are a lot more specific than mine at this point. Sam Skinner's been mentioned for quite some time.

MR. LEHRER: Let's remind everybody who he is. He's from Illinois. He's an Illinois lawyer, a close, longtime political friend of George Bush. He is now Secretary of Transportation.

MS. SANTINI: And importantly, not considered a conservative.

MR. LEHRER: Oh, is that right?

MR. GOODGAME: That's right.

MR. LEHRER: He's another one of those good moderates?

MS. SANTINI: Uh huh.

MR. LEHRER: You in the press are going to do a good number on, is that it?

MR. GOODGAME: Someone who's considered a good crisp manager. I mean, George Bush in cases where several cabinet agencies have had a shot at a particular crisis like the oil spill in Alaska, he's chosen Sam Skinner to take the lead on it.

MR. LEHRER: And, David, the story I read, one of the stories I read today said that he, Skinner very much wants the job, is that true?

MR. GERGEN: Well, he just got his transportation bill through the Congress here a couple of weeks ago, so that he's basically got his monument built at the Transportation Department. This is a good time to move on for Sam Skinner. He's the kind of fellow who likes politics. He does have a political background. He helped to run George Bush's campaign in Illinois back in '88. He also ran a Jim Tunsten campaign. So that gives him the kind of political credentials that would be important in a campaign here. Sam Skinner's a very ambitious, effective man. He is the kind of model you ordinarily look to to find a chief of staff.

MR. LEHRER: So if Maureen is right and he is offered the job tonight, your feeling is he'll take it?

MR. GERGEN: My feeling is he'll take it. I think there is an outside chance of another scenario, and that is, I can conceive of Sam Skinner going to the Defense Department and Dick Cheney coming in to be the chief of staff.

MR. LEHRER: But, David, Dick Cheney's leaving tomorrow on a ten- day visit around the world.

MR. GERGEN: Dick Cheney can do a lot of things. I know he's scheduled to leave, but I'll say this. There are a lot of people in town that would like to see Dick Cheney -- but I think these people are right. Sam Skinner is the very, very likely choice.

MR. LEHRER: What do sources close to Mark Shields have to say about this?

MR. SHIELDS: I think that sources close to me have very little to say about it, other than John Sununu's gone. I was reminded of a button that legislators used to wear in New Hampshire, "Will Rogers Never Met John Sununu." But John Sununu, I mean, John Sununu didn't change when he came to Washington. He's the same guy that you saw when you went to New Hampshire, and the old Washington line about false humility is better than none at all and John never pretended to have false humility. He was just as, just as vain and just as sure of himself at any time.

MR. LEHRER: What word have you heard on Skinner?

MR. SHIELDS: I've heard Skinner. I've heard that Skinner wants it and Skinner unseemly positioned himself earlier, when one of the earlier flaps, I think it was air Sununu, when Sununu was flying everywhere in government aircraft --

MR. LEHRER: Skinner said, what about me?

MR. SHIELDS: He slipped his resume under the door and said, hey, hey.

MR. GOODGAME: Another name that's come up is Fred Malek, who is a banker in Washington, longtime friend and political adviser to the President, also is considered a very good man.

MR. LEHRER: And also is in line to have a key job in the campaign, is he not?

MR. GOODGAME: Well, that's one of the things that's brought this to a head, because as the White House and the party have been looking at what to do about the economy, no one can agree what exactly to do in economic policy, but almost everyone agrees that what they have to do politically is to get on a campaign footing and start responding in a political way to these, you know, initiatives by the Democrats. And as the President sought advice on this, the consensus advice that he got was that you're not going to be able to get very far unless you get rid of John Sununu.

MR. LEHRER: Okay.

MR. SHIELDS: He'd better move quickly on it though because, otherwise, the conservatives, those who are miffed and hurt at John Sununu and the President's flops or whatever on policy, are going to start the little drum beat.

MR. LEHRER: Well, fortunately, we do this program five nights a week so we'll see what happens tomorrow. It could be Skinner, if Maureen's right. We'll see. Thank you very much, all four.

MR. MacNeil: Still ahead on the NewsHour, health care in Hawaii, Nelson Mandela, and Rosenblatt on Pearl Harbor. FOCUS - TOTAL COVERAGE

MR. MacNeil: We turn next to an issue that will play a major role in the 1992 elections, health care. The complaints about the current system are universal. American health care is too expensive and too many people have little or no access. These are problems the state of Hawaii is trying to solve with its own health care insurance plan. Correspondent Jeffrey Kaye of public station KCET- Los Angeles reports.

MR. KAYE: Unlike millions of other Americans, when residents of Hawaii enter clinics and hospitals, they generally know that most of their costs will be paid by insurance.

SPOKESMAN: Are you covered? Are you insured?

PATIENT: I'm covered pretty well.

MR. KAYE: Even these single moms on welfare have no complaints about their health care coverage.

MR. KAYE: What doesn't it take care of? Is there anything that's not covered?

MOTHER: Just about everything.

MR. KAYE: Really?

MOTHER: Yeah.

MR. KAYE: So have you been able, could you get prenatal care?

MOTHER: Yes. They covered that too.

MR. KAYE: They covered that too?

MOTHER: They cover it all, take care of the hospital and everything.

MR. KAYE: Really?

MOTHER: Yeah.

MR. KAYE: Officials boast that 98 percent of Hawaii's population has health coverage. By contrast, nationwide, about 14 percent of the U.S. population has no health insurance at all. That's the case for some 35 million Americans, most of them working people, and their families.

DR. JOHN LEWIN, Hawaii Health Department: Hawaii by health outcomes is the healthiest place in America.

MR. KAYE: Dr. John Lewin is director of the state's health department.

DR. LEWIN: It has the lowest early death rates from cancer, heart disease, for emphysema, the lowest infant mortality, tied with Vermont this year, of American states, and the lowest health care costs in the United States today where small business pays about half of what its counterparts pay on the mainland for health insurance, for out-of-pocket costs, and for total health care.

MR. KAYE: Most businesses in Hawaii are required to carry health insurance. That's the cornerstone of the state's program, in place since 1974.

DR. LEWIN: If you have a job, period, you have health insurance. Every worker in this state who works 19 hours a week or more has a health insurance policy, as does his or her family members, if they so choose.

MR. KAYE: And if you work fewer hours than 19?

DR. LEWIN: Then you're covered by a program which we developed here in the last few years called SHIP, the State Health Insurance Program, where it's a split cost between you and the state of Hawaii.

MR. KAYE: The vast majority of Hawaiian residents are covered by health plans carried by employers. Under state law, workers pay a portion of the insurance, 1 1/2 percent of gross wages, or half the premium, whichever is less. While employers can choose their health plans, the law requires a minimum package of benefits. Those include full hospital care up of to 150 days, emergency services, physician visits, maternity and well baby care. According to Dr. Lewin, the system emphasizes prevention.

DR. LEWIN: And that's part of the reason our rates are low. Our out patient visits are twice the per capita number as the rest of the country, twice as many visits to the doctor's office, to the primary care provider's facility, but the in-patient, the super- expensive visits, are half to two-thirds the national average. And that's the source of saving the cost. And that's also part of the information as to why people live longer with cancer, heart disease, et cetera. They get diagnosed sooner.

MR. KAYE: But Hawaii's system of universal health care coverage does not get universal acclaim from the business community. Some companies, small businesses in particular, consider employer- mandated insurance an unnecessary burden. The Cona Ranch House, a restaurant in Kailu, Acona, employs about 60 people. Owner Bill Brye says it costs him about $5,000 a month to provide the required health insurance. That's 5 percent of his monthly earnings and that's just for starters.

BILL BRYE, Restaurant Owner: Other than health care, you must provide all types of different insurance, worker's compensation, general insurance, liability insurance, unemployment insurance, all of which eats away at the bottom line, if there is any.

MR. KAYE: And you think then that this is too much of a burden for you?

MR. BRYE: I think it could be spread out in a different way.

MR. KAYE: What do you say to some of the small businesses who say that's too much of a burden?

DR. LEWIN: Well, what I say to 'em is they're right, of course, but I want them at least to know where we're starting from, that in Hawaii small businesses are buying insurance policies that cost between a thousand and twelve hundred a year for their employees, or three thousand a year for their families. They don't know what's going on in America today where the prices are twice to three times that wherever you go, and where they are literally excluded from buying coverage and underwritten and if somebody in your business had diabetes or AIDS, the whole company is either thrown out or the rates triple. That doesn't happen in Hawaii.

MR. KAYE: Doesn't happen because employees around the state make up what is essentially one large insurance pool. 60 percent of the state's population, some 670,000 people, are insured through one company, the Hawaii Medical Service Association, Blue Cross-Blue Shield of Hawaii. Marvin Hall is the company's president.

MARVIN HALL, Hawaii Medical Service Association: We would never cancel anybody. We would never fail to enroll any employer and if you have the worst kind of experience, you would still pay the standard rate just along with anybody else.

MR. KAYE: And what about the system enables you to do that?

MR. HALL: We're guaranteed that within an employer every employee is going to buy coverage, not just the high risk people. So if we're into an employer, we're going to get the good with the bad.

MR. KAYE: So the fact that there's a mandated system guarantees a large pool and helps cut the risks.

MR. HALL: Helps keep the risk down, yes, definitely.

MR. KAYE: As the state's major health insurer, HMSA is a sounding board for complaints about the system.

SERVICE REPRESENTATIVE: [On Phone] I wish that you didn't have to call so often but I can assure you that I will take care of this.

MR. KAYE: The most frequent complaints have to do with access, patients with health insurance in search of doctors who will take them.

DOCTOR: [Talking to Woman in Hospital] You don't have a doctor, huh? Can't get in to anybody. That's a problem.

MR. KAYE: The problem is most severe for people on welfare, in Hawaii known as DSS. They often can't get seen by doctors who can pick and choose between patients with private insurance and those who rely on less profitable Medicaid. Delsea Detalamoa went six months without seeing a doctor even though her thyroid condition is serious.

DOROTHY ELDERTS, Patient's Mother: Most of the doctors don't take welfare people, so it is difficult for her to get help, medical.

MR. KAYE: Were you turned away by doctors?

PATIENT: Yes.

MR. KAYE: What did they tell you?

DOROTHY ELDERTS: They don't take DSS. She was getting sicker and sicker. That's the reason why we brought her in to the emergency room to get help.

DR. FRED HOLSCHUH, Hilo Hospital: I'm surprised she didn't come in her sooner.

MR. KAYE: Dr. Fred Holschuh is chief of staff at Hilo Hospital on the Island of Hawaii.

DR. HOLSCHUH: She'll get good care here now and she'll get good care in the hospital and then the question is whether she will be followed by the physician who takes care of her by virtue of either admission or discharge from the ER to that person's practice. It's not a guarantee.

MR. KAYE: As with the rest of the country, the problem of access is particularly acute among the rural poor. Hilo Hospital is located in an economically depressed area of the state, a region that's been hit hard by the downturn in the sugar industry. There aren't enough doctors to go around.

DR. HOLSCHUH: You, yourself, probably couldn't go call a doctor's office right now and get in this afternoon if you had bronchitis or something and said, oh, I'd like to see a physician. You'd be directed to the emergency room.

MR. KAYE: So, exacerbated by a shortage of doctors and nurses, Hawaii's emergency rooms fill up just like on the mainland. In rural Hilo, the hospital sometimes sends patients to Honolulu, more than 200 miles away, for treatment. Universal health insurance means Hawaii hospitals have no shortage of patients. Access to health care is a particular problem among native Hawaiians. They comprise some 20 percent of the Hawaii population and are generally poorer in health and income levels.

DR. ALEXANDER MILES: [Talking to Patient] Well, I think this one is --

MR. KAYE: Dr. Alexander Miles, who is part native Hawaiian, himself, says many Hawaiians have never accepted Western medicine.

DR. MILES: The older people don't trust Western medicine much. I think in Western medicine you see larger volumes of patients and you don't spend the time that you would under the old system, where maybe a medicine man would spend. Like they may spend one hour or two hours with one patient, establish rapport and laying of hands, and a real trust, bond between the patient and the healer which doesn't exist in Western medicine.

MR. KAYE: Henry "Papa" Auwae is a medicine man, a native Hawaiian healer. He treats his patients with medicinal plants which he cultivates and gathers. He says patients he sees often won't go to doctors.

HENRY "PAPA" AUWAE: I think of all the Hawaiians I really can tell you about 90 percent of them.

MR. KAYE: 90 percent of them are what?

HENRY "PAPA" AUWAE: They don't believe the white man's way of treating them.

MR. KAYE: Hawaii officials concede the problem has its limitations and they're already embarking on a reform program.

DR. LEWIN: I can give you a whole list of flaws in the Hawaii system. It's just that we're light years ahead of everybody else and we've got some incredible results of 17 years of duration that need to be examined. The people of Hawaii have a system of health care that works better than any place in America.

MR. KAYE: Hawaii officials say they're disappointed that in a search for answers to America's health care problems, Hawaii has generally been overlooked. U.S. Sen. Daniel Inouye says that's because Hawaii often isn't taken seriously.

SEN. DANIEL INOUYE, [D] Hawaii: It's an attitude thing, so a plan comes out of Hawaii and they say, oh, oh, must be made out of coconut milk. I hope they'll take us seriously for a change, because our plan can save lives.

MR. KAYE: But here in California at least one official does take the Hawaii plan seriously. Dr. Molly Joel Coye, director of the state's health department, calls Hawaii our most important laboratory.

DR. MOLLY JOEL COYE, California Health Department: I think it could operate in the mainland. There's no question about that. Whether the politics of creating here are possible I'm not at all sure.

MR. KAYE: What? What are the roadblocks?

DR. MOLLY JOEL COVE: Well, there is a lot more skepticism about mandated health insurance now and very real concern about the impact on small employers.

MR. KAYE: Why is it that the system of employer mandates might work in Hawaii and not elsewhere?

DR. MOLLY JOEL COVE: The easiest answer, and it may be true, is that it's an island, that there was really no problem in terms of competition, the small employers couldn't leave Hawaii very easily, and so you had a captive economic population in a sense.

MR. KAYE: Supporters of the Hawaii health care system say their plan might work for all Americans, but they realize it'll take a whole lot of political maneuvering to make it happen. NEWSMAKER

MR. LEHRER: Next tonight a Newsmaker interview with South African leader Nelson Mandela. Charlayne Hunter-Gault conducted the interview.

MS. HUNTER-GAULT: Mandela's visit this time is a comparatively low key affair in contrast to the tumultuous greeting he received when he came to the United States in 1990. That visit came soon after Mandela's release from nearly 30 years in prison. Then Mandela was the internationally renowned symbol of the struggle against apartheid, a modern day hero. Now, even he calls his trip a pragmatic mission. Since his release from prison, Mandela has been negotiating with the government of President F.W. DeKlerk over how to dismantle apartheid and to draft a constitution that for the first time gives political power to the black majority. Just this weekend, the government, the ANC, and other groups finished the preliminary work for a constitutional convention that would begin December 20th. That historic gathering is supposed to negotiate the political future for a non-racial, democratic South Africa, but it's not been all smooth going for Mandela and the ANC. Fighting and killing among black groups, especially between the ANC and the Zulu-based Inkatha movement, has claimed thousands of lives. While the violence has been abating recently, there are other problems. More radical black nationalist groups have criticized Mandela's approach to negotiating reform, threatening to boycott the Constitutional Convention. In turn, more radical white groups have criticized the DeKlerk government and the conservative party has shown some strength in bi-elections, indicating dissent and division in the white minority. Meanwhile, in this country the Bush administration lifted most sanctions on South Africa last summer. But Mandela continues to urge that all sanctions remain in place for the time being. I talked with him about this and other issues earlier today.

MS. HUNTER-GAULT: Mr. Mandela, thank you for joining us.

MR. MANDELA: You're welcome.

MS. HUNTER-GAULT: Over the past weekend, I think it was 19 of the 20 parties that will be involved in the process of establishing a constitution in South Africa met and Cyril Ramaposa, the secretary general of the African National Congress, said we are convinced we are walking the last mile. Why was he so hopeful, and do you share that optimism?

MR. MANDELA: Well, he is hopeful because in the first place we have got a very powerful case for effecting, for the effecting of democratic changes in our country. Secondly, what has happened in the past in the discussions between the ANC and the government gives us the hope that in future discussions we are going to score as much success as we have already done.

MS. HUNTER-GAULT: So you think the process is irreversible?

MR. MANDELA: No. It cannot be irreversible until the majority of the people of South Africa or in parliament are able to defend whatever democratic changes have been brought about. That moment has not yet arrived.

MS. HUNTER-GAULT: When the groups meet again on the 20th of December, all of the parties come together, what do you expect to happen?

MR. MANDELA: There are certain important issues which are going to be addressed at that convention, the question of the constitutional principles upon which the Constitution should be drafted, the mechanism for supervising the transformation from an apartheid state to a democratic society, the mechanism which should be adopted in order to draw up the Constitution that the masses of the people themselves should be involved in that process. There should be no negotiation above the heads of the people. And the question of the reincorporation of the so-called independents, these are the principle issues that will be addressed.

MS. HUNTER-GAULT: Now, as I understand it, the ANC wants an elected constituent assembly to draw up a Constitution. The DeKlerk governmentdoes not want that. How do you see that being resolved, or has a deal already been struck on that?

MR. MANDELA: They have no case whatsoever to oppose an elected constitutional assembly because that is the democratic process, that the masses of the people should mandate any persons who are going to be entrusted with the task of drawing up a new Constitution.

MS. HUNTER-GAULT: But how do you see that issue getting resolved? Do you see that as a major sticking point?

MR. MANDELA: It is being resolved now because we are nearer, the government is nearer to our thinking than many people realize.

MS. HUNTER-GAULT: So you're saying that there will, you're predicting that there will be an elected constituent assembly?

MR. MANDELA: We are demanding that and there is no substitute to an elected constituent assembly. Whatever compromises we might make, until we assure the minority of whites in the country that they have nothing to fear from a democratic South Africa, whatever concessions we make, it will not be on this ground. An elected constituent assembly is absolutely necessary.

MS. HUNTER-GAULT: What do you see then as the biggest obstacle now facing these talks?

MR. MANDELA: The biggest obstacle is the thinking of the regime that from what has happened so far they are changing their thinking. We are not, however, unduly optimistic and that is why we keep on saying that in addition to the discussions that we're having we are reserving the power of the people to coerce the government if discussions do not quite fit with the results that we require.

MS. HUNTER-GAULT: You mean demonstrations?

MR. MANDELA: Demonstrations and other form of mass pressure.

MS. HUNTER-GAULT: How concerned are you about the cohesiveness of black groups in this process?

MR. MANDELA: We have agreed on the convention for a democratic South Africa, the dates and the agenda, and we appointed a steering committee from the 19 political organizations which stood unanimous in spite of the attempts by one group to destabilize that unity and the resolution which emanated from that meeting.

MS. HUNTER-GAULT: Do you see it as a serious threat to the process?

MR. MANDELA: We don't see it as a threat at all. We think that their action is merely a storm in a teacup. And I would spend no sleepless nights over their withdrawal from the talks.

MS. HUNTER-GAULT: That's the group, the PAC. What about the violence, Mr. Mandela? Do you see an end point to the violence?

MR. MANDELA: The important thing is that the major political parties have now realized that no useful purpose can be served by us not taking effective steps to put an end to the violence. And we have spent quite a great deal of time in assuring that we should be able to put an end to all kinds of violence, whether they come from the political organizations of the oppressed, from the government, or from its security forces, or from the hit squads which have been ravaging the country for so many years.

MS. HUNTER-GAULT: So that you feel all of the groups bear some responsibility?

MR. MANDELA: That is correct in a way, although the violence that was sparked off by political differences amongst the resistance group has been reduced to a mere trickle. And the main violence of which today is a cause of great concern comes from some element of the state security forces and there is clearly connivance on the part of the government because they are not using their capacity to put an end to the violence, a capacity which they enjoy.

MS. HUNTER-GAULT: Does the ANC favor an interim government while these constitutional arrangements are worked out?

MR. MANDELA: That is our demand, but we must have an interim government of national unity because one of the problems is the present regime. That is one major obstacle to the formation of a democratic South Africa. And, therefore, an interim government which would be seen to enjoy legitimacy and credibility and as representing the masses of the people is the answer.

MS. HUNTER-GAULT: How would it work? I mean, for example, just operationally, if the ANC were a part of it, are there areas that you would target that you would want to have responsibility for?

MR. MANDELA: This is a matter for negotiation which can, one cannot speculate on on the basis of individual views, but what we are concerned with is that there should be a representative government which is going to be seen to be expressing the will and wishes of the majority of all the people of South Africa, and that interim government should exercise sovereign powers. In fact, one of the conditions on which we are insisting at this convention for a democratic South Africa is a clear commitment on the part of the government that its decisions will be given legal force.

MS. HUNTER-GAULT: Is that going to happen? Is there going to be an interim government?

MR. MANDELA: Well --

MS. HUNTER-GAULT: Because there are rumors that the ANC and the government have already agreed on this and that it's going to take place in February.

MR. MANDELA: Well, don't worry very much about gossip. As political organizations and as institutions of information, let us base our views on facts which can be proven.

MS. HUNTER-GAULT: You have urged the U.N. and others to keep the pressure on South Africa, not to remove sanctions until the ANC sends the signal for this to happen. What will be the trigger mechanism that would cause the ANC to say, okay, now it's time? Would it be an elected constituent assembly, an interim government, what?

MR. MANDELA: We have made it clear in all our policy documents that a certain category of sanctions will be lifted as soon as an interim government has been installed.

MS. HUNTER-GAULT: That category being?

MR. MANDELA: This is diplomatic sanctions, gold coins, trade, trade credits, financial sanctions, all these will be lifted as soon as an interim government has been installed.

MS. HUNTER-GAULT: And not before?

MR. MANDELA: And not before. And then, of course, oil embargoes and arms embargo when a democratic Constitution has been accepted.

MS. HUNTER-GAULT: How has the U.S. lifting of sanctions which you argued against affected the process, the process towards democratization?

MR. MANDELA: Not really, because the decision of the United States government was premature and wrong and nevertheless, in spite of the fact that they have elected a certain group of sanctions, we still insist on the maintenance of sanctions.

MS. HUNTER-GAULT: You're going to be seeing President Bush and presumably Sec. of State Baker while you're here. What role do you see for the U.S. government in the process now?

MR. MANDELA: Certainly the United States government can play a very positive role in assuring the speedy forward movement in our quest for democratic changes. But precisely what I will say to President Bush should not be a subject of our discussion here.

MS. HUNTER-GAULT: There are those who say that the ANC has sent mixed signals about the investment climate in South Africa. Can you clarify the ANC position for this audience on the subject of nationalization and under what circumstances this might happen?

MR. MANDELA: We have got a stated position as far as economic issues are concerned, but we realize that the building of a shattered economy in any country cannot be the responsibility of one organization. And for that reason we have gone out of our way to circulate a draft economic policy to business generally inside and outside the country, because one of the policies that we have accepted and on which we are working is that we can only succeed in rectifying all the imbalances in our economic situation by cooperation with business and other opinion makers. And our, this process is far advanced already.

MS. HUNTER-GAULT: Finally, Mr. Mandela, do you feel now that the ANC is on a level playing field, that you have the resources to compete equitably in this process of moving towards a democratic, non-racial South Africa?

MR. MANDELA: The response from governments and the people in all continents to our appeal for resources has been very positive. In some cases, that response has exceeded our wildest expectations.

MS. HUNTER-GAULT: Well, Mr. Mandela, thank you very much for joining us.

MR. MANDELA: You are welcome. ESSAY - PEARL HARBOR REMEMBERED

MR. MacNeil: We close tonight with another in our week long series of essays and reports marking the 50th anniversary of the attack on Pearl Harbor. Our essayist tonight is Roger Rosenblatt, editor at large for Life Magazine.

MR. ROSENBLATT: When I visited the memorials of Hiroshima in 1985, I was struck that nowhere was there mention of Pearl Harbor. The two bombing raids are linked in the minds of Americans but not in the Japanese. In the Hiroshima Memorial Museum, every token of destruction is on display except Pearl Harbor. It is not a museum of war or of politics, but of catastrophe, thus the exhibits, photographs of burned blackened bodies, a melted lump of coins, clumps of hair that had fallen from the heads of Hiroshima's victims, fingernails two and three inches in length that had grown on a hand where the skin was burned off. Most eery of all, a picture of the shadows of vaporized people that remained in the street after the people had been blown away. But no Pearl Harbor, nothing of Pearl. In the minds of the Japanese, the fact that they began the sequence of attacks that ended in Hiroshima is like the bodies that disappeared, leaving the shadows as remnants. Hiroshima is the shadow, but the original substance, the cause of the shadow, is not to be seen. Effect, the Japanese have decided to dwell not on cause but effect. I find this very strange and unsettling not just when the Japanese do it but when any country, including ours, decides to skew history toward its own self-pity or self-righteousness. It may be said that Pearl Harbor cannot fairly be compared to Hiroshima, the scope of damage so different, the consequences for the world so different. But had there been no Pearl Harbor, there never would have been Hiroshima. So maybe the nuclear age started not on August 6, 1945, but on December 7, 1941, when conventional bombs and torpedoes struck Awahu. Maybe all that has ensued in nuclear threat and diplomacy in the past 50 years started in Pearl. Maybe Pearl was Hiroshima. Nothing but debating points is to be gained by arguing such things. But I think there is something valuable in being clear about cause and effect, especially when it comes to wars. There are no isolated acts of war. War is by nature an institution out of control. It is meant to breed chaos. He who survives the chaos wins. To think of Pearl Harbor as merely the first slight push in a process that led to the most destructive shove in history is a grave mistake I believe, both for the Japanese and for anyone who recoils reasonably from the terror of Hiroshima. Whenever a slight push occurs in war, Hiroshima is the shadow in waiting. Give me the Arch Duke Ferdinand, a tiny, insignificant assassination. Give me the Sudatanland, a tiny, insignificant territory. The chain reaction doesn't happen only in bombs. The chain reaction is us. The propensity for war is so obvious in history, the fact that we never catch on to the connection of cause and effect has got to be a sign of human perversity. But at least we ought to acknowledge when we look at Pearl and Hiroshima that a real bridge exists between these islands and others. "There never was a war that was not inward," wrote Marion Moore. When war emerges from a mind, it may start out in a very small place, but eventually everyone is heard to say exactly what the pilots of the Anola Gay exclaimed as they let their cargo drop -- My God, what have we done! I'm Roger Rosenblatt. RECAP

MR. LEHRER: Again, the major stories of this Tuesday, White House Chief of Staff John Sununu resigned, hostage Alann Steen was released by his captors in Lebanon. That leaves only one American still being held. He is Terry Anderson, the Middle East bureau chief for the Associated Press. There were reports Anderson will be set free tomorrow. Good night, Robin.

MR. MacNeil: Good night, Jim. That's the NewsHour tonight and we'll see you tomorrow night. I'm Robert MacNeil. Good night.