The MacNeil/Lehrer NewsHour

Intro JIM LEHRER: Good evening. Leading the news this Thursday, Secretary of State Shultz said the U. S. will stop military support for Afghan rebels once a Soviet troop withdrawal begins. A winter storm hit the south and moved on north and east. And British actor Trevor Howard died. We will have the details in our news summary in a moment. Robin? ROBERT MacNEIL: After the news summary, we look first at child care legislation. Congressional correspondent Cokie Roberts reports on the politics of the issue, and three experts on child care debate the rival proposals. Next, an update on the case of the Johns Hopkins Hospital doctor who contracted AIDS. He now faces deportation. And finally, we have a remembrance of British actor Trevor Howard.News Summary LEHRER: There was more serious talk today of a settlement in Afghanistan. Secretary of State Shultz said in Washington the U. S. is ready to withdraw its military support for the anti government, anti Soviet Afghan rebels once Soviet troop withdrawals begin. He spoke at a State Department news conference. GEORGE SHULTZ, Secretary of State: We look for Soviet agreement to a firm schedule for withdrawal. We think that schedule must be front end loaded so that once it starts there's a certain inevitability to it, there's no turning back. BARRY SCHWEID, Associated Press: Would the United States stop aiding the resistance at the beginning of the withdrawal, some point during the withdrawal, when it's completed? Sec. SHULTZ: As withdrawal proceeds, as it takes place, we hope in a peaceful atmosphere, then you don't have the need for that continued support, then it would cease. LEHRER: The Secretary said the U. S. would continue to support humanitarian concerns and economic development, even after the Soviet withdrawal. Robin? MacNEIL: Secretary Shultz also referred to the Palestine demonstrations in Israeli occupied territory, saying authorities could maintain law and order without the use of lethal force. A U. S. Senator, Republican John Chaffee of Rhode Island, had to cut short a visit to a Palestinian camp when demonstrators hurled stones and bottles at his party of U. S. and United Nations officials, and the army responded with tear gas. The incident occurred when the visitors were touring the Kalandia Camp north of Jerusalem. No one was hurt in the incident. Later in the day, Israeli troops shot dead one Palestinian, as the protest spread. At least 26 Palestinians have now been killed in the unrest over the last month. Michael MacMillan of the BBC has a report on one of today's confrontations. MICHAEL MacMILLAN, BBC: Controversy over Israeli security tactics continued today when this bus full of Arabs was boarded by police, who used the vehicle to fire tear gas grenades at rioters in a West Bank camp. More tear gas was fired before arrests were made, and it wasn't long until another teenager was destined for a period of detention. Incidents such as this one, highlighted by media coverage, invariably make cameras unwelcome. But it is the deteriorating relationship between the Palestinians and Israeli security forces which is the issue here, and the tension increases. MacNEIL: In Jerusalem, Israeli Prime Minister Yitzhak Shamir said he would refuse to meet a U. N. official now on his way to Israel to investigate the plight of Palestinians in the occupied territories. Marrack Goulding, Undersecretary General for Special Political Affairs, is being sent under terms of a Security Council resolution of December 22nd, condemning the Israeli crackdown. LEHRER: Back in this country, Vice President Bush had to talk again today about the Iran contra affair. He told reporters in Des Moines, Iowa that his position on the matter had not changed, that he stood with the President on dealing with Iran, and that mistakes were made. He said he did not think it was an arms for hostages deal.

GEORGE BUSH Vice President: ,If we erred, the President and I and others who supported it erred, it was on the side of human life. It was over concern about freeing Americans, one of whom was reported to have been tortured, and I guess eventually died. So we were very much concerned about getting those people out. LEHRER: The questions arose following a long story on the front page of this morning's Washington Post. The story said Bush was much more aware of the Iran deal than he has admitted. Bush said in Iowa that while Iran Contra seemed a preoccupation for some, he believed the American people are focusing on other issues now. MacNEIL: Heavy northern winter visited the south today, closing airports and snarling road traffic, as record cold temperatures continued to grip the midwest and northeast, storms dumped up to a foot of snow, from eastern Kansas to the Atlantic coast. Schools closed in many southern states. First lady Nancy Reagan cancelled a scheduled trip to Nashville after that city was blanketed with more than five inches of snow. Snow plows gave up trying to clear roads in some areas; drivers, unaccustomed to snow and ice caused so many accidents that police in Memphis, Tennessee told them to stop reporting them. At the Riverbank Zoo in Columbia, South Carolina, polar bears were kept in heated dens, because the keeper had feared for their safety in the unusual weather. The heavy snowstorm was headed north, up the east coast, tonight. LEHRER: That Pennsylvania oil spill headed for West Virginia and Ohio today. Residents of cities and towns on the Ohio River turned to alternative water sources and supplies that had been hoarded in the last few days. In Wheeling, West Virginia, the 60,000 citizens served by that city's water supply prepared for the possibility of dry faucets. A local grocer gave away 4300 gallons of fresh water, and city work crews prepared to divert water from an uncontaminated creek and nearby towns unaffected by the oil spill. MacNEIL: Finally in the news, Trevor Howard, the British film actor, died today at the age of 71. Howard, a former WWII paratrooper, who trained as a Shakespearian actor, was best known, perhaps, for his roles in the films ''Brief Encounter,'' Orson Welles' ''The Third Man,'' and ''Mutiny on the Bounty. '' At the end of the program, we'll have a remembrance of Trevor Howard. But first, the politics of providing day care facilities, and an update on a doctor with AIDs. Debating Day Care LEHRER: Day care for children: should the government pay for it? That is our major agenda item tonight, as it will be for Congress when it comes back from its holiday recess. The fact that it's even on the national agenda is a surprising new development. It's there because of a new fact of American life: more and more women in all financial and social circumstances are working full time, and more and more of them cannot find adequate, affordable child care. The result has been bipartisan support for the Federal government to subsidize it. What lies behind that support is the subject of this report by our Congressional Correspondent, Cokie Roberts.

COKIE ROBERTS: More than half the electorate in 1988 are members of the baby boom generation. The postwar babies have grown up now, and are having babies of their own. To pay for those babies, and the homes they live in, takes two earners in manycases. Now most mothers of school aged and preschool children work outside the home, and children's issues in general and child care in particular have become problems they want their politicians to address, as parents like Roseanne Tatti struggle with the question of who will take care of the kids. ROSEANNE TATTI, Working Mother: It's very frustrating. Sometimes you just feel. . . you're torn. You don't know where to be first. Finding the right day care person to take care of the child, the day care center, the babysitter, somebody to come stay at the home, and making sure the kids are happy and keeping it consistent. ROBERTS: Roseanne Tatti is a court reporter in New City, New York. Her husband works for a plastics manufacturer. The family needs two incomes to make ends meet. Now, after years of child care difficulties, their children, Mark and Pamela, are cared for by a babysitter in their home. MRS. TATTI: I have to work. It's for economic reasons, and I need a babysitter, I need a child care, day care center, I need somebody to take care of my children. I want the kids to get the love from this day care person that I would give. ROBERTS: That's what Marcy Peppers is looking for as well. A New York City management consultant, Marcy has found that care for her two and a half year old son, Sam, is neither available nor affordable. Sam is currently on the waiting list for three child care centers. MARCY PEPPERS, Working Mother: It's an expense and it's a big chunk. College universities are $10,000 a year, and it just seems here I am sending him to nursery school for the same price as an Ivy League school, and it's frightening. ROBERTS: Because it is so frightening, the child care situation is an issue that can translate into votes, according to Democratic pollster Peter Hart. PETER HART, Democratic Pollster: I believe people will vote on this issue. For now, I would call it a sleeper issue of 1988. And I think it has the potentiality to motivate a lot of the baby boomers, but I think it's going to also motivate people throughout the voting process. I can see somewhere in the neighborhood of 40% telling us that it makes a difference and it is something that they will take into consideration when they choose a presidential candidate. ROBERTS: So far, no presidential candidate has gotten out front on this issue. Neither has either political party. HART: I would call this issue a jump ball. Either side can grab onto it, depending upon what they're willing to do, and where they're willing to take it. But you're going to have to talk about investing in tomorrow, and making a difference. For now, neither party has grabbed that issue. ROBERTS: But both parties agree that child care is an issue ready to be grabbed. Times have changed markedly since the early '70's, when conservatives argued against providing child care, claiming it would encourage mothers to leave their children to go to work. Now, Republican consultant Roger Stone says those voices of opposition cannot be heard. ROBERTS (O/C): Is anybody saying this time around, as they did in 1971, ''I'm just against day care''? ROGER STONE, Republican Consultant: No, and what that is is a testimony to the size of the bulge of baby boom voters in the country, and the enormous influx of women, with children, entering the work force. ROBERTS: According to Stone, the only dispute now comes over how best to fund child care services. STONE: No one is going to stand up and say, ''I am against child care, it's a terrible idea, we shouldn't spend money on it. '' That shows you how far the argument has come. The two approaches are going to be, should government foot the bill, or should private enterprise foot the bill? And then the larger question is, Do we have a vibrant enough economy for either one of them to foot the bill? ROBERTS: The question of whether the federal government or private enterprise will foot the cost of child care will be played out in Congress, but the issue sits so close to home that each House has created a day care center for staff members, and several measures have been introduced to deal with the day care dilemma. A measure to provide two and a half billion dollars to expand day care services, help low income families pay for day care and establish federal child care standards has the backing of a coalition of labor unions, religious groups and children's advocates. The bill' chief Senate sponsor, Connecticut Democrat Christopher Dodd, claims that support for action is broad and deep. SENATOR CHRISTOPHER DODD, (D) Connecticut: I think there's incredible recognition that this is a major problem in the country. It's no longer a question of wouldn't it be nice to do. You just mention child care in an audience, and it's amazing the reaction you get from people, and the stories people will tell about how far the father had to drive to find a child care center, or the difficulties when they have found one about feeling secure that the people who are taking care of them are actually going to be taking care of them. Or the cost of it. ROBERTS: Cost is one of the points of contention that will be debated as Congress decides what to do about child care. A more modest bill, $875 million dollars over three years to encourage states and communities to develop child care programs, was introduced by Republican Orrin Hatch. He argues this is no longer an issue conservatives can ignore. ROBERTS (O/C): Do you get any heat for taking that view? SENATOR ORRIN HATCH, Utah: (R)Sure I do. As a conservative? There's no question that there are conservatives out there who aren't looking at these facts, who really are just looking at old Shibboleths, who are looking at 1971 mentality. And frankly, whether it's better to have the mother and full time parenting in the home or not, and I think almost anybody would agree with that, the reality is that a high percentage of women have to work today. ROBERTS: Senator Dodd agrees. Those facts have completely changed the politics of this issue, since the last time Congress passed a child care bill. DODD: This is an issue that is no longer owned by the more progressive elements. Conservatives have come to recognize that there's a major issue out there among a conservative constituency for decent, adequate, affordable child care in this country. So we're beyond that. The debate is no longer about whether, the question is now how. I'm going to do everything I can to try to solve this problem. It's my number one legislative effort for this next year. And by the end of this next year I intend to see a child care bill passed and I'm not going to be arrogant about it, I'm willing to work with anybody and everybody to see that it gets passed. ROBERTS: As Congress debates the child care question, members of that baby boom generation will be watching, hoping they can get the issue raised to the forefront of the national political debate. Roseanne Tatti insists any presidential candidate who took the lead on child care would get her vote. Mrs. TATTI: Definitely, because day care has become a very demanding subject right now. And if he's truly for it, I would definitely vote for him. Not just because day care is the topic, because there are a lot of women out there working and it's because of society and economic reasons that women are working. And the rules in the community and government haven't caught up with the majority of women working today. MacNEIL: We turn now to a discussion of just what role the government should take in funding day care. We start with Ellen Galinsky, the project director of Work and Family Life Studies at Bank Street College in New York. She's also the President elect of the National Association for the Education of Young Children. Ms. Galinsky, first of all, is it essential that there has to be a federal role in this issue in your view? ELLEN GALINSKY, Bank Street College: I think that the people who were on the show were speaking about the magnitude of the problem. This is not a problem that can be solved piecemeal any more. We need a solution that befits the intensity of the problem. But before we talk about that, I'd just like to go back and comment on a couple of things in the taped piece. One was that the mother called the person who came to take care of her child a 'babysitter,' and I think it's important to recognize that nobody sits on babies, that this is a very important profession, and it takes skill to provide care for children. We know that. In fact, once the government spent eight million dollars to do a study that showed that training makes a difference in terms of how well children do. The training of child care providers does make a difference. So I think it's important to recognize that. The second point that I wanted to make is that, yes, it is expensive, but that doesn't mean that child care workers are well paid. That the average salary, if they work 52 weeks a year would be $9,500 a year, so that one of the reasons we have a crisis is that there's such high turnover in the child care field. MacNEIL: Let me ask you, of the two bills that Cokie Roberts described, which one do you and people who think like you support? Ms. GALINSKY: I'm very happy that Hatch has introduced a bill. I think that that's a very important thing, and I think that Hatch has some provisions in his bill that are important -- that is, understanding that we need tax incentives, to change some of the liability laws, there are some very important things in his bill. But I'm very supportive of the Act for Better Child Care -- MacNEIL: The Dodd bill? Ms. GALINSKY: The Dodd bill. We call it ABC. That bill has right now -- it was introduced on November 19. Since it was introduced, about one third of the House, and one third of the Senate have signed on as cosponsors. There are a hundred national organizations, or more, actually, who are in support of this bill. I'm in support of this, because it is so -- was so carefully done, and it really understands the complexity and the intricacy of the child care world. It addresses the three major problems that we have in child care. The first problem is affordability. And in this bill, it helps parents pay for child care -- 75% of the money is to go to low and moderate income people, to help them pay the cost of child care on a sliding scale. MacNEIL: People below the mean average -- Ms. GALINSKY: A hundred and fifteen percent of the mean income of the area, so that it is adjusted by what the income is in that area. It also, the second thing that it does is deal with the issue of availability, that we simply, people can't find child care. And the surveys that we at Bank Street do with corporations, a survey that we just did found 65% of the people had a difficult, or very difficult time -- MacNEIL: Finding -- Ms. GALINSKY: Finding their infant care, right. There just aren't enough people and programs to take care of the children that we have. In Florida there is a waiting list of 30,000 children who need child care. So we have a desperate need for this. And this bill will stimulate new people to come into the field, and it will set up loans for new programs to get started. So it deals with the whole issue of not enough child care. MacNEIL: And the third? Ms. GALINSKY: The third issue is the quality of child care. Child care varies enormously because we've let it happen sort of untended by and large in this country. And this bill will provide training for people -- every child care provider will get training under this bill, which is terribly exciting to us in this field, and something that people in the child care community really want. And it would provide information for parents on how to choose quality child care. It will also provide resource and referral. And by that, I mean that that will help parents find child care. These are agencies and communities that help parents find child care. MacNEIL: Ms. Galinsky, we'll come back. Jim? LEHRER: Now two other positions on this issue. Jan Calderone Yokum is the Executive Director of the Rosemount Center for Children and Families in Washington, D. C. , and she's the President of the National Institute for Hispanic Children and Families. Stuart Butler is the Director of Domestic Policy Studies at the Heritage Foundation, a conservative think tank here in Washington, who recently wrote a book called Out of the Poverty Trap. Mr. Butler, is subsidizing day care a job for the federal government? STUART BUTLER, Heritage Foundation: I don't believe so. Of course you must remember that the legislation not only provides money, but it also increases the regulation of day care. And I think one of the big problems with availability of day care is that the states in particular, and now we're talking about the federal government, has made it increasingly difficult for people to come into that profession, into that business. That increases the cost of day care. It also means that many community based day care providers find it extremely difficult to provide services. So I think that what we're seeing is what so often happens when a federal government comes in. You spend a lot of money, but you also in fact increase the cost through increasing regulation. So what you take away with one hand, you're trying to get back with the other. LEHRER: So the $2. 5 billion that is in the Dodd bill, you're saying that that money would not actually be properly spent to help the day care problem? Mr. BUTLER: Well, I think what would actually happen is that first of all, one has to recognize that most children that are in day care in fact are in home based care -- about 70% are looked after either in home or in nearby homes. Only about a third are actually in day care centers, using the term very loosely. And what this legislation basically does is to channel money in for that second sector. It doesn't do anything really to encourage much less expensive community based and home based day care. I think also it's important to recognize that when the federal government is spending money on this issue basically it's taking the money from taxpayers as well. Andwhat you're going to find happening is that those parents that choose home base care, or to have the wife actually staying at home, are going to be subsidizing the two earner families, which is fine for the two earner families, but it seems to be a little inequitable. LEHRER: What's the alternative then? Mr. BUTLER: Well, I think steps should be taken to actually reduce the regulation of day care. There's always the assumption that somehow you've got to keep increasing the regulation to improve the quality. What's actually happening is that because of very extensive regulation at the state level, you're finding more and more people going into the informal sector -- both home based care and also illegal care, as effective centers are set up that are not regulated at all. Because they would shut down if they tried to meet regulations. So you have a situation of in fact many, many children being pushed, if you like, into the informal, illegal area, because regulations are too tight. But we must remember that regulations are often put forward at the behest of those who provide services to try and increase the cost and to make sure that people go to licensed providers. We see it in so many different fields, and I think we're just beginning to see it now in the day care area. LEHRER: Ms. Calderone Yokum, what is your view of this, as far as what the federal government should be doing. And you've heard what Mr. Butler's said, you've heard what Ms. Galinsky has said, and what Senators Hatch and Dodd have said. Where do you come down? JAN CALDERONE-YOKUM, Rosemount Center: Well, let me say that I think that I'm probably in the middle of my two colleagues. I do see a role for the federal government. I am not particularly convinced that either the Dodd Bill or the Hatch Bill is THE role for the federal government. I think that the federal government has the obligation and the responsibility to see that families have the necessary means by which to support themselves. And that part of that includes the day care. However, I think if we look at the bills, both of the bills, particularly when they talk about low income, and they talk about the median, the state median being 115% of the state median, that isn't very much. I was looking at the preview that Cokie Roberts gave before. Most families would not qualify, yet both of them said expense was one of (unintelligible). For example, in the District of Columbia -- LEHRER: Wait a minute, let me make sure I understand what you're saying, that if the Dodd bill, or the Hatch bill, were enacted into law, they would not help any of the people in that taped piece -- Ms. CALDERONE-YOKUM: -- that we saw. For example, 115% of the median income in the District of Columbia, where the median income is about $20,000, 115% of that, which is the highest you could go, would only be $23,000. LEHRER: And clearly those people with a double income are making more money than that. Ms. CALDERONE-YOKUM: But even -- you know, if they're making $25,000 income, double, which most will make. Or even if a single parent's making $25,000, and you have one child, and that child is, say, nine months, and the average cost in the urban areas for infant care at a minimum is $100 a week, 25% of your income is going to go to pay for child care, but that particular bill subsidy, you're not going to be eligible for. So it's not going to help in that way. It needs I think a very serious look -- needs to be taken by the House and the Senate and those who propose child care legislation, in terms of what do we mean when we say subsidy? The second part of it, I agree that availability is one. But if only 25% is left, for example, in the Dodd bill after the subsidized, both to expand, to give loans, to provide training, to increase salaries of day care workers, etc. , 25% is not that much, and it's such a general type of bill that when you talk, for example, Ms. Galinsky, in terms of salaries, from what to what? Are we talking about the $9500 for the teacher with a degree? $9500 for a head teacher? To what? LEHRER: It's not in there -- your question is who makes that decision. Ms. CALDERONE-YOKUM: Who makes that decision. I mean, and how do you say how much money is needed if you don't know how much salaries are going to be increased? Because whether we like it or not, day care is personnel intensive. LEHRER: (unintelligible) Ms. CALDERONE-YOKUM: You cannot -- LEHRER: You can't turn it over to a machine -- Ms. CALDERONE-YOKUM: And when you print the budget, you can't say, well we're going to cut out this person, we're going to have one person for 25 kids. So you know, you're sort of caught in that (unintelligible). LEHRER: Well, let's say there was going to be a Calderone Yokum bill. What would you put in it? Ms. CALDERONE-YOKUM: What I would put in it is first of all, I think that there really needs to be a look at what is already taking place, what do we have now, what is this mess? And it is a mess we have now. It's uncoordinated, we have a variety of regulations, depending on where you live, the salaries are inadequate, etc. But I think we need to have every single state really look at what are they going to need for child care for all of the families who are working and training, and (unintelligible) in the next five years. LEHRER: Regardless of income -- Ms. CALDERONE-YOKUM: Regardless of anything. Because -- let's -- why do people work? They work for their income. But it stands to reason that their income increases every year. For the most part. It will increase every year. LEHRER: And if it doesn't -- Ms. CALDERONE-YOKUM: You get another job, you've got a real problem. So as you're going up that ladder, you're going to get to the point where you're no longer going to be eligible for that subsidy. So you've either got to either go for zero, where many states charge nothing, to fund the complete child care that you need for your family. LEHRER: So -- Ms. CALDERONE-YOKUM: So that as the going up that ladder, the state then needs to then look at, what are we going to need for all of the families who are going to need this child care? How are we going to do it? I believe -- and I have not heard my two colleagues say it, perhaps they believe the same way -- that it isn't a question either the family pays or the federal government pays. It's a question that the whole community has to come in. Government at both the local, state and federal level, the families, the private sector, the business and industry, has to come in and say how are we going to provide for care of our children. I would disagree with my friend Stuart here in terms of if families work, they pay taxes, both federal and state. LEHRER: Everybody pays taxes. Ms. CALDERONE-YOKUM: Everybody pays taxes, so there's money coming back in when you provide money for a child care bill. But it's not a question that the federal government should, in my opinion, fund the whole thing, because that's an impossibility. It'd probably take 75% of the national budget, and I don't think either side's going to vote for that. LEHRER: All right. Thank you. Robin? MacNEIL: Ms. Galinsky, there are a lot of objections to the plan that you like. Starting with Mr. Butler's. He says that the federal government shouldn't be getting into this, it will just increase the regulations which are already increasing the cost, and which are pushing people out of, into informal, illegal care already. Ms. GALINSKY: Well, I'd like to describe what the regulations are in this field, because in fact, all they do is really provide just a floor of safety for the informal kind of child care that he was describing, or family day care. There are four regulations. One is, how many kids in a group, how many infants in a group, what the minimum age of the caregiver should be, and health and safety. That's just a floor. I mean, that is really that we don't want one person -- MacNEIL: And those regulations will not push the cost up? Ms. GALINSKY: Those regulations really make sure that our children are safe. Yes, it's cheaper to have 25 babies with one adult. But is that a safe situation for us? We don't think about having 80 kids in a classroom, you know, we would say no one could learn. MacNEIL: Well, let's go back to Mr. Butler. Mr. Butler, Ms. Galinsky says you need the regulations just to make sure the kids are safe. Mr. BUTLER: Well, of course, everybody says that. Nobody's in favor of regulation in order to push people into the illegal area. But of course what passes for health and safety regulations often mean applying very rigid rules and rigid regulations, and particularly in the less formal sector, which effectively drive people out. If you start saying that certain building codes, and certain zoning requirements, and certain licensing requirements must apply, without regard for local circumstance, then you effectively do push people out. So you try to -- you argue, of course, that you're doing this in order to improve safety and health, and quality. But in practice, it has the effect of decreasing it, because it does push people out into the informal sector. MacNEIL: You're in favor, I gather, of professionalizing day care. Is that right? Of making qualified professionals take it over? Ms. GALINSKY: Well, in family day care regulations, it only says the minimum age that person could be a provider. Would you want a 14 year old to be taking care of a group of children? No. And there are a lot of states that don't have any regulations right now to that effect. I think that what I'm in favor of is some accountability that children will be safe. We wouldn't think of going into a hospital that didn't have some sort of minimum regulation, and we need to think about that in terms of our children. MacNEIL: Let's go to Mr. Butler's wider point, that the federal government doesn't need to be into this. I assume you mean that the states and local communities can look after it, is that what you mean, Mr. Butler? Mr. BUTLER: Well, I think that we have a lot of experience really over the last 20 or 30 years, where the assumption is that the federal government just comes into this area, somehow that will solve all the problems. What you tend to find happening, and we've really seen it since the 1960's, is that as the federal government comes in, you tend to get another layer of regulation coming from the federal government, you tend to get an industry being created around that federal program that looks to enforce those regulations and to expand them, and to siphon off even more of the federal dollarsto that profession, rather than to the poor people it's supposedly to serve. And I just see you know, there they go again. We see the same basic process, political process, being set in motion. And even more important, it's one where the middle class and two earner yuppie family is also going to be part of that pressure to expand the federal government. I can see why it's such a great political issue for some people. Ms. GALINSKY: Could I just describe how the regulations are arrived at? That they really are coming to a median of what most states already have. We're not talking about a whole new system. We already have a system of regulation. MacNEIL: Could we move on from the regulations and answer his point, that what this is just going to do is create another industry with federal backing. Ms. GALINSKY: We already have regulation in every state. There -- we have people to do this. In this bill, one of the wonderful things about it is that it limits the amount of cost that can be spent on administration. Only 10% can go to administration. So that this bill is very cognizant of the fact, the number one purpose in this bill, the first goal, as it's written, says to assist states in carrying out their roles. And each state will be asked to come up with its own standards through a process of community involvement. I think that the creators of this bill, and it was developed over a year with conservatives and progressives, with people from for profit child care, with people from not for profit child care, all sitting in a room, discussing different points of view, until we reached consensus. So this bill has been created out of a very long and thoughtful process. Cognizant of the problems that he's describing. MacNEIL: Are you saying that the kind of study to assess the needs and the projected needs and everything in the different states has already been done behind this bill, the one that Ms. Calderone Yokum is talking about? Ms. GALINSKY: We do know, there's no uncertainty about -- MacNEIL: You're saying what she's proposing isn't necessary? Ms. GALINSKY: We know what makes good quality care. More than any other country I would say in the world, we have studied this, and we know what it takes to make sure that children -- but we're not even talking in this bill about high quality care. But we know how to do it. What we're talking about is just a floor of safety. MacNEIL: Ms. Calderone Yokum? Ms. CALDERONE-YOKUM: I don't think I was referring to quality care. I wasn't talking about that we didn't know the quality. What I was talking about is that states really need to analyze what it is that they need in the area of child care for these citizens of that particular state. It doesn't have anything to do with quality. How much child care are we going to need for children, zero through school age, 12, 14, how are we going to do it, and who's going to pay for it? Ms. GALINSKY: Jan, each state has to come up with a state plan that does that, with he ABC bill. Ms. CALDERONE-YOKUM: But what I'm saying is that I think we've put the cart before the horse. That you need to have the plan before you put out a piece of legislation that is $2. 5 billion, because you don't know what the need is. Ms. GALINSKY: This bill provides the process for creating a plan. I think that it is a beautiful design in order to move us forward. We have a crisis right now. I guess the question to me is, how long are we going to go, to make this crisis worse? For example, we all got very enamored with Jessica McClure falling down the well, and rescuing her. It cost a lot more money to rescue this child than it would have to prevent this accident from happening, because she was in unlicensed family day care, and was not being supervised at the time. MacNEIL: Let's go back to Mr. Butler just finally here. Is it inevitable, given the climate, that there's going to be some kind of federal day care bill passed by this congress before the presidential election, would you think? Mr. BUTLER: I would say politically it's very likely, for the very reason that it was mentioned in the beginning, that this is an issue where you find middle class families, two earner families, feeling this is a way to reduce some of my cost at somebody else's expense. And you find also an industry that sees this as a way of getting federal money to expand our services and to create jobs for people to provide day care. I think that's a very potent force politically, and will probably lead to legislation. MacNEIL: Okay. We have to leave it there. Thank you all three. Jim? LEHRER: Still to come on the NewsHour tonight, an AIDS case update, and the late Trevor Howard. Hazardous Duty MacNEIL: Next tonight, an update. Last fall, we reported the story of Dr. Hacib Aoun, a Baltimore physician who contracted AIDS while trying to save a patient's life. Dr. Aoun is a Venezuelan married to an American. Not only is he fighting for his life against AIDS, he's had a fight with the hospital where he contracted it, and now has a battle with the immigration service to stay in this country for treatment. Here is the story as Kwame Holman originally reported it.

KWAME HOLMAN: The story begins here in 1983, in the bone marrow transplant unit of Johns Hopkins Hospital in Baltimore. A young leukemia patient receiving massive transfusions begins to vomit blood. His doctor needs to know how much blood the boy is losing. Hacib Aoun remembers grabbing a thin crystal tube to run a test. Dr. Acib Aoun, Cardiologist: As I was performing the test, the capillary tube broke and went through my finger, and lacerated my finger, cut my finger. And I at the time got really scared, because of the possibility of hepatitis from the patient, or the possibility of ending up with leukemia like the patient, or one of the other infections which he was having. But of course, AIDS at the time was not even a remote possibility, because not even the virus had been discovered in 1983, in February of 1983.

HOLMAN: In March, the boy with leukemia died. And Dr. Aoun developed a puzzling illness. His medical records document it: fever, fatigue, a rash, glands that were swollen for months. The diagnosis: an unnamed virus. But by June of 1983, Aoun had recovered. The native of Venezuela resumed his 70 hour work weeks, and continued to rise through the ranks at Johns Hopkins, becoming a chief resident and instructor at the hospital. In 1985, he married a Hopkins intern. The following year, Patricia Aoun gave birth to a daughter. Last fall, at age 31, Hacib Aoun was seriously ill, suffering from extreme fatigue and sudden weight loss. Last Christmas eve there was a definite diagnosis, infection with the human immune deficiency virus, the virus that causes AIDS. Dr. AOUN: (unintelligible) was a disaster. We several times went asking for advice about treatment, about testing Patricia. Patricia's test was negative. And that has been the only good news that we have had in seven months, I can tell you that. We -- there was a lot of confusion around the time, because I was in no risk group at all, I had never been transfused, never been a homosexual, never been an IV drug abuser, never been a promiscuous person.

HOLMAN: Aoun says the only risk factor for AIDS that he can recall was the 1983 accident. On a hunch, his physician, who works at the University of Maryland cancer center, obtained a sample of the leukemia patient's blood, blood that Hopkins had saved routinely for research. Test results from the Maryland State Health Department were unequivocal -- strongly positive for AIDS. Aoun was convinced he'd been infected by the leukemia patient's blood, blood that had been contaminated by a transfusion. It was the beginning of a chain of events that led to Aoun's filing in June a $35 million lawsuit against Johns Hopkins Hospital and University. (to Aoun) Do you blame Johns Hopkins for contracting this illness? Dr. AOUN: No. And it's important to tell you that, because the lawsuit is not about having contracted AIDS at Johns Hopkins. No, we cannot blame them for that. The issue is telling Johns Hopkins that what they did after they knew was wrong. The slandering, the trying to just push us away, breaching confidentiality, that we blame them for.

HOLMAN: Dr. Aoun says when he told officials here at Johns Hopkins Hospital that he had contracted AIDS related complex, they promised their full support, confidentiality about his disease, a job as instructor in the cardiology department, and financial support for his wife and child if he should die from AIDS. Aoun says confidentiality was the first promise to be broken. He says his boss, Dr. Kenneth Baughman, assistant dean at Hopkins Medical School, assured him his identity would be kept secret. Dr. AOUN: Because who's going to employ you once you know that you are infected, or once other people know that you're infected.

HOLMAN: But Aoun says Baughman, Aoun's collaborator on several research projects, revealed his name to Hopkins administrators and lawyers. Dr. Baughman is a codefendant, along with Hopkins in Aoun's lawsuit. So is Dr. John Stobo, the hospital's director of medicine, and another mentor from whom Aoun sought help. Dr. AOUN: I think it was March 22. Dr. Stobo, the chairman, sat down with several chief residents and plain told them, ''Well, Hacib Aoun has AIDS. ''

HOLMAN: Johns Hopkins officials say top administrators had to be told of Dr. Aoun's condition in order to arrange financial help for him. Dr. Theodore King, a hospital vice president, also said staff doctors had to be told that one of their colleagues had acquired AIDS. Dr. THEODORE KING, Johns Hopkins Hospital: Certainly if you had someone within your department acquire AIDS in this manner, you'd be irresponsible if you didn't bring it to the attention that there is a problem with acquiring AIDS when we care for our patients.

HOLMAN: Dr. King insists those disclosures alone do not constitute a breach of confidentiality. But Aoun and his wife say news of his illness spread quickly. Dr. PATRICIA AOUN: We got a call from a reporter from the Baltimore Sun who had information concerning my husband's illness. They wanted to write a story about it. And -- Dr. AOUN: Look, medical students knew, a whole bunch of medical students, house officers knew -- HOLMAN: (to King) Who broke the confidentiality? Dr. KING: I would have no idea. And your question assumes that confidentiality was broken. I don't think it became common knowledge among general people within the hospital community. I think it became knowledgeable to people who were immediately involved in certain areas of the medicine department, including the cardiology service.

HOLMAN: The Chairman of the American Medical Association takes a stricter view of confidentiality. Dr. Alan Nelson says knowledge that a physician has AIDS should be severely limited. Dr. ALAN NELSON, AMA: I think that physicians with AIDS should be afforded the same rights to confidentiality as any other patient with AIDS, should be afforded the same opportunity to make a living as anyone else, understanding that casual contact doesn't transmit that disease. And a physician who has positive AIDS antibody tests, assuming that there's no risk whatever to patients, should not be discriminated against and identified.

HOLMAN: According to Aoun, as news about his disease spread, so did rumors about how he contracted it. He says Hopkins officials openly suggested he was bisexual, or promiscuous, leaving him bewildered and angry. Aoun is suing the institution for slander and liable. Johns Hopkins officials firmly deny all of Dr. Aoun's charges. Dr. AOUN: You know, I have been an individual of unquestionable character up to this time, and all of a sudden the lawyers decided -- or somebody up there decided -- that I wasn't it anymore, I was somebody else. Dr. DAVID GLASER, Johns Hopkins Graduate: His reputation became gone -- he just lost his reputation entirely.

HOLMAN: Denver physician David Glaser is a recent graduate of Johns Hopkins Medical School, and a friend and former student of Aoun's. Dr. GLASER: Despite the size of Hopkins, it's a pretty small community in some ways, and the word, I think, had permeated pretty much the entire hospital, especially since AIDS is such a sort of feared or easily gossiped subject anyway.

HOLMAN: Johns Hopkins officials initially challenged Dr. Aoun's account of how he got AIDS, questioning the accuracy of the AIDS test performed on the leukemia patient's blood. They now say his story is probably true, but they say the more important issue is how he should be compensated. Aoun's attorney, Marvin Ellin, agrees, but says from the start the hospital lost sight of its basic obligation. MARVIN ELLIN, Aoun's attorney: They have been less -- I think -- than forthright in dealing head on with the problem that exists here, and that is a physician who has contracted a fatal illness while trying to help a patient. He wanted to continue to work. He wanted the assurance that when he dies that there would be certain death benefits for his widow. It must be remembered that he contracted this disease in the course of his employment.

HOLMAN: At the time of his diagnosis, Dr. Aoun was doing heart valve research in this Hopkins cardiac unit. But Aoun says he didn't want to run even the smallest risk of passing the AIDS virus to a patient, so he asked his department chairman for another job. Instead, says Aoun, he was told to see hospital and university lawyers about going on workmen's compensation. Dr. AOUN: I didn't even know what the workmen's compensation was all about, so I asked the doctor what it would amount to, and basically it came back to be something really pitiful. And I asked him, ''Do you think that's fair?''

HOLMAN: That Dr. Aoun lacked job security and life insurance is not unusual. Nationwide, doctors in training typically have one year contracts, Forty percent of teaching hospitals do not provide full disability coverage for house staff. Thirty percent do not pay the full cost of life insurance. The Association of American Medical Colleges says it may be time to reconsider benefit policies. Dr. AUGUST SWANSON, Asso. of American Medical Colleges: Even though the possibility of contracting AIDS in the workplace is small if one follows usual precautions, the severity of the disability if AIDS is contracted is such that institutions need to review those policies, both disability and perhaps life insurance benefits as well. Dr. GLASER: I think they have to show support, because this is something that could easily happen again. More and more patients are coming in with the AIDS virus, and there's blood exposure all the time to physicians, to nurses, to all health care professionals. And certainly you shouldn't have to face the prospect of losing your job, losing your reputation, losing all your benefits. Dr. AOUN: The things that were being requested were very basic. Keep my wife and baby, life insurance. This gave me peace of mind. And give me a job. I need to work. I'll work until the day I have to go into the hospital. Because that's my nature. That's all I have done all my life.

HOLMAN: Negotiations between Dr. Aoun and officials here at Johns Hopkins proceeded haltingly. Aoun says that at one time he was offered a job, but no payment to his family if he died. At another time, he was offered the payment, but no job. Dr. KING: I truly believe everyone wanted to prepare something for Dr. Aoun that he and his wife would find acceptable for themselves as well as for their baby. And truly, the institutions were making all efforts to arrive at such a package. It is unfortunate that it wasn't worked out. HOLMAN: (to the Aouns) They say the whole case is about money. How does that statement strike you? Dr. PATRICIA AOUN: If my husband could have his health and his reputation and the last eight months of his life back, they could keep their money. It's not a question of money. It's a question of human dignity. Dr. AOUN: There has to be something good that comes out of all of this, that a hope that we're slowly, little by little, passing the message to our health workers, take care. And even if you take care, be sure that you're protected economically. And do not ever -- because these patients need you -- push them aside, no matter how afraid you are of the illness. Do not -- now, I'm one of those patients, and I wouldn't want to be left by myself in a room with the nurses not wanting to come in contact with me or the house officer, because I have the infection. Because next time it could be them. And because that's what medicine is about, it's about taking care of people, and it's about taking care of the people that need you the most, and these patients are the people that nowadays in the 1980s need you the most. MacNEIL: Last month Dr. Aoun settled his lawsuit against Johns Hopkins for an undisclosed sum. He's been hospitalized four times for AIDS related illnesses since he was interviewed for our report. Now, the Immigration Service has removed his legal right to stay in the United States, saying he was here under an arrangement that requires foreign doctors to return to their native countries to practice medicine for two years. Complicating his request for permanent residence in the United States is a 1986 Senate vote that people with AIDS should not be allowed to emigrate, and temporary residents who have the disease should not be permitted to remain in the U. S. But Dr. Aoun is receiving experimental AIDS treatment here that he could not get in Venezuela. The INS told the NewsHour today that it might consider a request on humanitarian grounds to delay deportation. Recap LEHRER: Again, the major stories of this Thursday. Secretary of State Shultz said the United States is willing to stop military support to the Afghan rebels even before all the Soviet troops are gone from Afghanistan, if the full withdrawal is underway. A major winter storm hit the South and moved on to bring snow and freezing temperatures to the mid Atlantic and Northeast. And Trevor Howard died. The distinguished British actor was 71 years old. He appeared in more than 30 films. One the first was Brief Encounter, made in 1945. His co star was Celia Johnson. Thirty five years later he again co starred with Johnson in the Grenada television film, Staying On. Here are excerpts from both.

[Excerpt from Brief Encounter] TREVOR HOWARD: You know what's happened, don't you? CELIA JOHNSON: Yes, I do. HOWARD: I've fallen in love with you. JOHNSON: Yes, I know. HOWARD: Tell me, honestly. Please tell me honestly if what I believe is true. JOHNSON: What do you believe? HOWARD: That it's the same with you, that you've fallen in love, too. JOHNSON: It sounds so silly. HOWARD: Why? JOHNSON: I know you so little. HOWARD: It is true, though, isn't it? JOHNSON: Yes, it's true. HOWARD: Laura. . . JOHNSON: No, please. We must be sensible. Please tell me to be sensible. We mustn't behave like this. We must forget that we've said what we've said. HOWARD: Not yet. Not quite yet. JOHNSON: But we must, don't you see? HOWARD: Listen, it's too late now to be sensible as all that. It's too late ot forget what we've said. And anyway, whether we said it or not couldn't have mattered. We know. We've both of us known for a long time. JOHNSON: How can you say that? I've only known you for four weeks. We only talked for the first time last Thursday week. HOWARD: Last Thursday week. Has it been a long time for you since then? Answer me truly. JOHNSON: Yes. HOWARD: How often did you decide that you were never going to see me again? JOHNSON: Several times a day. HOWARD: So did I. I love you. I love your wide eyes, the way you smile, and your shyness. And the way you laugh at my jokes. JOHNSON: Please, don't. HOWARD: I love you. I love you. You love me, too. It's no use pretending it hasn't happened, because it has. JOHNSON: Yes, it has. I don't want to pretend anything either to you, or to anyone else. But from now on, I shall have to. That's what's wrong, don't you see? That's what spoils everything. That's why we must stop here and now, talking like this. We're neither of us free to love each other, there's too much in the way. There's still time, if we control ourselves and behave like sensible human beings. There's still time. HOWARD: There's no time at all. [Clip from Staying On] HOWARD: What the hell's happened to the garden? Hasn't old Marley been -- JOHNSON: I really don't know, Tuscany. I've been so busy with -- HOWARD: Has that sod of a Marley been today? SERVANT: No, sir. HOWARD: Or yesterday? SERVANT: No, sir. HOWARD: Or for the last ten days? SERVANT: Oh, no, sir. JOHNSON: The garden looks all right to me, Tusca. Ibrahim's making you some nice broth. HOWARD: Of course it's not all right. I only have to be ill for a few days for the place to look like a jungle. JOHNSON: Don't exaggerate, Tusca. HOWARD: It's that bloody Boolaboy woman's fault, up there. Just wait 'til Billy Boy gets back from Rampur, I'll have her guts for garters. JOHNSON: I expect that Marley's been ill, that's all. HOWARD: Not the point. Not the point. It's that woman's job to see that my grass is cut and my flowers are watered every day, every day of the bloody year. It's in the lease. Bring me the bloody box. JOHNSON: Nice broth first, bloody box later. But not today. Now, if we drink up all our nice broth, and then have a good sleep this afternoon, who knows, we might have a nice Arrowroot biscuit for tea. SERVANT: No arrowroot, Memsahib, only digestives. JOHNSON: Oh, well, then a nice digestive, Tusca, dear. HOWARD: It appalls me. JOHNSON: What does? HOWARD: A woman of nearly seventy, talking like a child of seven. I wonder what's keeping Billy Boy so long? LEHRER: Good night, Robin. MacNEIL: Good night, Jim. That's the NewsHour tonight, and we'll be back tomorrow night. I'm Robert MacNeil. Good night.