The MacNeil/Lehrer NewsHour

Intro JIM LEHRER: Good evening. Leading the news this Wednesday, the Supreme Court approved strong school control over student publications. Israel went ahead with the deportation of four Palestinians from the West Bank, as Israeli troops killed two more demonstrators. And President Reagan exchanged promises of trade cooperation with the Prime Minister of Japan. We'll have the details in our news summary in a moment. Robin? ROBERT MacNEIL: After the news summary we debate the impact of today's Supreme Court decision on free speech in high schools. Next, special correspondent Paul Solman describes the issues behind the visit of Japan's new Prime Minister. Then, today's AMA proposal to reform medical malpractice. One of the doctors behind the plan and a trial lawyer debate it. Finally, an evaluation of Margaret Thatcher, now Britain's longest serving Prime Minister this century.News Summary MacNEIL: The Supreme Court ruled today that public schools may censor student newspapers and other forms of expression. In a five to three decision, the court ruled that a high school principal in Hazelwood, Missouri, did not violate the free speech rights of students when he ordered two pages deleted from a student produced newspaper. One article removed dealt with teenage pregnancy, another with the effects of divorce on children. For the majority, Justice Byron White wrote, ''A school need not tolerate students speech that is inconsistent with its basic educational mission, even though the government could not censor similar speech outside the school. '' In a dissenting opinion. Justice William Brennan said, ''The principal violated the First Amendment's prohibitions against censorship of any student expression that neither disrupts class work nor invades the rights of others. '' Jim? LEHRER: President Reagan spent a bad evening with a stomach bug, but was pronounced well and able this morning. The President's doctor described the condition as gastroenteritis, which means upset stomach in laymen's language. The President himself had this to say about his illness:

Pres. RONALD REAGAN: I'm looking forward to lunch. I'm feeling pretty good. LEHRER: Mr. Reagan will go to Bethesda Naval Hospital Friday for his regular six month checkup. The examination is a preventative measure against recurrence of colon cancer. A White House announcement today said the timing was a coincidence. It has nothing to do with last night's illness. Mr. Reagan did cancel some appointments today, but he went ahead with the meeting with Japanese Prime Minister Noburo Takeshita. Afterwards, they said they made progress on trade issues.

Pres. REAGAN: I was pleased with his assurance that he intends to resolve a particularly difficult trade issue, the problem of access for the U. S. construction industry in a satisfactory manner. I expressed appreciation for the Prime Minister's efforts on trade, stressing the urgency of expanding opportunities for U. S. farmers and other exporters at a time of increasing pressure for protectionism here in the United States. We concurred on the importance of keeping trade flowing and barriers down. NOBURO TAKESHITA, Prime Minister, Japan [through translator]: I am determined to carry out a vigorous economic management policy with emphasis on domestic (unintelligible) expansion to promote structural adjustment to improved market access and to strive for a further steady reduction of the current account surplus. LEHRER: The two leaders met on a day when the price of the dollar fell against the yen on foreign currency markets. Dealers blamed the decline on continuing fears about the U. S. trade deficit. MacNEIL: The President of Taiwan, Chiang Ching Kuo, died today at the age of 77. The government declared a month of mourning for the man once feared as head of the secret police, but later popular and a respected leader. Chiang was the son of the World War II Chinese leader, Chiang Kai Shek, whose government fled to Taiwan when the communists seized power on the mainland. Confined to a wheelchair in recent years, President Chiang presided over dramatic political changes, ending martial law, releasing political prisoners, tolerating opposition parties, and relaxing press controls. LEHRER: There was finally some good news today about drug abuse in America. The government said it was down among young people. A survey released by the U. S. Department of Health and Human Services said particular progress was made in curbing cocaine use. HHS Secretary Otis Bowen spoke at a Washington news conference.

OTIS BOWEN, Dept. of Health and Human Services: During 1987, the use of cocaine by high school seniors and other young Americans was the lowest in eight years, dropping 20% in a single year. And attitudes toward cocaine and other illicit drugs now reflect a greater awareness among our young people of the dangers of drug use. It is still true that far too many Americans are using drugs, and much remains to be done to counter drug abuse, including new emphasis on the problems of alcohol abuse and alcoholism. But this year's survey gives us new evidence that the war on drugs can be won and it calls on all of us to redouble our efforts against drug abuse and for our young people and their future. MacNEIL: The FBI may change the way it conducts background checks because of the recent case of Judge Douglas Ginsburg. Ginsburg withdrew his name from consideration for the Supreme Court after it came out that he had smoked marijuana in the past. FBI officials told the Associated Press and the New York Times that some of the judge's associates apparently lied to FBI agents when they denied knowing that he'd used marijuana. Although it's illegal to lie to federal investigators, charges are unlikely, because the background interviews are not conducted under oath. But the official said that in the future, nominees for federal jobs may be asked directly about drug use. LEHRER: Some new ideas were floated today about medical malpractice. A committee of the American Medical Association did the floating. They recommended bypassing the court and jury system and proposed state panels of medical experts to determine fault and damages. The proposal is the AMA's solution to rising insurance premiums they say is caused by large jury awards. The solution drew criticism from Ralph Nader's Public Citizen Group. They said it was too much to expect a panel of doctors to seriously discipline their fellow doctors. MacNEIL: Israel today deported four Palestinians it said had instigated unrest in the occupied territories, as violent clashes with Israeli troops continued. The four were flown to southern Lebanon. Five more Arabs are fighting deportation in the courts. The deportation order had been condemned by the United Nations Security Council, and today the U. S. State Department said it was an ''action we deeply regret. '' At least two more Palestinians were killed during another day of clashes between Israeli security forces and Arab protestors. One disturbance took place in an Arab suburb of Jerusalem, where Palestinian youths stoned Jewish homes in an adjacent area. Elsewhere in the West Bank, Israeli soldiers fired tear gas and chased demonstrators who hurled rocks and set up barricades on roads leading to refugee camps. The United Nations envoy Marrack Goulding visited a refugee camp and told Palestinians their views would be communicated to the world. He told reporters, ''The Palestinians are angry about the conditions under which they live and they have reason to be angry. '' LEHRER: Formal charges were brought today in Nicaragua against American farmer James Jordan Denby. Denby's small plane was forced down by Sandinista rifle fire December 6. His family in Carlinville, Illinois has claimed he flew over Nicaragua by mistake during a storm. The Sandinistas claim he was there to assist the anti government contras. Today's charges are of violating public order and security laws. Officials said he could be imprisoned for thirty years if convicted. There was no word of when a trial might begin. MacNEIL: That's our news summary. Still ahead on the NewsHour, schools and free speech, U. S. /Japanese relations, mending malpractice, and the Margaret Thatcher phenomenon. Gag Order? MacNEIL: We turn first tonight to today's Supreme Court decision on high school free speech. As we reported, in a five to three ruling the court held that public school officials may censor high school newspapers without violating the constitutional rights of student journalists. The case comes from Hazelwood East High School in Hazelwood, Missouri, a suburb of St. Louis. Five years ago this two page spread was set to be published by the school newspaper, The Spectrum. The articles focused on some of the real live pressures facing teens: the increase in teenage pregnancy, the divorce rate, teen marriages, the effect of divorce on kids and the growing number of juvenile runaways. The school principal did not allow the articles to be published, saying they violated the privacy of students and their families. Three students on the newspaper staff filed suit, claiming their First Amendment rights had been violated. Today, nearly five years later, the Supreme Court decided they were not. Joining us now to discuss the impact today's ruling will have is Gary McDowell, resident scholar at the conservative Center for Judicial Studies in Washington and columnist Nat Hentoff, who writes frequently about civil liberties for New York's Village Voice and the Washington Post. Mr. McDowell, what's your general reaction to the ruling? GARY McDOWELL, Center for Judicial Studies: I think that generally what we have here is a very sensible decision on the part of the court. The issues that were raised were not really a censorship case in any strict or meaningful sense. What we had was a principal who deleted a couple of pages from the student newspaper because of questions he had about propriety. Had there been more time in the school year, he was very likely to allow them to have been published with editorial revisions. That's not censorship in any meaningful sense. MacNEIL: Mr. Hentoff, a sensible decision? NAT HENTOFF, Syndicated columnist: I think it's a very sad decision, and ironically it's very injurious to education. I mean, education and what it is to be an American. One of the most serious defects in our schooling, aside from basics like reading and math, is the other basic thing -- and that is what's the Constitution all about? What's the Bill of Rights mean to a student? I travel around fairly often to high schools and there are surveys to indicate this, but I'm going empirically, most kids, the vast majority of kids, are denotatively ignorant of the Bill of Rights, the First Amendment, for example. That's one of the worst taught subjects in school. It has the same impact on them as learning the mean average of rainfall in Wichita. And exceptions to that, almost invariably, are those kids who work on student papers, who have fought with their principals and their school boards, have used ACLU lawyers, have pointed to the Supreme Court Tinker decision, which despite what Justice White said today has been wiped out. And in learning what it is to be, to use the First Amendment. These freedoms and liberties mean nothing on a piece of paper. And this will mean that the First Amendment rights of all kids now in school, in working in high schools -- for that matter, the decision extends as I read it to oral speech as well -- they're gone. MacNEIL: Mr. McDowell? Mr. McDOWELL: I don't think that's true at all. One has to consider the fact that a high school newspaper, especially the one in this case, was a newspaper that was part of a curriculum. It was part of a journalism class. It was not an independent student organization. The purpose of the course and running the student newspaper was to teach the students journalistic responsibility and journalistic ethics. The principal had some very serious questions about two particular articles on sensitive subjects that might invade the privacy of other students, parents, and so forth. Other articles on those two pages that he did not intend to censor but did so simply out of a matter of expediency, exclude from the pages, dealt with the same subjects. This is not censorship of sensitive subjects, it was only an editorial judgment of bad writing. Mr. HENTOFF: That's marvelous. It's straight out of Orwellian Newspeak. The guy takes two pages out of the paper, has it taken out at the plant, does not talk to the students. They say there wasn't time. I've been in this business a long time. There is time. You can get to telephones. The kids didn't know the stuff had been taken out until the morning the paper arrived, they open it up, ''Whaddaya know? It's not censorhip, he's trying to help us. We'd have been okay later in the year. '' I know that principal's record. That's simply not true. He doesn't believe that -- he honestly doesn't believe that students have First Amendment rights. MacNEIL: What about Mr. McDowell's point that that newspaper is published under the aegis of a classroom situation? Mr. HENTOFF: That's the crucial point that I thought was going to be handled today, and Justice White mentioned that it went beyond that. The argument of the school is, ''Look, this is part of the curriculum. You can't be on the paper unless you passed Journalism I. Forget the fact that students are allowed to write letters for the editor from all over the school, they've had freelance writers, pieces by other students. Okay, let's assume this was true. That means that 75% of all the kids in this country who write for school newspapers fall under that category. They're in journalism classes. So there are no First Amendment rights -- if you're in a journalism class -- that's a great way to learn journalism. MacNEIL: And you're saying, Mr. McDowell, there are limited First Amendment rights for students whose publisher is a school, a public school, and therefore the government. Mr. McDOWELL: Surely. This is in no way license for public schooladministrators to waltz in to the student newspaper room and close down the presses. This is simply a matter of trying to inculcate journalistic ethics and responsibility. One would hope that journalism classes would do that. It seems not at all odd that an editor would pull a story from a newspaper if facts were included in that newspaper that might make that newspaper liable. And that's sort of what happened here. Mr. HENTOFF: There was no threat of a liable suit. That was a (unintelligible) brought in by the principal. MacNEIL: Let's move on from what you think about the decision to what you think it is going to do. What impact do you think it's going to have in your view? Mr. HENTOFF: Oh, boy. Justice White's recurrent motif here is that if a principal or an officer of a school feels that a piece in the student newspaper goes against the educational mission of the school, he can censor it. That is the broadest, vaguest phrase you can use. I know a lot of principals. This is going to be, despite what Mr. McDowell says, this is the greatest day in their lives. They can walk into the school newspaper office and say, ''I don't like that, that and that, because I have decided that the educational mission of our school excludes that. '' I mean, this is really training people to live under a society that does not have free press rights. It is the most incredible decision. MacNEIL: What do you think it will do to student newspapers, Mr. McDowell? Mr. McDOWELL: Probably not very much. My view is that probably most high school students tonight are not sitting glued to this program wondering what the future of their rights are. They're out doing what high school students tend to do. Most student newspapers as you saw from the headline in this one in question, deal with prom court royalty, nothing more volatile than that. MacNEIL: But the point has been made, Mr. Hentoff's implying it, but it's been made elsewhere today, that this may reduce student newspapers to sort of bulletin boards of student activities, or PR outlets for the school. And that it will prevent the presentation of issues that are vital, or are very important in the lives of teenagers today in a context and in a medium which they will pay attention to -- like teenage pregnancy, for example. Mr. McDOWELL: I don't think the decision does that. You know, I think Justice Brennan has exercised over this, as has Mr. Hentoff, not because of the case today, but what this implies for the future of Tinker vs. Des Moines School District -- We've now had two cases dealing with students rights -- MacNEIL: Now, let's -- you both mentioned that. Let's just interrupt there. That was the decision in 1969 by the Supreme Court -- Mr. HENTOFF: Abe Fortas, seven to two, which said that free expression by students, the Constitution does not stop at the schoolhouse door, and nobody can censor that expression unless it is legally obscene, defamatory or imminently disruptive of the school. And based on that, through the years have been a number of free press decisions, which are now wiped out, wiped out by this decision. MacNEIL: Tinker is wiped out by this decision? Mr. McDOWELL: I don't think it's wiped out, but I think the court has now taken two steps away from it. Mr. HENTOFF: Ha! Mr. McDOWELL: And I think rightly. I think Tinker was a bad decision. As do a lot of people. MacNEIL: But that is the decision on which school newspapers have been published ever since 1969. Or their freedom has been based ever since 1969. Mr. McDOWELL: More broadly, student expression. MacNEIL: Well, I interrupted you to define Tinker, get Tinker defined, when you were about to say that this would not stop papers from dealing with issues like abortion or teenage runaways or teenage pregnancy. Mr. McDOWELL: No, and I go back to the original point of this case in point. And that is that this principal was not going to censor those articles because of their substantive content. He was simply censoring them or withholding them -- if they could have been edited he would have allowed them to go through -- because of questions of invasion of privacy of students who were mentioned in the stories. It seems to me that this is in no way going to have a chilling effect on student newspapers. Student journalists are going to be able to report the news in a responsible way. Mr. HENTOFF: But this is unreal. No matter what the motivations of Mr. Reynolds, the principal, and let me say for the sake of argument that I don't believe it, that what you're saying is accurate, the decision doesn't take his motivations into account. The decision gives free license to any principal to censor anything that that principal unilaterally decides, and to hell with the First Amendment, is against the educational mission of the school. I mean, this is like Pinochet. MacNEIL: Well, why is that bad in the school context? Why is it bad that a principal who's running an institution with one purpose should interfere with what's in the school newspaper. Mr. HENTOFF: It has now become a commonplace that one of the basic functions of our schools is to teach people to think. To think independently. How do you think independently when you know that the principal is ready and waiting any time you independently say something, or write something, that he finds impossible to have in the school. MacNEIL: Mr. McDowell, you've actually been a schoolteacher, haven't you? Mr. McDOWELL: That's right. MacNEIL: Answer Mr. Hentoff's question. Mr. McDOWELL: I think that is simply outrageous. This case in no way goes to the issue of whether students' expression is curtailed. It deals with the student newspaper in particular circumstances of a (unintelligible) situation and it is quite limited in its scope. Mr. HENTOFF: Read the decision. That decision encompasses oral as well as written speech. Mr. McDOWELL: Well, we go back to the essential point. Schoolrooms are a special place, and as Hugo Black said in the Tinker case, in no way does the Constitution demand that American educators turn over the schools to American students. Mr. HENTOFF: And that's why we have passive adults by and large who couldn't pass a test on the Bill of Rights, because they never learned to exercise them. MacNEIL: Is this -- we have just a minute -- is this -- what's the political context of this decision? Is this part of the general tightening on the liberalism that began to affect all of American education, starting in the '60s, Mr. McDowell? Is this to be seen in that political context? Mr. McDOWELL: I think one can see it in that context. Although it would be more accurate if Justice White had explicitly overruled Tinker. MacNEIL: I see. Do you see it that way? Mr. HENTOFF: No. I tend to avoid these large theories. I think Justice White has been consistently hostile to various forms of free expression. He's not a friend of the press, for example. And it was just a logical thing for him to say that these little people, or littler people, also shouldn't have free rights -- No, I think if you look at the court's decisions, the only surprise to me today, and I thought it was shocking, was that John Paul Stevens should side with the majority. And he knows better. And I don't know why he did it -- MacNEIL: Otherwise it would have been a tie -- Mr. HENTOFF: It would have been a tie. The Circuit Court decision would have been upheld, and the kids would have won at least in that district. MacNEIL: Well, we have to leave it there. Nat Hentoff, Gary McDowell, thank you both. Jim? LEHRER: Still to come on the NewsHour tonight, trading with Japan, reforming medical malpractice law, and a Margaret Thatcher anniversary. East Meets West LEHRER: The new Prime Minister of Japan paid a call on the President of the United States today. It was all friendly and smiles between Misters Reagan and Takeshita, in keeping with their roles as leaders of two nations that are important friends and allies. But there is that trade problem, the source of much mutual resentment and misunderstanding between the two. And with that in mind, here are some words about how Japanese view their Prime Minister's Washington visit. They are from our business correspondent Paul Solman, who did a recent six part series for us on the Japanese economy.

PAUL SOLMAN: This is President Reagan with the last Japanese Prime Minister, Yasuhiro Nakasone. They developed an apparently close relationship that the Japanese called Ron/Yasu from their names. Whether they appeared together on the red carpet or the podium, these consummate popular politicians acted suitably diplomatic, even if they sometimes forgot their lines. Pres. REAGAN: Both Japan and the United States recognize that the current trade imbalance is politically un -- unsustainable and requires urgent attention.

SOLMAN: Translated into plainer English, Reagan meant that it was time for Japan to change dramatically, to open up its economy to imports from us, to stop subsidizing exports. Nakasone, meanwhile, was out to placate the American President. And through him, the American people. America was after all the market on which Japan depended. Japan needed us. YASUHIRO NAKASONE, former Japanese Prime Minister: We are determined to cooperate closely on American economic policy and exchange rates.

SOLMAN: Compared to Nakasone, however, Noburu Takeshita is a very different man. And so is Japan's economic relationship to and attitude toward America these days. Takeshita is considered inscrutable even by the Japanese. A very nonpublic figure, there isn't even much news footage on him. And since he has said little, the cameras don't linger. But behind the face he shows the camera, Takeshita undoubtedly shares some of his constituents growing contempt for America. This is a man who recently joked that American servicemen in Okinawa could no longer afford the local bargirls, and would have to make do with giving each other AIDS. In Japan it was not considered a shocking statement. To many, it was simply recognition of the decline and fall of the American empire. Many of Takeshita's people think America has gone soft. To them, it appears that instead of getting our economic house in order, we whine. Instead of cutting consumption, balancing our budget, saving and investing, we blame the Japanese. To many Japanese, we're a country whose currency has dropped by half and is still in trouble, a country saddled with speculative markets, an increasing disparity of wealth, a massive minority underclass, street crime and AIDS. Looking at it from their point of view, you can see why they might be a little smug. But there's another major change in Japan's attitude towards us besides this creeping contempt. They don't need us as they used to. After a shock when the yen began to rise, the Japanese economy is once again on the rebound. Led by domestic demand, not exports. And as the Japanese become less dependent on the American market, they become less dependent on American public opinion. Prime Minister Takeshita would like to keep America mollified. After all, we're bigger, we have the army, and we can hurt the Japanese economy. But considering how dependent we are on Japanese goods and Japanese investment, we can't hurt the Japanese economy much without hurting our own economy as well. Besides, the Japanese think they have been making big concessions. For years, little by little, trade barriers have come down. The government has just announced it will help share more of the cost of maintaining American military forces in Japan. And it has undertaken major public works programs. Today, with President Reagan, Takeshita offered American companies access to some of that new construction business. In short, Japan thinks it's been doing all anyone could ask: spending its money while moving away from its export obsession. That is the Japanese consensus these days. And Noburo Takeshita is above all a keeper of that consensus. He was chosen as Prime Minister when no obvious successor to Nakasone could be found. He's a man who regularly convened private groups of Japanese with very different points of view than his in order to keep himself in touch with the broad range of public opinion. Most of all, he is concerned with his constituents and their economic interests. The sacred cows of Japanese business. The ranchers and their beef quotas, fishermen and their fishing rights, the retailers and their need to keep out discount stores. And above all, he is responsible to the politically powerful farmers, who refuse to be plowed under in the name of progress. Many Americans don't realize just how strong these special interest groups are, affecting almost every effort at economic change in Japan. In other words, there are pressures on Noburu Takeshita not here in America, but back in Japan. This trip may be a necessary piece of ceremonial diplomacy at a time of conflict between our two countries. But beneath Takeshita's smile may lurk a hint of the contempt now surfacing in Japan, as well as a very politically savvy sense of what play is not in Peoria, but back home in places like Sapporo. MacNEIL: This afternoon, Japanese officials said Prime Minister Takeshita's comments about American GIs and AIDS had been taken out of context. They said he was quoting other Japanese who had made such comments. Government spokesmen said they were upset that an official statement to that effect had not put the issue to rest. Rx for Malpractice LEHRER: Next tonight, a new battle in the medical malpractice war. Once again, it's between the doctors and the lawyers, and once again, it's over ways to dispose of patients' claims of malpractice against doctors. The medical profession maintains the current court and jury system way is ruining private medical practice. The legal profession maintains it's only incompetent doctors who are facing ruin. At any rate, the doctors' organization, the American Medical Association, today announced its recommendations for a new system. It would take the court and jury system out of malpractice cases, and replace it with a medical review board. And it would cap some damage awards. One of its chief architects is Dr. James Todd, the AMA Senior Deputy Executive Vice President. A leading critic is Eugene Pavalon, a Chicago lawyer who is President of the Association of Trial Lawyers of America. He joins us from Chicago. Dr. Todd, to you first. Explain the Medical Review Board system, how would it work? Dr. JAMES TODD, American Medical Association: Well, first of all, let's all agree that there is great debate as to really what causes the malpractice crisis problem. But two things are clear. That the federal government has said it, independent think tanks have said it, two things need to be done. One, we need to try alternative dispute resolution mechanisms. And secondly, we need to improve physician discipline, surveillance and re education. Our plan will do just that. Under our plan, any patient, regardless of the magnitude of injury, without any cost to them, if they believe that they've been injured, they may apply to this agency which will be created by the state, have their claim reviewed independently with the use of experts -- LEHRER: What kind of experts? Dr. TODD: Physician experts in the specialty in which they're involved. And then go on to a hearing before essentially the administrative law judge, who will objectively determine the facts without the (unintelligible) position of emotional -- it's difficult enough to tell what goes on in medical care without introducing the emotional adversary system of the courtroom. What we're really trying to do is find out what the facts are. This -- the patient then could do this at no expense, can get expert -- LEHRER: In other words, the lawyer would be provided -- would be represented by a lawyer at this hearing, right? Dr. TODD: The lawyer would be provided -- from -- not necessarily, but usually, yes, from the agency, provided by the state and at no cost to the plaintiff. Now, the second piece of this, which is terribly important, that this reconstituted medical board, or separate agency if the state so wanted to do, would have a minority of physicians. The majority of the members would be lay people, attorneys, consumers, any number of people, so that it would not be doctors looking at doctors. But in place would be a very complicated and extensive reporting system. This board would know about all of the malpractice actions. It would know about all of the credentialing adverse activities in hospitals, it would be required to review a physician's practice every two years, and instead of having anecdotal information about physicians' behavior, they would have an ongoing stream of information that would allow them to identify the few loose cannons that are out there before they go off. We believe that this is patient oriented. We believe it is very demanding of the physicians, and we believe that it is equitable and fair and restores some predictability and rationality to a system now out of control. LEHRER: Mr. Pavalon, what do you think of that idea? Mr. PAVALON: Well, let me say that there are several problems. One is the problem, or the question and issue of dealing with the claimants, people who are grieved because they have suffered injury in the delivery of health care. And the second problem has to do with the disciplinary process and the quality of health care being delivered. And the two are really separate and specific identifiable problems. I would welcome and join with the American Medical Association in addressing the problem of the quality of health care. Certainly there's been a great deal of recent recognition in the fact that the medical disciplinary process is inadequate. It is not doing the job it should be doing. To that extent, the report of the AMA, and particularly the press release that came out a couple of days ago, recognizing the fact that more needs to be done with regard to the policing of medical and the delivery of health care, I welcome that, and I would say that -- LEHRER: But what -- Mr. PAVALON: -- at trial bar. Now let's talk about the program itself. LEHRER: Right. Mr. PAVALON: The panel program I think is an insult to the intelligence of the American public and the consumers of health care. What it does is it trashes the civil justice system that is time honored and has been proven to be one of the best dispute resolution systems in the world. And in its place it submits and it provides for a panel, a panel that becomes both the trier of the law and the trier of the fact. The panel, Dr. Todd said, would include doctors, but a minority of doctors. But the fact that he doesn't mention is that the entire process really is run by doctors and the medical reviewers who will have the ultimate responsibility of determining whether or not or concluding based on the rules promulgated by this particular program, whether or not a doctor is liable -- liable under the rules -- new rules I might add -- of liability. There is no review process at all. The review process simply is that an appellate court has an obligation and responsibility if it ever gets that far of determining whether or not the panel abused its discretion or acted in an arbitrary and capricious fashion. So for all intents and purposes, the determination of this panel and board becomes the final determiner as to whether or not the victim of malpractice is entitled to recover at all. But then it goes further. And this is sort of rubbing a wound with the salt of consumers of health care. It also provides significant limitations across the board for the actual victims, those people who the board in fact finds are entitled to recover because they were victims of medical malpractice and medical negligence. Its across the board limitations have been rejected by virtually every legislature of this state that has considered all of these, the complete panoply of the so called Tort Reform Agenda as patently unfair. It places arbitrary caps and limits on the amount that a victim can recover, and it changes (unintelligible) dramatically. LEHRER: I want to get to that issue in a moment. But Dr. Todd, how do you respond to -- Dr. TODD: Mr. Pavalon needs to read the report. Because it doesn't trash the civil jury system. There's precedent for what's going on. National Labor Relations Board has used this system, and Workers' Compensation has used this system. The No Fault Automobile system has removed these injuries from the courtroom. It's not trashing the system. It's saying that it's not working. Fifty seven percent of the premium dollars that go to malpractice are used in transaction costs, that is, attorneys fees, investigational fees, and what not. And here is an agency that at no cost to the patient is going to do this investigation, and when the award is given, the patient keeps 100% of it. LEHRER: Let me ask you both one question. There's many people in the lay public say that whenever there's an argument about malpractice, it is basically the self interests of the doctors vs. the self interest of the lawyers. Is that -- would you agree at least that Mr. Pavalon from your perspective is arguing the self interests of the lawyers? Dr. TODD: I don't want to comment on Mr. Pavalon's intentions. But I can tell you from our point of view, we are not arguing income or protection of it, because we don't know what the costs of the system is going to be. Clearly, under our system, more patients are going to receive awards for -- LEHRER: More patients? Dr. TODD: Yes. Because today there is the contingency fee threshold, that if the award isn't going to exceed that, there are a fair number of patients that never get an opportunity to have their case heard. Here, any patient, regardless of minimal, maximal injury, without cost, can get into the system. Now, it may increase the total cost. But we are so convinced that this is a fairer system to the patient, a more predictable and stable system that if it costs more, we're prepared to assume that cost. LEHRER: But are you also -- isn't it also correct to say that this will essentially help doctors, too? Dr. TODD: I'm not sure it will. I think certainly the fact that you're going to have objective determination because don't forget in the courtroom, in many respects the decision handed down depends on the skill of the attorneys. It may well be that an objective system such as we're proposing will be just as hard on physicians as patients. LEHRER: What do you think of that, Mr. Pavalon? Mr. PAVALON: Well, first let me say something about what Dr. Todd just said concerning workers compensation and the National Labor Relations Board. First of all, in both of those procedures and processes, you have an adversary system, and you have much more extensive review. So that is absolutely not true when he says this system has been used in other areas. It has not. In fact, this is the first time in history that I could recall that anybody has proposed a fault base system that is non adversarial, without a pervasive reviewing process. It's absolutely unheard of. And particularly when you have doctors in essence controlling the ultimate outcome. Now, let's talk about whether or not more patients will be compensated. I just don't see where that is the case and the proposal. The fact of the matter is that would assume that you have an overly generous board and that you have an overly generous process, a process that in essence is going to be controlled by doctors, who are going to be ruling and determining whether or not another doctor has to pay a victim who claims to be a victim of medical malpractice. LEHRER: So you just think that's absurd on the face of it, that doctors are going to turn around and bite their own fellow doctors, right? Mr. PAVALON: Well, it's like having -- Dr. TODD: (unintelligible) in this whole thing. You have administrative law judges, you have attorneys in the process, you have claims investigators who are answering to a board composed of a majority of lay people with physicians in the minority. Where is the physician control? Why is the legal profession so afraid to try an innovative -- and we're not pushing this as the solution -- a solution. LEHRER: Mr. Pavalon, one final word. Mr. PAVALON: Sure. LEHRER: No, go ahead. You go. Mr. PAVALON: What I suggest to Dr. Todd is that there are certain problems in delivery of health care. Both in terms of the consumer, in terms of the cost of insurance, and in terms of the quality of medical care that's being delivered. An alternative dispute resolution process and system can be part of the system if it'sa voluntary and patients know what they're choosing and have an opportunity to select it. But we should never, never trash the civil justice system, which is indeed the best system that we have today. LEHRER: We have to leave it there. Mr. Pavalon in Chicago, thank you. Dr. Todd here, thank you both. Rule Britannia MacNEIL: Finally tonight, we have a close look at British Prime Minister Margaret Thatcher. She has now held Britain's top elective office for longer than any Prime Minister this century, including the great names like Lloyd George and Winston Churchill. When Mrs. Thatcher passed that milestone ten days ago, the BBC program Panorama broadcasts an evaluation of her leadership. We have an extended excerpt from that program. Robert Harris was the correspondent.

ROBERT HARRIS, BBC: Marxists, Mrs. Thatcher once observed, get up early in the morning to further their cause. We must get up even earlier. And so, soon after six, whilst the rest of White Hall sleeps, the Prime Minister is waking up to vitamins, black coffee and the early morning radio. She lives in a tiny flat above the shop in Downing Street, and puts in up to a 20 hour day seven days a week. Yet, despite this grinding schedule, Mrs. Thatcher yesterday completed 3,167 days in office, overtaking the 20th century record set by the great liberal premier, Herbert Henry Asquith. She's outlasted Asquith and most other world statesmen, too. Of the seven major Western leaders in office nine years ago, she's the only one left. Pres. REAGAN: When you sit around that table with the seven heads of state at the economic summit and discussions come many times when we're firing back and forth over different things, you can't help but notice the respect when she addresses a subject, when she speaks. She is, you might say -- we wait to hear from her. HARRIS: And sometimes you can't get a word in edgeways, I've heard it said. Pres. REAGAN: I haven't found her trying to dominate in that way, no.

HARRIS: But dominate she does. If less abroad, then certainly over her colleagues in the cabinet at home. Not since Churchill has a Prime Minister so stamped their personality on the government. Lord HAILSHAN, former Lord Chancellor: You can't put her for instance in the same category as (unintelligible) Elizabeth I, Queen Anne, Queen Victoria. Well, she does remind me more of Elizabeth the First. Out of those four. Her handling of men is not altogether dissimilar, and if you'd been a courtier of Elizabeth I, you would never know quite where you were going to get the treatment of an admired male friend, or a poke in the eye with an umbrella if she'd got an umbrella, which she hadn't.

HARRIS: In the great Library at Longleat, the Marquis of Bath has a private collection of Margaret Thatcher memorabilia, an honor shared only by Churchill and Hitler. Her image, graven in plastic and china on crockery and chipboard. She has become an icon, not just the seventh longest serving premier in our history, but actually the fourth longest in terms of an unbroken span in office. And she has done this as the leader of one of the most traditional, tribal, male dominated parties in Western Europe. How many of these famous Tory Prime Ministers whose portraits hang in the Carlton Club would have expected to see a woman in Downing Street for the best part of a decade? Mrs. Thatcher will go down in history not just because she's a woman, but because of the way she's used her power to bring about what she sees as a revolution in British life. MARGARET THATCHER, British Prime Minister: I'll now say a word about secondary education. A number of us have our own beliefs about the way in which secondary schools should be organized.

HARRIS: When Mrs. Thatcher was Education Secretary in the Heath government, no one dreamed she'd be Prime Minister. She was the Cabinet's token woman. Even she didn't expect to see a female leader. Mrs. THATCHER: I don't think that there will be a woman Prime Minister in my lifetime. And I don't think it depends on so much were it a man Prime Minister or a woman Prime Minister, as whether that person is the right person for the job.

HARRIS: What was it that transformed this archetypal Tory lady into the longest serving premier this century? The answer was part luck, part determination, but above all the fact that her ideas so unstylish in the '60s and early '70s, suddenly came back into fashion. The rise of union militancy and a world recession led the Heath government to abandon its free market policies. When Heath lost power in 1974 against a background of industrial chaos, it produced a crisis of confidence in the Tory Party. Mr. Thatcher became the focus for Tory MPs angry at the failure of the Heath government. In 1975, she emerged as the only ex cabinet minister prepared to challenge Heath for the leadership. And to his astonishment, she cut him to pieces on the first ballot. Her opponents had underestimated her, not for the first time, nor for the last. JOHN BIFFEN, former cabinet member: The fascinating story of that election was how Margaret Thatcher, having been elected on the ticket that she was the most suitable replacement for Edward Heath, then had to set about turning her victory into a victory for her views and her opinions. And that wasn't a foregone conclusion. It was done with great determination, as you might imagine. And skill and some luck.

HARRIS: Mrs. Thatcher's views and opinions were formulated in the late 1930s and '40s in Grantham in her father's grocer shop. It was Alfred Roberts who first laid down the principles his daughter has since turned into Thatcherism, the philosophy of shop and Sunday chapel, small town and school. ''My policies,'' she has said, ''are based not on some economic theory, but on things I and millions like me were brought up with. An honest day work for an honest day's pay, live within your means, put a nest egg by for a rainy day. Pay your bills on time. Support the police. '' ENOCH POWELL, former member of Parliament: It seems to me that Mrs. Thatcher operates with a relatively limited total of fairly simple ideas and notions. She seems to be convinced of what most politicians have ceased to be convinced of, that there are such things as good guys and bad guys. Not to say good and evil. It that kind of simplicity of perception, of speech and of analysis, which leads me to hesitate when I'm invited to say that Mrs. Thatcher is a thinker.

HARRIS: Her moment finally came in the winter of 1978, the so called Winter of Discontent. As industrial chaos spread, Mrs. Thatcher's instinctive beliefs found a new resonance in the country. She was to be swept into power on a wave of uncollected garbage. Mr. BIFFEN: Margaret Thatcher's greatest success was that she secured the leadership in 1975, and with only a handful of those who thought like her on the questions of the economy and had views about the balanced budget and all the rest of it, which we now call monetarism, she nonetheless set about securing first of all a growing number of monetaristsinside her cabinet, and developing a growing degree of support from monetarism in the Parliamentary Party, and eventually for the party and the country at large.

HARRIS: The first Thatcher cabinet contained few actual Thatcherites. She'd been obliged to include in it many who'd been close to Edward Heath, the Wets, as she derisively dubbed them. And the first two years were to be marked by frequent rows. It was partly a matter of policy, but also a product of her style. Sir JOHN NOTT, former cabinet member: She likes an argument. She likes arriving at decisions by argument. And some of my colleagues in the cabinet, you know, hated argument. As soon as an argument began, she very often used to provoke one for no reason that one could really discover, they used to bury their head in the table and they used to clam up. Others of those who weren't necessarily of the same view, like Jim (unintelligible), used to love an argument and used to create one for no conceivable reason. But basically, she liked arriving at decisions by strong discussion. Some of my colleagues didn't like that very much.

HARRIS: Meanwhile, the problems besetting the government worsened. Unemployment and bankruptcies reached record levels. There were riots in the inner cities. It seemed a replay of 1974. And Mrs. Thatcher increasingly looked as though she might go the way of Mr. Heath. Inside Downing Street, the cabinet agonized. Would Mrs. Thatcher do what Edward Heath did and begin bailing out British industry? Or would she defy a growing number of her own colleagues and cut public spending still further? Mrs. THATCHER: To those waiting with bated breath for that favorite media catch phrase, the U turn, I have only one thing to say. You turn if you want to. The lady's not for turning.

HARRIS: A few weeks after this ringing declaration, Mrs. Thatcher made her first decisive move against the Wets. In January, 1981, Norman St. James Stevens was sacked. Eight months later, Ian Gilmore, Lord Soames and Mark Carlisle were also dropped. Altogether in the past 8 l/3 years, more than three quarters of Mrs. Thatcher's original cabinet have resigned, retired or been sacked. Only five of the 1979 team remain, and of those, only one is still in the same job: Mrs. Thatcher. Certainly Mrs. Thatcher has downgraded the importance of the cabinet, and to her it meets only once a week, half as often as it did before she came to power. Policies are decided in advance of discussions here. Previous Prime Ministers have spent more time in cabinet, building up alliances, talking things over with cronies, often late at night. Mrs. Thatcher's approach is much more businesslike. Mrs. THATCHER: Are there any other points that we wish to raise generally before we go into the main business? NORMAN TEBBIT, member of Parliament: I think that women are simply not clubbable in the way that men are. And therefore there's far less chance of her forming a small clique around about her. She treats I think all her ministers far more on a bilateral, equal basis than probably any male prime minister would ever do. Because one has chums, you know, and her relationships are slightly different from that. And I think it's partly being a woman which makes it so. Sir FRANK COOPER, former senior official: She's been in the most powerful office not only longer than our ministers have been there, but of course much longer now than many of our most senior officials have been in their particular posts. So she's been living with some subjects longer than the people who are supposed to be advising her on those subjects. This has happened imperceptibly over a very considerable period of time. HARRIS: And what effect does that have? Sir FRANK: It means that she won't (unintelligible) with (unintelligible) from Sunday trying to give her a line of (unintelligible), quite frankly.

HARRIS: Four minutes is said to be the maximum time the Prime Minister allows a civil servant to present a brief. After that, her eyes tend to glaze over. She not only reads every paper in her red boxes, she annotates almost every document. Lord HAVERS, former Lord Chancellor: She uses the dye thing that makes the words stand out, brings it out with the yellow or red. You see the documents all marked. You're sitting there at her, thinking, ''My god, I really got to be on top of this one, she'll (unintelligible). And it's all done (unintelligible). And not I think by her staff, I think by her. She has the barrister's knack of mastering her brief, of speedreading, which is the thing that all barristers are meant to be taught. And it is sometimes quite formidable to go into a meeting with her and find that she knows absolutely everything from A to Z.

HARRIS: For what then might history remember her? Perhaps above all, for an event quite outside the normal run of British politics. The Falklands War was the most dramatic example of Mrs. Thatcher in action. She was determined not to compromise, despite the costs and the appalling risk. Sir JOHN: I think it's doubtful whether any male Prime Minister would have actually seen that Falklands thing through to the end. I think probably the vast -- I can't think of a man who wouldn't in the end have probably done a deal at some point in time. But, no, she was going to win and she was going to win at any cost.

HARRIS: For Mrs. Thatcher, the Falklands crystallized everything her government was about. A statuette depicting this scene is amongst the most treasured possessions. Mrs. THATCHER: This is all in porcelain. The quality of the work is superb. Look at the beauty, look at the craftsmanship of it, the loveliness. But look above all at the expression of the faces of the marines. No gloating at all. The just, unbelievable kindliness and pride. Once again, raising the flag of Britain. More than that, restoring freedom to the people of the Falklands. And look at it. It is the spirit of Britain.

HARRIS: The view of the Prime Minister as vividly expressed in this party election broadcast is that the national spirit has been rekindled. Britain in the words of the election slogan, is great again. Increasingly, the Prime Minister plays on the world stage. As the longest serving leader in the West today, she sees herself spreading the gospel of Thatcherism to everyone, capitalist and communist alike. To no one has she proved a more dependable ally than to the current president of the United States. And the feelings are mutual. Polls consistently find her the most popular foreign leader in America. She may not always appreciate his handling of matters. She recently ticked him off over the size of his budget deficit. But mostly she keeps any reservations to herself. And he is happy to throw protocol out of the window to talk about their special relationship. (to President) Mrs. President, how close is your relationship with Mrs. Thatcher? Pres. REAGAN: Well, I think we're very good friends. And it's a friendship that I treasure very much. At the same time, in the economic summits where the seven heads of state sit around that table and all, I've noticed that we usually, without any preplanning, we usually seem to wind up on the same side of the subject. HARRIS: Is she someone you speak to a lot, and is she someone you speak to on the telephone fairly regularly? Pres. REAGAN: Oh, we have, we stay in communication on a great many things.

HARRIS: Ronald Reagan is the second American president with whom Mrs. Thatcher has dealt since she occupied Downing Street. And when he leaves office at the end of the year, she will have to get to know a third. It's facts like these which make one realize just how long she's been in office. And there's no need for another election until the summer of 1992. At Madame Toussaint's, they're already working on the fourth model of the Prime Minister. She's been in office so long the others are out of date. Only one other figure has required more versions, Winston Churchill. And at 62, Mrs. Thatcher is still three years younger than Churchill when he first came to power. Asquith was deposed as Prime Minister an exhausted man. Mrs. Thatcher's appetite for the job is undiminished. Mr. BIFFEN: I think she can go on for a long time. And anyway, what would she do if she wasn't being Prime Minister? Can't imagine her making marmalade for the Doubly Y, or knitting woolies for the grandchildren. She's a very, very active woman.

HARRIS: Mrs. Thatcher betrays no sign of even thinking of retirement. By 1991, she will have overtaken the records of Palmerston and Lanston. If she wins another election, she could supersede both Salisbury and Liverpool to become the third longest serving British Prime Minister. It would be a rash man who would give odds against her. Recap MacNEIL: Again, the main points in the news today. The Supreme Court ruled that public schools may censor student newspapers and other forms of expression. Israel deported four Palestinians from the West Bank as troops killed two more demonstrators. Good night, Jim. LEHRER: Good night, Robin. We'll see you tomorrow night. I'm Jim Lehrer. Thank you and good night.