The MacNeil/Lehrer NewsHour

MR. MacNeil: Good evening. Leading the news this Tuesday, Pres. Bush will veto Medicaid abortions for rape and incest victims, rain stopped the launch of the shuttle carrying the spacecraft Galileo, stock prices fell moderately after bad trade deficit news. We'll have details in our News Summary in a moment. Judy Woodruff is in Washington tonight. Judy.

MS. WOODRUFF: After the News Summary, the drug war gripping Colombia is our lead focus. Correspondent Charles Krause has a documentary look at the terrorism that threatens that country and an interview with Luis Gabriel Cano. Next, a start of a series on the difficult conditions facing hospitals. Tonight Jeff Kaye reports on the emergency room crisis in Los Angeles, and finally Education Correspondent John Merrow talks with Tracy Kidder, the author of a best selling book about a year in the life of an elementary schoolteacher.NEWS SUMMARY

MS. WOODRUFF: Abortion was back in the news today both at the federal and at the state level. In Illinois, a committee of the state House of Representatives today voted to block a bill that would have imposed further restrictions on abortion. And at the White House, a spokesman said Pres. Bush plans to veto a bill that expands federal funding of abortion to cases of rape and incest. The bill passed the U.S. House last week and has yet to win final approval by the Senate. Mr. Bush had said a few days ago that he would consider a compromise on the issue but negotiations with Congress failed. Today's threat brought reactions from Congress members on both sides.

REP. BARBARA BOXER, [D] California: And such a veto would be the height of hypocrisy. The President supports the right of wealthy women to choose an abortion if they are the victim of rape or incest. But if she's poor, the President says, I can't help you. You have to twist in the wind, you have to bear the product of violence without a choice.

REP. CHRIS SMITH, [R] New Jersey: We think the President has taken a very principled, albeit very difficult stand, but a very principled stand based on protecting again to the maximum extend possible the lives of the unborn.

MS. WOODRUFF: The pro choice members of Congress concede that they did not have the votes to override a Presidential veto. Also today at the White House, Press Secretary Marlin Fitzwater said Pres. Bush is seeking an understanding with Congress to relax restrictions on support for potentially violent attempts to overthrow foreign governments. Fitzwater said the proposed changes would not alter a longstanding executive order banning assassinations, but would allow the U.S. to have contact with the plotters of a coup that might result in the death of a foreign leader. Current restrictions are believed by some to have tied the hands of the U.S. in the recent coup attempt against Panama's Gen. Noriega. Robin.

MR. MacNeil: In Colombia, the nation's judges called a three day strike in response to today's assassination of one of their colleagues, Federal Judge Hector Rodriguez. Today's killing happened in Medillin, the center of the drug trade. The judge was shot on his way to work by an assassin on a motorcycle and drug traffickers claimed responsibility. They said it was the first retaliation for the extradition of several accused drug traffickers to the U.S.

MS. WOODRUFF: Rain postponed today's planned launch of the shuttle Atlantis. Shuttle managers said they will try again tomorrow. The shuttle remains heavily guarded because of a large number of protesters who oppose the nuclear fueled Galileo space probe that will be launched into space by Atlantis once it is in orbit over the earth.

MR. MacNeil: The stock market depressed by bad trade figures failed to sustain yesterday's big rebound from the big selloff on Friday. The market opened sharply lower, recovered, and then fell back. The Dow Jones Industrial Average ended the day down nearly 19 points. Trading volume was heavy but far less than yesterday. The Federal Reserve Board pumped an estimated 1 1/2 billion additional dollars into the money supply as a further effort to keep Friday's mini crash from having a ripple effect through the economy. The trade figures were more negative than expected. The deficit jumped to a new peak for the year, with imports exceeding exports by 10.77 billion dollars. And the July deficit was revised upwards. Analysts said the figures reversed signs that the deficit problem was being solved.

MS. WOODRUFF: On Capitol Hill, the House Banking Committee today heard testimony about a faltering California savings & loan institution which the government failed to crack down. William Seidman, the Chairman of the Federal Deposit Insurance Corporation, said a 1986 exam of Lincoln Savings & Loan showed numerous violations of sound banking practices, that the Irvine, California thrift was allowed to continue to operate without government intervention. Seidman said the failure of the Federal Home Loan Bank Board to take control during the three year period will eventually cost taxpayers between 1 1/2 and 2 billion dollars.

MR. MacNeil: East Germany's Communist Party leaders met tonight amid growing speculation over the political fate of Pres. Eric Honecker. The meeting follows another pro democracy demonstration held last night in the City of Leipzig, the largest ever held in East Germany. More than 100,000 people participated. There were banners demanding freedom of the press and free elections. And there were chants of power to the young people and a call for the 77 year old Honecker to accept reform or retire.

MS. WOODRUFF: Pres. Bush met at the White House today with South Korean Pres. Noh Tay Woo and assured him that U.S. troops will remain in South Korea as long as there is a threat from the North. He also expressed support for Noh's efforts to reduce tensions on the Peninsula. But he said that while Korean workers and companies have benefitted from access to open markets in the United States, Korea has yet to open its markets adequately to U.S. products. In response, Noh said the Korean government has been moving toward wider openings in its markets.

MR. MacNeil: In South Africa, Black Nationalist Leader Walter Sisulu, released Sunday after 26 years in jail, refused to renounce violence in the battle against apartheid. He also called for stronger economic sanctions against his company. We have a report narrated by Louise Bates of Worldwide Television News.

MS. BATES: Walter Sisulu emerged from his Sweto home for the first television interview he has ever given. He and later the South African foreign minister, Pik Botha, made it clear the day of negotiations is drawing nearer.

WALTER SISULU, African National Congress: We are ready to talk to the government. We have made declarations of what we want and it is for the government to respond to that. It's a demand, universal demand. And I think that if they are reasonable, they would have to react to that demand.

PIK BOTHA, South African Foreign Minister: We are in contact with a number of leaders and as I stated earlier, we have started to remove the obstacles to negotiation.

MS. BATES: Police outside Sisulu's home were more interested in removing posters, supporting just the organization the government's preparing to talk to. The ANC is still illegal but that is apparently something the government at least is willing to overlook. Whether it'll start talks without formally unbanning the ANC has yet to be seen. In Cape Town, meanwhile, Archbishop Tutu was visiting one of Sisulu's former jail mates, Oscar Ampheta, an elder statesman of the resistance movement. The scene had the air of a victory celebration.

MR. MacNeil: Responding to fears that elephants may become extinct 76 nations agreed today to ban ivory trading. But at a special United Nations conference in Lozan, at least three countries, Zimbabwe, Botswana, and Mozambique, said they would defy the ban. They argued that ivory trading did not threaten their elephant populations.

MS. WOODRUFF: That's it for our summary of the day's top stories. Just ahead, the impact of the bloody drug war in Colombia, the growing problems facing American hospitals, tonight the emergency room crisis, and a year in an elementary school. FOCUS - UNDER THE GUN

MR. MacNeil: Colombia is first tonight. The drug cartels deadly war continued today when a Judge was assassinate in Medillin. A caller to a radio station said Judge Hector Hemanez Rodriguez was killed in retaliation for the extradition of Colombians wanted on drug charges in the United States. The assassination prompted a three day strike by the court workers union. They virtually shut down Colombia's judicial system. This latest assassination was sparked by a political assassination in August that lead to a new Government crack down and an angry response from the cartel that now threatens Colombian society. Charles Krause has a report.

MR. KRAUSE: It was early evening August 18th. Presidential hopeful Louis Carlos Galan has just arrived at a campaign rally. Seconds later, Colombia's most popular politician, a reformer often compared to Robert Kennedy was dead. Gunned down at point blank range.

MR. ARRIETTA: During his life, he made it a point to fight drug traffickers. He really believed they were the evil of the country.

MR. KRAUSE: Carlos Gustavo Arrietta is Dean ofColombia's most prestigious Law School. Los Andes. Despite hundreds of murders attributed to the cartel Arrietta says Galan's murder came as a shock.

CARLOS ARRIETTA: They had never attacked such a high person. When they attacked Galan it seemed like it was really the drop which finally filed the cup.

MR. KRAUSE: Colombians by the tens of thousands turned Galan's funeral into a protest against the hit squads and private armies which Colombia's drug lord had created to terrorize the Country. There was real anger and defiance as Galan's coffin made its way through Bogota's central plaza. Galan would almost certainly have been elected Colombia's president next year. Now his death has left a dangerous political vacuum. In one stroke, the cartel not only silenced its most outspoken opponent it tore at the very heart of Colombia's democratic system. Ironically, it was one of Galan's political rivals Conservative Party Presidential hopeful Rodrego Lloreda who most eloquently expressed the rage which many Colombians felt.

RODRIGO LLOREDA, Presidential Candidate: I think the country lost a great man. And in the cemetery, what I wanted basically is to give the message of a new generation in this country that wants change that is seeking to strengthen values. That all these things Galan represented.

MR. KRAUSE: Do you view the Medillin cartel as a threat to Colombia?

MR. LLOREDA: Definitely, they have declared war on the country and the whole system.

MR. KRAUSE: Since that war was fired in August Colombia's National Police and Army have seized homes, planes, and millions of dollars worth of other assets belonging to the Medillin Cartel. But so far, it's the government and Colombia's political system that have suffered most from the war and appear to be in the greatest danger. More than a hundred and fifty banks, newspapers, hotels and political party offices have been bombed. Businessmen and a former mayor of Medillin have been murdered. Bogota , Colombia's Capitol is a armed camp. Soldiers patrol the streets. The government is virtually paralyzed, barely able to cope with the avalanche of terror. Security for the 13 remaining Presidential candidates has become especially tight, while the campaign itself has come to a virtual halt. None of the candidates is more heavily protected than Ernesto Sanpare. Like Galan, he is a liberal party Senator who is running for the party's presidential nomination. Day and night Sanpare is surrouned by at least a dozen body guards. That's because last March, he was himself gunned down at the Bogota Airport. Samper's body was riddled by 11 bullets. Miraculously he survived, but like so many other Colombians in public life Sanpare has lost his freedom has lost his freedom. You can't go out of your house without body guards. How do you feel?

ERNESTO SAMPER, Presidential Candidate: It is very sad, because I want this country as it was 10 years ago when you can go with the children to the parks, to the sports and you can walk the streets without a problem. But I understand that this is the cost I have to pay to be in the public realm as I am at this moment.

MR. KRAUSE: Samper, and the other candidates have become have in effect have become prisoners of their own security. Their movements are planned and executed with military precision. All public events, parades, and political rallies, the stuff of politics have been cancelled. Speeches are restricted to hotels and other relatively secure locations. Elsewhere the candidates race from heavily guarded office to heavily guarded event. They travel in armored cars. Guns are always present. Ambulances, blood and plasma are never more than a few minutes away. Lloreda says Galan's assassination has clearly had a lasting impact on the campaign.

MR. LLOREDA: Some of the events have to be announced after they have taken place and not before. So a lot of changes in practical terms have taken place and this of course will limit the capacity of being in contact with people of sharing with people as has been the custom in our political activity.

MR. KRAUSE: Are you concerned that it could undermine the political process in this country?

MR. LLOREDA: I would hope not in the sense that we have a democracy. We want to keep it. We want elections. And unless terrible things happen in the next couple of months I would think that elections will take place that we will have a normal process in spite of the limitation that I have spoken of.

MR. KRAUSE: The U.S. Ambassador to Colombia agrees.

THOMAS McNAMARA: Let me recall for you the situation in the United States in 1968 which was not dissimilar where we had a presidential candidate assassinated. We had Martin Luther King assassinated and we had another Presidential candidate through attempted assassination wound up crippled for life. The system adjusted in 1968. The campaign continued. We elected a President and we over came the crisis of the moment. In a sense, Colombia is going through a period that is not dissimilar to what we went through in 1968. The history of Colombian democracy, the stability of the political system and the manor in which the country and the population have dealt with these crisis in the past suggests to me that they will be able to make the adjustments. They will in fact elect a president and they will and they will continue to function as a democracy.

MR. KRAUSE: But many of the Colombians are not so sure in part because of the country's current President Virgilio Barco. Abroad he is one glowing praise for getting tough with the cartel but at home he is rarely seen and he has been widely criticized. Conservative Party Newspaper Editor Juan Carlos Pastrana is one of Barco's leading critics.

JUAN CARLOS PASTRANA, Editor, La Prensa: The very clear fact is the President is locked in his palace. he has been there for the last two or three weeks. Obviously if the man who is the Commander and Chief of the Army, who is the head of a nation he can not go out in the street it is very difficult to think of an effective political campaign. It is I would rather say optimistic to think of a possibility of having an election, a real election I mean.

MR. KRAUSE: Some Colombians go even further. They worry that if the cartel's power to intimidate politicians and public officials continues to grow the drug Mafia could end up with a veto over the Government and in control of much of the Country. Already, the cartel has used its vast resources to buy judges and politicians. By one estimate, 40 percent of Colombian's Congressman and Senators have accepted drug money to finance their campaigns. Key police and army units are riddled with corruption. Then they are killed. No one is safe. Law and order in Colombia have broken down.

MR. KRAUSE: Do they have a political objective or are they just trying to eliminate any one who opposes their activities.

CARLOS ARRIETTA: That is a very interesting question. My personal impression is that they do not have a particular political objective. Basically what they want to get rid of any one who opposes them.

MR. KRAUSE: But Arrietta worries even if the political cartel does not have a clear political agenda the break of law and order, the chaos could soon destabilize the Government and the country.

MR. ARRIETTA: If you take into account more than 200 judges which have been murdered. Thousands of civilians, thousands of military men, thousands of politician plus the political effects, which is caused by the activities of the para military right forces. You can understand the effect that can have in a country like Colombia. Political effects, economic effects, social effects, which could change radically the basis of our social system.

MR. KRAUSE: Yet it was not until Galan's assassination just a two months ago that Colombia's Government finally decided to get tough with the cartel and requested help from the United States. What the Bush administration dispatched was $65 million worth of mostly outdated military equipment stock piled from Viet Nam. But what the Colombians wanted most was electronic and communications gear to intercept drug shipments and help protecting judges, government ministers and other vulnerable public officials. Washington's emphasis on guns rather than economic aid and security has become a political issue.

RODRIGO LLOREDA: I think as far as the United States could help us to maintain a good sound economy. And this combined with close cooperation in the training for people in sophisticated technical instruments to deal with this particular type of war. We would be doing a better job then flying down helicopters and planes and things which are probably a big show. I don't place too much hope in the U.S. response to tell you the truth. I think we're in this war a little bit by ourselves.

MR. KRAUSE: So far, nothing has stopped the continuing violence and terror. Not one of Colombia's top drug dealers has yet been caught. There's a feeling the cartel is so rich and powerful it may be invincible. Pastrana says Colombians are growing cynical and weary.

JUAN CARLOS PASTRANA, La Prensa: It preys on people's strength, on their capacity to hold on in the face of terror, on the everyday stress, on the life of people, on their families, their life their children who are real targets and probable victims.

MR. KRAUSE: Because the government has not rallied the people, Pastrana says public opinion could soon shift from support for the war on drugs to demands for negotiations with the cartel.

MR. PASTRANA: If a country is not gathered you run the risk of losing support at one point of eroding some alternatives becoming possible in minds that are not really strengthened and rallied around a cause.

MR. KRAUSE: Compromise might end the violence but Arrietta says the price, Colombia's future would be too high.

MR. ARRIETTA: It is very difficult to imagine how a country at least in the traditional concept of a country, of a democracy can be run by drug traffickers. We would probably finished as a country at least with the concept we have of a democracy of a country and an economy and we change in to a total different concept which I can't describe because I don't know how at this moment.

MR. MacNeil: Journalists are in the forefront of fight to preserve Colombia's democracy. And as Charles Krause reported, they're also high on the cartels hit list. Chief among them are the owners and employees of the country's second largest newspaper, El Espectador. The newspaper's been bombed and the drug cartel has threatened to kill one of its employees a day. Last week the Inter American Press Association honored Luis Gabriel Cano Publishier of El Espectador. Charles Krause talked with him in Miami on Sunday.

MR. KRAUSE: Let me begin by asking you why you are your family and your newspaper have lead the fight against the drug traffickers in Colombia?

LUIS GABRIEL CANO, Publisher El Espectador: We have been journalists for all our life. My grandfather who found the paper 103 years ago fight very much against any person that violate the law and he teach ourselves and our fathers to continue with that policy in our paper, so it is because we are journalists and it is our profession and because of the tradition of our paper that we fight anything that is against the law.

MR. KRAUSE: Did you realize when you began this fight how risky and dangerous it might be?

MR. CANO: Yes, but not as it is now.

MR. KRAUSE: Your newspaper began many years ago to point out the dangers, but it took until only a few months ago for the Government of Colombia to really begin to counter attack. Why did it take so long.

MR. CANO: We always try to convince our government to go ahead and attack this problem since the beginning which could have been easier than it is now but we don't get attention to that. I think that we and telling we is not Colombia but the whole world awake very late on this big problem. I don't know why there is not more action here. A week ago I was in New York and one of suppliers invited me to lunch at the Waldorf Astoria. He came to the Grand Central Station and from the Grand Central Station to the Waldorf Astoria he told me four people go by him offering drugs. I wonder what is the fight you are having here in the States if the drugs can be offered freely in the streets and these people are not punished. So we need badly that the consuming countries and more especially with the United States fight very strong with us this problem.

MR. KRAUSE: Since August when the government declared war on the cartel it struck back. There have been 150 bombs or more placed in banks, in your owe newspaper, in political party offices. What is the cartel attempting to do?

LUIS GABRIEL CANO, Publisher, El Espectador: To threaten the people of Colombia in order to get the power of the government. That is why they are attacking all the different activities in Colombia. They attack, of course, the press. They are trying to put a sense of the press with terrorism.

MR. KRAUSE: What effect is this campaign having on your newspaper and other news papers in Colombia is a sense of what you are able and willing to publish about the drug traffickers?

MR. CANO: In the case of El Espectador, they are doing another type of terrorism against our advertising people. Companies that put advertisements in the El Espectador are threatened and they call by telephone and say if you continuing using El Espectador as a media of publicity we will bomb your business or whatever and for us it is difficult because we are losing revenue and you know that the newspaper lives from advertising.

MR. KRAUSE: You've said publicly that El Espectador may go bankrupt?

MR. CANO: Yes. the destruction of the power plant with a bomb cost at least 2 and 1/2 dollars and we of course don't have that fund so we don't have any insurance because the companies do not, the insurance companies in Colombia were not able to insure us. We asked for the terrorist clause but they were not able so. We don't have any insurance. It was total loss and we don't have the funds to reconstruct the paper.

MR. KRAUSE: We've talked about your financial problems as a result of the cartel, but they've also killed your own brother and five others who have worked for El Espectador over the last three years. Two or three of them in the last couple of weeks. What effect is that having on the other people who work for your newspaper and their own willingness to publish information that could result in their being killed.

MR. CANO: We have 1200 employees and no one has resigned.

MR. KRAUSE: If your newspapers are forced out business because your advertisers are threatened, because you can't find 2 and 1/2 million dollars to rebuild your plant. What will that say about Colombia and the situation in Colombia?

MR. CANO: Well I think if the EWl Espectador disappear this Mafia is going to win the battle. The other papers will disappear very soon or have to change the policy and don't announce anything on the drugs. But I think the El Espectador and the government knows that. There was a very strong communique from the government with a very strong support for the El Espectador because they know that if El Espectador disappear this battle is almost finished.

MS. WOODRUFF: That was Charles Krause talking with Luis Gabriel Cano. Still ahead on the Newhour the emergency room crisis and a year in the class room. SERIES - EMERGENCY

MS. WOODRUFF: Next we begin a three part series on hospitals in crisis with a look at the squeeze facing emergency rooms. Recently the American Colleges of Emergency Physicians reported that hospital emergency departments in 41 states are so overcrowded that the welfare of patients is threatened. We have a report from Correspondent Jeffrey Kaye of public station KCET-Los Angeles.

SCOTT CLOUGH, Paramedic: Any day of the week, we run into a problem with hospital closures on a regular basis. Weekends we're hit much harder.

DR. BRIAN JOHNSTON, Emergency Physician: The system is collapsing. Patients are not getting the care that they need. The county hospital is overwhelmed. The private hospitals are overwhelmed.

DAVID LANGNESS, Southern California Hospital Council: Many times now we've come across what we now call medical gridlock in Los Angeles. We've had hospitals so full in their emergency rooms and trauma centers that ambulances have had to go to the third furthest or the fifth furthest or the tenth furthest hospital.

MELISSA HENDRICKS, Emergency Nurse: In the time that I've been here, I would say over the last two or three years it's gotten just almost unmanageable at times. It's very scary.

MR. KAYE: ERSAT, that's short for emergency room saturation. This is one of many busy hospital emergency rooms that on any given day in Los Angeles may be closed temporarily to ambulances.

LISA MORAN, Paramedic: The closest hospital is closed to saturation. We're going to have to bypass it and go to the next hospital, which is about another five minutes away. It's been happening all day long. We're lucky we're going to the second. Normally we're going to the fourth or fifth close hospital.

DR. BRIAN JOHNSTON, Emergency Physician: We are not getting the care they need and to an increasing degree, they are suffering increased morbidity. And in fact, I feel it's very likely that people are dying today in Los Angeles for lack of this care.

JEFFREY KAYE, KCET: Nobody knows the medical impact of the emergency room closures, but one nightmarish case shows a serious case was getting out of hands two years ago. Monday, November 9, 1987, late in the afternoon, dispatchers at LA's 911 control center received this call.

CALLER: Would you get Paramedics to 707 East 87th Place?

DISPATCHER: What's the matter there, sir?

CALLER: The man can't breathe.

MR. KAYE: The man with the breathing difficulty was 60 year old Ultress Hunter, a retired truck driver with emphysema. Paramedic Ron Lingo went with his partner to Hunter's home.

RON LINGO, Paramedic: He was very apologetic for calling us and said he had tried his medication, it wasn't working, and he wanted us to, if we could help him out, and we told him that we could.

MR. KAYE: The paramedics took Hunter from his home, put him in the ambulance and gave him medication. They were dispatched to the closest hospital.

MR. LINGO: Then they came back and told us on the radio that the hospital was closed to everything, saturation. So we asked for the next closest hospital.

MR. KAYE: The four closest hospital emergency rooms were closed. The paramedics took Hunter to one anyway, an overcrowded county hospital, because his condition had deteriorated, but they put him back in the ambulance because the wait was so long. Finally, an hour and ten minutes after the 911 call was made, they brought him to Memorial Hospital of Gardena.

MR. LINGO: When we got to Gardena, the doctor met this very critical patient, was very upset why we had brought him in there in this condition.

DR. GRANT: I was just upset that there was a man here that was potentially salvageable and that's what we're supposed to be here for, and he was not saved.

MR. KAYE: Not saved because Ultress Hunter arrived at the hospital too late for help according to Dr. Grant. Hunter had a heart attack and died.

DR. JAMES GRANT, Memorial Hospital of Gardena: The fact that it took so long for him to get to some place where we could intervene in that situation obviously put a strain on his heart and induced him to have a heart attack.

MR. KAYE: But the lessons of Hunter's death two years ago have had little effect. At LA County's Medical Alert Center, coordinators monitor the constantly changing status of LA's emergency rooms so they can notify paramedics.

MR. KAYE: And what does that mean?

SPOKESMAN: This means that the emergency room at White Memorial now cannot absorb any more patients; their emergency room is full.

MR. KAYE: Hospitals complain they are overwhelmed by the demand. David Langness who represents the 225 member Hospital Council of Southern California collects war stories from the front lines.

MR. LANGNESS: What kind of an increase have you folks seen since the closure of other surrounding ER's and trauma centers?

DR. EUGENE KELLER, Cedars-Sinai Hospital: I think it's getting worse. I don't think any of the politicians or the people who are in charge of funding understand the depth of the problem. I think it's going to take some major big wigs to die because they can't get the kind of service that we can provide under normal circumstances.

JEFFREY KAYE: These days normal services in emergency rooms are being squeezed by the growing numbers of drug abusers as well as victims of violence. While victims of street violence often overwhelm emergency resources temporarily, paramedics are also having to cope with a more critical problem. In the last five years, 11 Los Angeles hospitals out of 104 shut their emergency room doors permanently. The reason for the crisis is a combination of rising hospital costs and the increased numbers of non-paying patients.

DAVID LANGNESS: 25 percent of the population in Los Angeles County is uninsured and is therefore indigent, can't pay for their health care, 37 million people in America are uninsured, and as a result, we have filled hospitals with patients who are unable to pay.

JEFFREY KAYE: Because patients who can't pay tend to put off seeing doctors, they are heavyusers of emergency care. At Daniel Freeman Hospital 1/3 of the patients have no medical insurance and administrators are considering closing down their emergency room permanently.

DR. BAYLISS YARNELL, Daniel Freeman Hospital: The emergency department is the door through which the medically indigent patient and patient who is under insured gets into the private hospital. The hospital loses money with these patients and that cannot continue.

JEFFREY KAYE: Many hospitals, particularly those in low income neighborhoods, are losing money as medical costs skyrocket. But critics complain hospitals may be too quick to abandon the emergency room business. For example, Centinela Hospital Medical Center located in a relatively poor Los Angeles community shut down much of its emergency services in May. At the same time, the hospital was expanding its sophisticated sports medicine clinic for professional athletes and business executives. While they were stepping up operations at the sports clinic, hospital officials claimed they couldn't afford the financial burden of treating uninsured patients in their emergency room. We asked two experts to examine the hospital's records, Shoshanna Sofaer from the University of California, Los Angeles, and Glenn Melnick with the Rand Corporation. They concluded that compared to many other hospitals in poor neighborhoods, Centinela is actually treating an extremely low proportion of poor people.

GLENN MELNICK, Rand Corporation: I think it gets back to the question of do non-profit community hospitals such as Centinela which enjoy the benefits of being a non-profit, that is, they don't pay taxes during those periods where they have higher profits, and they don't pay property taxes, so the local communities are providing benefits to those hospitals. Do they have an obligation to take care of the basic needs of the community they serve?

MR. KAYE: Is Centinela?

MR. MELNICK: And it appears that Centinela falls short in that area.

SHOSHANNA SOFAER, U.C.L.A.: If hospitals are selecting the services they offer on the basis of the profitability of those services rather than on the need to the community, you do have to ask some questions about to what is there a commitment.

MR. KAYE: Those questions remain unanswered. Officials at Centinela Hospital declined our request for an interview. But David Langness at the hospital council offered one explanation.

DAVID LANGNESS: Emergency rooms are expensive to operate. They take enormous amounts of staffing, they take enormous amounts of time, labor, energy, capital, et cetera. I would submit to you that any business that has a quarter of its customers, whether it be a hardware store, a doctor's office, a hospital, will go out of business sooner or later if those people can't pay.

STANDLEY DORN, National Health Law Program: The medical business is different than the hardware business. If you don't get a piece of plywood, you're not going to die. If you don't get emergency room care, you die.

MR. KAYE: While advocates such as Standley Dorn of the National Health Law Program are making demands of hospitals, the health care industry in turn is asking government for help. Hospital officials want more money but California's governor has vetoed many health care spending bills and his health and welfare secretary, Clifford Allenby, isn't holding out much hope for the future.

CLIFFORD ALLENBY, California Health & Welfare Agency: We have to balance our budget and we have to make hard choices. There are never enough dollars to provide for all the things that government probably wants to do, in many cases even government should do.

MR. KAYE: The hospitals most seriously affected by the emergency room crisis are the four run by the county, including LA County, University of Southern California Medical Center. It is jammed with patients transported by ambulances that were turned away from private hospitals and by poor people seeking care.

PATIENT: I'm so tired. If I had a bed, I could sleep right here.

PATIENT: I've been waiting since about 1 o'clock.

MR. KAYE: That's almost four hours.

PATIENT: Umm hmm.

PATIENT: Every time I come it's like eight hours, eight, nine, ten hours.

MR. KAYE: Do you have health insurance?

PATIENT: No, I don't.

MR. KAYE: Do you, sir?

PATIENT: No, I don't.

MR. KAYE: So this is really the only thing you can do when you need a doctor, you have to come to the emergency room?

PATIENT: Yeah, that's all I have. That's the only thing I have.

MR. KAYE: We were forbidden from videotaping in the emergency room of LA County USC Hospital. This tape was shot with a concealed camera. It shows how patients on gurneys are routinely placed in hallways without monitoring equipment. The corridors get so crowded that the fire department has issued citations for blocked exits. Doctors and nurses say the worst sometimes happens.

SANDRA CORREIA, Emergency Nurse: When there's 42 people in the hallway, 50 patients in the hospital, that's really horrible. I mean, I've heard of horror stories where they find patients that have arrested, and the only reason they found out because the nurse went over to change a dry IV bag.

MR. KAYE: When you say have arrested, you mean they've had a heart attack.

MS. CORREIA: Cardiac arrest; they're dead.

MR. KAYE: The county run hospitals are taking the brunt of the emergency health care crisis, but because emergency rooms are closing temporarily and permanently throughout Los Angeles, everyone, regardless of income level, is potentially in danger.

DR. JOHNSTON: The paramedics, when you call, they don't know whether you're rich are poor. The paramedics can only respond and they do, and they do the best they can. But everyone is at risk. In fact, the business community in Los Angeles should be very concerned. Because if I were a businessman, I couldn't in conscience ask people to come here for a convention or ask people to conduct business in this town. We don't have basic services. And it's a threat to public health and safety.

MR. KAYE: Everyone interviewed for this story agreed there needs to be a better system of health care financing and more comprehensive health care insurance. While politicians debate those issues, paramedics in Los Angeles and around the country keep looking for open emergency rooms to take their patients.

MS. WOODRUFF: We'll continue our series on the crisis in hospitals tomorrow night. CONVERSATION

MR. MacNeil: Next tonight a year in the life of an elementary schoolteacher. Author Tracy Kidder has written a best selling book on the subject. Our education correspondent, John Merrow, talked to him about it.

MR. MERROW: Chris Zajac is an elementary schoolteacher in Holy Oak, Massachusetts. A veteran of 17 years in the classroom, she is by all accounts a dedicated and talented teacher. While Mrs. Zajac insists the public schools have many such teachers, one thing sets her apart. Mrs. Zajac and her former fifth grade class at Kelley Elementary School are the subject of a best selling book, Among Schoolchildren. It's author is Pulitzer Prize Winning Writer Tracy Kidder. You began this with respect for teachers, in part I guess because your mother was a teacher. Did you end up the same way?

TRACY KIDDER: Yes. For this teacher, yes, and for some of the other teachers in this building, but I began to feel that the teachers were grappling with problems that an awful lot of the rest of society was willing to pretend weren't there and that, indeed, some of the most important things she did did not have to do with delivering the curriculum, or that some of the other things that she was trying to do were necessary in order to deliver a curriculum. And those were, as I said that attempt to give a kid a sense of success, that relentless, I think, but kind pressure on them to make them learn to be diligent, you know, just to begin to try to prepare them for the world as the world is. Yeah. I came away with quite a lot of respect for her and for the difficulty of what she does and for her determination and her doggedness and her honesty about it.

MR. MERROW: Among Schoolchildren is the story of one year in this fifth grade classroom. Mrs. Zajac had 20 students, most of them poor, inner city families. About half of them were Puerto Rican. In the book the children's names are changed to protect their privacy. And you spent a whole year in this room?

MR. KIDDER: A whole year in this room.

MR. MERROW: Where did you sit?

MR. KIDDER: I sat right over there in front of the globe with my back to the window, taking lots and lots of notes.

MR. MERROW: And the kids?

MR. KIDDER: Right behind you was Jimmy with his head down in his arms, and Robert right behind him, dismantling a pen, getting his pencil, covered with ink, and stabbing himself occasionally over there, Arabella smiling cheerfully over there, the brilliant lovely Judith over here, behaving like a 25 year old, and Clarence right here, Clarence in the desk as close to Mrs. Zajac as she could get it and also right out of the end of a row.

MR. MERROW: Clarence took up more of her energy than any other child. What was Clarence like? Why was he so --

MR. KIDDER: He was extremely charming. He was wonderfully looking. He was a very funny cut-up. But he was more than that. He'd go into this stony act, I can still see him, at the slightest remonstrance from her, the slightest suggestion that he had to do his work. She was there to teach him but da dum da dum, and his face would turn away just like that. There never seemed to be no way of reaching him. He never misbehaved much in her sight, she had such tremendous authority. But as soon as she left the room or he got out into the hall, he'd beat up a classmate often. "Chris gazed at Clarence in a while said, 'Okay, I'll make a deal with you. You go home and do your work and come in tomorrow with all your done, and I'll pretend these two days never happened. We'll have a new Clarence tomorrow, okay?' Clarence still had not looked at her tomorrow or answered. 'A new Clarence,' Chris said, 'promise?' Clarence made the suggestion of a nod, a slight concession to her, she figured, now that it was clear she would let him leave. Her face was very close to his. Her eyes almost touched his tear stained cheeks. She gazed. She knew she wasn't going to see a new Clarence tomorrow. Who'd be naive to think a boy with a file that thick is going to change overnight. But she'd heard the words in her minds anyway. She had to keep alive the little voice that says, well, you never know. What was the alternative, to decide an 11 year old was going to go on failing and there was nothing anyone could do about it, so why try. Besides this was just the start of the campaign. She was trying to tell him, you don't have to have another bad year, your life in school could begin to change. If she could talk into believing that, maybe by June there would be a new Clarence."

MR. MERROW: She promises a new Clarence and yet that's the main failure of her year.

MR. KIDDER: She thinks of it that way.

MR. MERROW: Don't you?

MR. KIDDER: Yes. Oh, yes. Of course, Clarence has vanished a little more than halfway through the school year, it wasn't her decision but it was her decision not to fight against it. Clarence presented the problem that I think most teachers sooner or later face, certainly in inner city schools, of a child who takes up so much time and energy from the teacher that he actually cheats his classmates.

MR. MERROW: Chris Zajac took the decision to remove Clarence from her classroom and send him to a special school as a personal failure.

CHRIS ZAJAC, Teacher: I had two major mistakes I guess. Clarence was one in the sense that I didn't reach him. I don't know if leaving the room was a mistake. I haven't really wrestled with that because I feel like the class itself, the environment of the class and the kids in that class were able to learn better without him in the room. But if public education is what it's truly supposed to be and I'm supposed to meet the needs of all these kids, I wasn't meeting Clarence's needs.

MR. MERROW: Chris Zajac's other mistake by her own admission concerned Robert, an emotionally troubled child who rarely did his homework. One day Robert failed to show up at the school science fair and Mrs. Zajac went looking for him. There's a wonderful scene at the science fair with Robert I guess when Chris Zajac comes back to the room.

MR. KIDDER: Right through that door.

MR. MERROW: And finds the project that -- and you must have been with her.

MR. KIDDER: I was with her. There he was sitting over there with his back to the door and she was quite angry, "You, get up, get over here." I can't remember exactly what she said. And he slowly got up and trudged in his way over toward that door from that desk over there. Then she saw it. I was watching her. I was watching him. It was hard sometimes to watch all of this, but there was what she saw on the desk and I saw her face go completely red and her shoulders droop. And it was, "Sit down, Robert." He had tried to make an electric light. And it was all lashed up with wires on a dirty old piece of board and even the light bulb had a broken filament. So that even if he had managed to make the various connections it wouldn't have worked. "All year long she had tried to get Robert to take a chance and make an effort. Now he had. He had tried. And he had sincerely failed. And she had rewarded him with humiliation. How many times had something like this had happened to him in his life already? Was this the reason Robert behaved as he did? His self-inflicted pain better than sadness and despair? She looked at the lashed up wires and bent nails on the dirty scrap of wood and it was all there in front of her, the dead, undeliverable letters that Robert had written to the father he'd never met. He had no one at home to help him make an electric light. That was why he'd said he didn't want to do a project. He wasn't just being perverse. 'How stupid I am,' she thought. She should have bent the rules and given him more help. She should have arranged a success for him. 'How stupid I am.'" Somebody said to me, I was saying the other day that Chris wasn't a miracle worker to a person who had been a high school teacher, and he looked at me and he said, "And she shouldn't need to be." I love that remark. I think it goes two ways. It suggests first of all we're not going to be able to recruit 2 1/2 million miracle workers to staff our schools, a. But, b, and more important, we shouldn't have children being sent to school in such desperate shape that in order to teach them, you have to be a miracle worker.

MR. MERROW: Chris Zajac is now a language arts resource teacher at another elementary school in Holy Oak. She oversees the teaching of reading and writing to about 15 classes. The children come from the same inner city population as Clarence and Robert, the two boys she could never quite reach, and Judith, her star pupil. How is Judith doing?

MS. ZAJAC: Well, really well. From what I hear she is at the top of her class, one of the two top girls, and seems to be, you know, still having parental support. I think Dad still picks her up at school at the end of the day and from what I hear, she's doing wonderfully.

MR. MERROW: And Robert.

MS. ZAJAC: Robert I don't know about. Robert, I did, the next year, he was still in the same building I was, I didn't have him that next year, and with the teacher that he had, he was still getting into the same scrapes, if not more difficult scrapes than when I had him, because he had a first year teacher and she was learning the ropes. And he thought he already knew them, so she was having real difficulty with him.

MR. MERROW: How about Clarence, how's he doing?

MS. ZAJAC: Clarence the same way. I've heard that in, you know, the grapevine, one minute I'll hear he's doing okay, and the next minute I'll hear he's not doing okay. It's a typical example if you put all this effort and time into children for one year and then you're not sure what happens to them. They get lost in the system or they move on to another teacher and they become his or her concerns, but then again I don't know if I've affected that child.

MR. KIDDER: "Chris used to believe in miracles. Now she tended to believe only in mysteries. 'I guess I used to feel I could really rescue kids, that if they had a good teacher, everything would be fine. It's not that I try less now. I'm just more aware of my own limitations.' Forlornly Chris said, 'But I don't think I've ever taken a really good student and wrecked him.' She should have been more generous with herself. Teachers usually have no way of knowing that they have made a difference in a child's life, even when they have made a dramatic one. But for children who are used to thinking of themselves as stupid or not worth talking to or deserving rape and beatings, a good teacher can provide an astonishing revelation. A good teacher can give a child at least a chance to feel, 'She thinks I'm worth something. Maybe I am.' Good teachers put snags in the river of children passing by. And over the years they redirect hundreds of lives. Many people find it easy to imagine unseen webs of malevolent conspiracy in the world. And they are not always wrong. But there is also an innocence that conspires to hold humanity together and it is made of people who can never fully know the good that they have done. RECAP

MS. WOODRUFF: Once again, the main stories of this Tuesday, Pres. Bush vowed to veto Medicaid abortions for rape or incest victims. And stocks fell nearly 19 points on news of a widening trade deficit. Good night, Robin.

MR. MacNeil: Good night, Judy. That's the Newshour tonight and we'll be back tomorrow night. I'm Robert MacNeil. Good night.