The MacNeil/Lehrer NewsHour

MS. HUNTER-GAULT: Good evening. I'm Charlayne Hunter-Gault in New York.

MR. MacNeil: And I'm Robert MacNeil in Washington. After tonight's News Summary we examine how what men did during the Vietnam War affects today's politics. We wrap up our stump speeches by Presidential candidates with Republican Patrick Buchanan, and we continue our series on how doctors would fix the health care system.NEWS SUMMARY

MR. MacNeil: The fur was flying in Washington today over competing tax bills designed to spur the economy. White House Spokesman Marlin Fitzwater called Democrats on the House Ways and Means Committee "weasels" for going behind closed doors to negotiate their plan. Yesterday in an open session, they rejected the President's version saying it was too generous to the rich and failed to provide promised relief for middle income families. Fitzwater said, "These guys are like weasels going into a hole. You've got to wait to see where they come out." But he made clear he thought they would come out with a tax increase. Committee Democrats said their plan would mean a tax reduction for most Americans. One added, "Even Fitzwater might vote for the package when he finally sees it." Also in Washington, the Securities & Exchange Commission proposed new rules on disclosure of corporate executive pay. The rules would require companies to clearly explain the compensation of top executives. They would also give shareholders more say in executive pay packages. Late this afternoon, SEC Chairman Richard Breeden spoke about the proposed changes.

RICHARD BREEDEN, Chairman, Securities & Exchange Commission: In one case I'm familiar with, a major U.S. automaker, the description of the incentive composition is 16 pages in length and it requires a Ph.D. in finance to begin to understand what was paid. We're going to try and take that information and capsulize it so that all shareholders can be able to see in one convenient location clearly presented the facts, what was the award made to a particular executive.

MR. MacNeil: The SEC proposals will be subject to public comment. Ford Motor Company reported today that 1991 was its worst year ever. It lost $476 million during the 4th quarter and $2.3 billion for the year. Chrysler last week reported an $800 million loss. GM reports its results later this month. There was some positive news on the economy today. It came from the Commerce Department which reported retail sales in January posted their biggest gain in eight months. It said they were up .6 percent. It also revised the December sales figure from a loss to a gain of .1 percent. Charlayne.

MS. HUNTER-GAULT: An independent counsel today began investigating who told the news media about Anita Hill's sexual harassment charges against Supreme Court Justice Clarence Thomas. Independent Counsel Peter Fleming was appointed by the Senate to investigate that leak. He subpoenaed New York Newsday reporter Timothy Phelps, who along with Nina Totenberg of National Public Radio, first reported the allegations. In five hours of closed-door questioning, Phelps refused to reveal his source. After the session, he read to reporters part of what he told the Independent Counsel.

TIMOTHY PHELPS, Reporter, New York Newsday: I respectfully decline to answer the special independent counsel's questions here today because they are posed for the explicit purpose of seeking the identity of my sources. I do so not only as an assertion of my rights under the First Amendment, but also of those of my readers and of the American people. They had a need and a right to know that serious allegations had been made against the nominee of the Supreme Court. It was my judge to tell them. No matter what is done as a result of today's events, you will not succeed in forcing to reveal my sources, because if it did, I might never again be able to tell my readers what their government does not want them to know.

MS. HUNTER-GAULT: Phelps said the investigation was improper and intimidating to all reporters. He could face contempt of Congress charges for his refusal to cooperate. The outgoing administrator of NASA today says there could be rough scenes and turbulent times at the agency after he leaves his post on April 1st. Richard Truly made the remarks in a closed circuit broadcast to NASA workers. He was apparently forced to resign yesterday after policy disputes with Vice President Dan Quayle and others at the White House. Presidential Spokesman Marlin Fitzwater said Truly had done an outstanding job. He also said, "Whether there are policy differences or not he deserves our gratitude and support."

MR. MacNeil: The Southern California Coast was pelted with more rain early today and residents prepared for a new Pacific storm heading for the area. Homeowners piled sand bags around their property in an attempt to stave off flood waters. Five days of heavy rains have killed at least seven people. Four others are missing. More than a hundred fifty houses have been flooded and many motor homes and cars washed away. Gov. Pete Wilson declared an emergency in Los Angeles and Ventura Counties. A house fire in Camden, New Jersey left eight people dead and two others seriously injured. The victims ranged in age from two to seventy-two. Last night's blaze was confined to a corner row house. Officials said the cause was uncertain, but the local fire chief said the main heating system in the house was not working. He said three kerosene heaters and an electric space heater were found in the rubble.

MS. HUNTER-GAULT: In Moscow, Russian President Boris Yeltsin told his republic's parliament that urgent action was needed to protect Russia's poor from free market reform. Reforming the former Soviet military was also on his agenda as he prepared for a summit in Minsk with other leaders from the commonwealth of independent states. We have a report narrated by Louis Bates of Worldwide Television News.

MS. BATES: Yeltsin called on all Russians to grit their teeth and give his reforms time to work. Continued shortages, high prices, and falling production have brought criticism from all sides. Yeltsin said urgent measures are now needed to support his free market reforms. He said more protection would be given to the poor and needy who've been hard hit by recent price rises. The Russian President later flew to Minsk for the commonwealth leaders meeting on the future of the former Soviet armed forces. Russia remains committed to a unified armed force for the commonwealth but hasn't ruled out forming its own army. Yeltsin has tried to use the Russian military plan to unite the Republics. But the commonwealth leaders are deeply divided on the issue and will have to work hard to reach consensus. The commonwealth's military commander, Marshall Yevgeny Shiposhnikov, is optimistic general agreement can be reached. Shiposhnikov hopes the commonwealth can create a new army but he believes the more delicate subject, the future of the Black Sea Fleet, can only be resolved by a political decision.

MS. HUNTER-GAULT: U.S. Sec. of State Baker continued his tour of former Soviet republics in the Muslim state of Tajikistan. He met with the republic's President, who denied that his country was selling uranium to other Muslim countries. Baker said the President had agreed to international inspections of his nuclear facilities. Several Western news reports had said the cash-starved republic had sold uranium for an atomic bomb to Libya.

MR. MacNeil: The United Nations Secretary General will recommend the dispatch of a massive U.N. peacekeeping force to the war torn Yugoslav republic of Croatia. A U.N. spokesman said the Security Council is expected to approve the deployment early next week. The nearly 13,000 man force would be the second largest U.N. peacekeeping effort ever. Heavy fighting was reported in the East African nation of Somalia today, despite peace talks at the United Nations. Since November, fighting between rival groups has killed or wounded more than 20,000 people in the capital. Most of those have been civilians.

MS. HUNTER-GAULT: That's it for the News Summary. Just ahead, the political legacy of Vietnam, a Buchanan stump speech and a doctor on healing the nation's health care system. FOCUS - POLITICS OF WAR

MR. MacNeil: We go first tonight to the political legacy of the Vietnam War. That legacy haunts the generation of political candidates now in their mid 40s, men who were of draft age in the Vietnam era. In particular, it surfaced in the New Hampshire Presidential primary. Yesterday Democratic Presidential Candidate Bill Clinton released a letter which he'd written in 1969 to the director of the Reserve Officers Training Corps at the University of Arkansas. The letter explains why he decided to give up the deferment he'd received and make himself available to the draft. We'll hear the views of four men, two who served and two who didn't, but first some excerpts from the Clinton letter to Col. Eugene Holmes of the Arkansas ROTC program. "First, I want to thank you, not just for saving me from the draft, but for being so kind and decent to me last summer, when I was as low as I have ever been. I came to believe that the draft system itself was illegitimate. No government really rooted in a limited, parliamentary democracy should have the power to make its citizens fight and kill and die in a war they may oppose, a war, which even possibly may be wrong, a war which in any case, does not involve immediately the peace and freedom of the nation. Because of my opposition to the draft and the war, I am in great sympathy with those who are not willing to fight, kill and maybe die for their country [i.e. the particular policy of a particular government]. The decision not to be a resister and the related subsequent decisions were the most difficult of my life. I decided to accept the draft in spite of my beliefs for one reason: to maintain my political viability within the system. For years, I have worked to prepare myself for a political life characterized by both practical political ability and concern for rapid social progress. It is a life I still feel compelled to lead. When the draft came, despite political convictions, I was having a hard time facing the prospect of fighting a war I had been fighting against and that is why I contacted you. ROTC was the one way left in which I could possibly, but not positively, avoid both Vietnam and resistance. After I signed the ROTC letter of intent I began to wonder whether the compromise I had made with myself was not more objectionable than the draft would have been, because I had no interest in the ROTC program in itself and all I seemed to have done was [to] protect myself from physical harm. I am writing ... in the hope that my telling this one story will help you to understand more clearly how so many fine people have come to find themselves still loving their country but loathing the military, to which you and other good men have devoted years, lifetimes, of the best service you could give. To many of us, it is no longer clear what is service and what is disservice, or if it is clear, the conclusion is likely to be illegal." Now four perspectives on the Vietnam factor in today's politics. James Webb is an author and former Secretary of the Navy during the Reagan administration. He was a highly decorated Marine Corps officer in Vietnam. James Fallows is the Washington Editor of the "Atlantic Magazine." He received a student as well as a medical draft deferment. Michael Mandelbaum is a professor of American foreign policy at the Johns Hopkins School of Advanced International Studies. He also had a medical draft deferment. Republican Senator John McCain of Arizona was a Naval aviator. His plane was shot down in 1967 and he spent five and a half years as a prisoner of war. He joins us from studios at public station KAET in Tempe, Arizona. James Webb, what does Bill Clinton's letter about his Vietnam ambivalence say about his fitness to be President and commander in chief?

MR. WEBB: I thought it was an interesting letter in two respects. The first is it was very British in the first part of it, I mean, in terms of the parliamentary democracy and the citizen's obligation. And Britain is one of the few countries that has rarely relied on a draft, is very heavily a volunteer system and was even through most of World War I. But that disturbs me also, because I fear as a nation that we are moving more toward the British idea of accepting class, rigid class structures in our governmental system, in our social life, and it's sort of ironic to me that Gov. Clinton spent a good bit of the Vietnam War in Britain, as did Jim Fallows by the way, and this idea that we can have an elite that doesn't have the same sorts of obligations, that has a different educational system, that has a different way to insulate itself from criminal problems and this sort of thing disturbs me. The second part of the letter which was specifically relating to the impact of the war on the individuals I have some empathy with. I don't agree with it. The premise, I think, from so many of the people of the elite in our generation who did not go into the military was that this was an odious, genocidal, immoral long war, and I don't agree with that.

MR. MacNeil: Does the letter say and the anguish behind it say anything about his fitness to be the commander in chief or the President?

MR. MANDELBAUM: I wouldn't be the one to pass judgment on it. I would rather let the voters pass judgment on it. I think it's appropriate for the letter be out and let people struggle with that themselves.

MR. MacNeil: Michael Mandelbaum, you wrote in the New York Times rather defensively about Bill Clinton. What do you think this says about his fitness to be President?

MR. MANDELBAUM: Well, let me say first, Robin, that I don't feel defensive about Bill Clinton. He's an old, although not a close friend.

MR. MacNeil: Supportively I should have said.

MR. MANDELBAUM: He is the most talented and gifted public servant I know and I think that he'd be a wonderful President. But let me say two things about that letter, because I think it does tell us two things that are important in judging him as a Presidential candidate. First, that letter demonstrates conclusively that Bill Clinton has told the truth about his Vietnam experience, contrary to some press accounts. He has said, and that letter bears out, as did some research I did, that what he did was to give up a deferment in an ROTC program that would have kept him out of Vietnam, put himself back into the draft pool, make himself vulnerable to the draft, with the expectation that he would be drafted for reasons of conscience. The second thing I think that this letter demonstrates is that the moral anguish of a young man, and there were many of us in that position, who was in an impossible position, torn between his hatred of the war and his love for his country, between his dedication to his principles and his dedication to his community. There was no single right choice. There was no way to be easy about what one did. The word "compromise" was in the excerpt that you read and that is the operative word. One could only compromise one's principles. I would also point out that what Bill Clinton ultimately decided to do speaks directly to the very important point that Sec. Webb made. He decided that he could not in good conscience accept an ROTC commission and avoid the draft as many of his high school classmates had not been able to do, because it wasn't fair for him to have an opportunity and a privilege and an exit from the war that they did not have. So his decision was based precisely on the very important point that Sec. Webb raised and that Mr. Fallows has written eloquently about.

MR. MacNeil: Okay. Sen. McCain, what's your view of the relevance of Mr. Clinton's, Gov. Clinton's behavior during the Vietnam era to his fitness to be President?

SEN. McCAIN: I have to say to you that I don't think it's very relevant. I think it's a situation of anguish, of difficulty and discord within our nation, which was very upsetting to all young Americans, no matter which decision they made. I think Gov. Clinton should be judged on his record as Governor, as Attorney General, on his proposals for America in the future, and I think that a letter such as he wrote displayed to a large degree what many young Americans were going through at that time. It's hard for us to recapture the incredible emotional instability that existed in this nation at that time.

MR. MacNeil: What do you feel about it, James Fallows?

MR. FALLOWS: I'd like to go back to a point Jim Webb was making, also that Michael Mandelbaum touched on. This precise point of class differences in America is one that I think many of us here on this panel share, although we might disagree about other things, and it was because Bill Clinton was taking that seriously, he was saying, it is not fair for me to isolate myself in the long run in a British type system, and that, I think, is to his credit. The other thing that struck me --

MR. MacNeil: Could I just get James Webb to come in on that point, since that was your point. Is that to his credit that he --

MR. WEBB: I don't pretend to be an expert on Bill Clinton's motives. You know, I've read a lot of different things about the timing of the letter and when he decided to recuse himself from this sort of consideration. So it wouldn't be fair for me to say whether that was an honest comment or not. I'm glad that all of this is out on the table and other people can judge.

MR. FALLOWS: Well, even on his own terms, he was dealing directly with this issue at a time when many people wanted to avert their eyes from the class effects of the war. So that is to his credit. The other thing this, the impact this letter had on me, hearing it last night at 11:30, was to bring back what that world was like. If you were for the war, as I was not, I assume it was a more straightforward decision, if you were for it, then you thought other people should fight and you should too. If you were against the war, as Gov. Clinton was and I was, it was a more complicated thing because you balanced, you didn't think anybody should go, but how you sort of squared your own sense of honor about what you did, and I think the letter showed him wrestling seriously with that issue.

MR. WEBB: I would like to come in on that.

MR. MacNeil: Yeah, do.

MR. WEBB: Because I think, you know, first of all in the letter itself he mentioned his political aspirations, and if it is true that he knew at that time that there wasn't going to be another draft called, and it doesn't show that, and again I leave that to other people, but the real problem here is with people struggling that we've never given the people who went forward and into the military the credit for their struggles too. I mean, I have a very close friend who is in a wheelchair right now because he enlisted out of conscience, because he struggled with these same issues, and the fact is that --

MR. MacNeil: There are many who are dead.

MR. WEBB: Yes. We all have, we all struggled with different elements of that and there are consequences that people need to be addressing.

MR. MacNeil: Beyond the consequences in the individual conscience, should they have immediate consequences in Presidential choices this year or the next time around or as long as the Vietnam generation are candidates for office? Let me introduce the name of Dan Quayle into this as well, because the voters appeared to have decided in 1988 at any rate that Dan Quayle's behavior in the war did not disqualify him for the highest office. So let's include him in the equation as we go around.

MR. FALLOWS: I would agree with the general sentiment that you don't want to drag, this was such a difficult time in American history for people on every side that it doesn't want to be an anchor on our life for the rest of our lives. I would, however --

MR. MacNeil: Doesn't want to be?

MR. FALLOWS: Well, it should not be. We would not want it to be. I would, nonetheless, suggest this distinction between Gov. Clinton's situation and that of Vice President Quayle. Quayle's position was that the war was a good idea and somebody should do it, but not him. Clinton's position was that nobody should do it. There seems to me a difference between those points of view.

MR. MacNeil: Do you see that, Senator? I saw you smiling when I mentioned Quayle.

SEN. McCAIN: Well, first of all, I don't agree that Vice President Quayle emerged unscathed. In fact, I think his very low popularity ratings can be attributed to a large degree over the enormous publicity surrounding his service in the Guard. And I certainly take strong exception to the last comment that because he joined the Guard, he, therefore, knew that he would not have to go. Just some year ago lots of Guard people went and fought and many of them died. So I reject that categorically. Also, could I say that, you know, it's interesting that with all of the media attention on this, we lose the attention on the issues that are very important to the future of the American people, and I wonder sometimes, and I'm not trying to bash the media -- I know that's non-productive -- but if they aren't inflating this issue to a degree which obscures the rest, and I want to point out finally that we've been through a difficult healing process in this country, culminating with Operation Desert Storm, and I'm not sure that it helps to go back into this debate again, no matter who the candidate is, particularly one who has a long record of public service as Governor Clinton does.

MR. MacNeil: How do you feel about that, Michael Mandelbaum? Is this an unprofitable diversion from the real stuff of the campaign, or what?

MR. MANDELBAUM: Robin, let me make a couple of points. First, in response to some very important points that Sec. Webb made, he raised the question which has been raised in the media of whether Gov. Clinton put himself back in the draft when he knew he would not be called. All the evidence we have, and the recollections of people who are with him every day is that that is not true. He did expect to be called. He was not finessing the draft. He fully expected to be drafted. The second point that Sec. Webb made I think is a very important one about people who did serve. Vietnam veterans have been very badly treated in this country over the last 20 years and I think there's a curious symmetry between the shabby treatment of Bill Clinton, and I think it has been shabby, and the shabby treatment of people who served. We just don't want to come to terms with that war. It was an unhappy, unpleasant experience, and anybody who had anything to do with it is tarred with that brush.

MR. MacNeil: Shabby treatment of Clinton by whom?

MR. MANDELBAUM: Well, that goes to the point that Sen. McCain made. There's been enormous focus on this issue at the expense of the important issues, and not only that, but there has been criticism, there has been attack, there has been even slander on Gov. Clinton for things that he didn't do, and on this issue he demonstrably didn't do it. He did not dodge the draft. He acted as honorably and decently and straightforwardedly as he knew how. And that action resulted in him making himself subject to the draft despite the fact that he opposed the war.

MR. MacNeil: Do you want to come back on that?

MR. WEBB: Again, I'm not too good on the exact chain of events on this, and as a result,that's why I'm not really commenting. I think it should be in front of the voters. But, you know, there is something here -- this argument that we're having about who went and who didn't and how they did it. It is an important argument for voters to look at. There is a question of moral authority.

MR. MacNeil: Why is it? Why?

MR. WEBB: First because it's a question of moral authority and that is again, it's for the voters to look at. Does Gov. Clinton based on having come of age and taken a specific set of actions during a war have the moral authority to order other people to die? I don't think it's essential for someone to have been a veteran to be President. We've had some very fine Presidents who are not. We've got a Secretary of Defense right now who was not --

MR. MacNeil: Why would it be a question whether he had the moral authority or not?

MR. WEBB: I think because of the questions that have been raised in terms of going into the ROTC unit and the timing of the draft and these sorts of things. And, again, I don't pretend to be an expert.

MR. MacNeil: More or less than, more or less than Vice President Quayle?

MR. WEBB: I agree with Sen. McCain on the point that I don't think that Vice President Quayle's situation was affirmed by a vote for George Bush four years ago. You know, I think, again, I would leave Vice President Quayle's situation to the voters too.

MR. MacNeil: Okay. Does it bring into question Gov. Clinton's moral authority to order troops into action if he became President?

MR. FALLOWS: If he deals with it honestly, I think not. I think this letter help is a step toward the kind of honesty that could in principle be cleansing for the nation and perhaps for the governor too. I say perhaps because he may end up being a victim of this, may be a casualty. What I have in mind here is there are certain kinds of truths that are acceptable and not acceptable in political discourse. It's now acceptable for people to say, well, I was interested in other women or men and I still want to be a candidate. The question with Gov. Clinton is whether it's acceptable to recall how divisive the mood was 25 years ago. I have great respect for what Sen. McCain was saying about reconciliation and healing. I disagree with him factually and what he said about the National Guard. Anybody who was in college in the late sixties knows exactly why one joined the National Guard then. There was no mystery about that at all. It's different now, but then --

MR. MacNeil: But he's right. Lots of National Guard units did go to Vietnam and many people from them were lost.

MR. FALLOWS: Yes, that is true.

MR. WEBB: Few did. And I was the Assistant Secretary of Defense, Reserve Affairs, and I ran the numbers on it. People knew when they were going into the Guard --

MR. MacNeil: I happen to know of a couple of units where significant numbers --

MR. WEBB: In '68, a small number were called up by President Johnson. That's the only time. There's a larger question here though, and that is that when as a class the elite of our age group did not go, many things happened. And Jim wrote about the danger of class warfare and it is there in this country in a lot of ways. But also think of the battlefield, itself. I mean, this is an accountability that people didn't have to think about. For every William Clinton who does not go into the military, the army has to find a William Calley. And when Harvard excludes itself, they lost 12 people in the military in the entire Vietnam War out of 13,000 people who graduated from '62 to '72, then it affects not only what they do for the rest of their lives but it affects battlefield performance.

MR. MacNeil: Let me ask the Senator again. Sen. McCain, what do you think about the question of Clinton or anybody else's moral authority to order troops into action with a background like this?

SEN. McCAIN: I think it's clear he would have entire moral authority, whatever is necessary, because, as I say, I think the issue was almost irrelevant. He has a long record of public service. We can judge him on that. And I think that to allege behavior of some person at 18, 19, or 20 years old would, therefore, affect their ability to conduct their duties as President is really not particularly accurate. And I would also like to make one other point.

MR. MacNeil: Sure.

SEN. McCAIN: And that is in case the professor missed it, there was a great healing process that took place, and I think it might have been the most beneficial outcome of the Persian Gulf War. And this reconciliation and this healing towards the Vietnam veteran was a tremendous manifestation, and what we're doing now may be reopening some of those wounds that were so painfully healed.

MR. MacNeil: Well, let me move it on to another person in this current Presidential race, and that is Bob Kerrey. You mentioned irrelevant. Many people expected Kerrey's heroism in Vietnam to make him an extremely viable candidate and so far, at least according to the polls in New Hampshire, he doesn't seem to have caught fire the way some others have. Mark Shields, who comments on politics on this program, suggests that his very heroism, his medal of honor, make many potential voters uncomfortable.

MR. FALLOWS: I would personally disagree. I am a Democrat, although I'm not involved in politics, and I think many Democrats were excited about the prospect of a Kerrey candidacy because it was a chance to unify around a hero, somebody who had proven this kind of heroism. The execution of this campaign has not been that great so far, but the idea of him as a candidate I think was energizing to many Democrats.

MR. MacNeil: What do you think about that, I mean, the way Kerrey's extraordinary performance in Vietnam has been almost irrelevant?

MR. WEBB: Well, again, I would say two things just very quickly. One is that I think the most important thing about who served and who didn't, and I've been saying this for years, is to grant validity to the people who went, and not to try to tear apart the people who didn't. And the second thing is that, you know, Jim Fallows wrote years ago that perhaps some day this would be viewed in the same sense as Trotsky versus Stalin, you know, something that gets us going but that other people view as, you know, sort of passe, and perhaps you see that in this sort of issue up there.

MR. MacNeil: What do you think of the Kerrey factor, Senator?

SEN. McCAIN: I think that my experience has been that the people that you are seeking to represent will show a great deal of gratitude for your past service, but I think that they are far more interested in what you are going to do for them in the future. And as not a close observer of the New Hampshire campaign, I think perhaps Sen. Kerrey's problem is he hasn't been able to focus enough on the issues that resonate with the people of New Hampshire who are in very bad conditions at this particular time. But I don't think anyone would do anything but praise his war record, which is clearly exemplary, but I don't think it would make anyone uncomfortable.

MR. MacNeil: Michael Mandelbaum, to pick upon the Senator's earlier point, do you think the Gulf War and the rapturous reception of those troops and the better reception which rubbed off on the Vietnam veterans have helped to dilute this as an issue and that we're really talking about something that is not a deep emotional core in the voters anymore?

MR. MANDELBAUM: It's certainly helped, and I would like to feel that that is right. I would like to feel that Sen. McCain is correct, that the Gulf War has helped us heal that gloom. But I recall Sen. Kerrey saying at one point that he thought his Vietnam service and his heroism was not an asset in New Hampshire, that it made people uncomfortable. I don't know whether we put this behind us, and I think the way we, as a nation, and we, as an electorate, treat Bill Clinton, whether we're able to get beyond all this and deal with the issues will be a test of that.

MR. MacNeil: Do you think the Gulf War and so on has diluted this issue?

MR. WEBB: Absolutely not. I disagree with Sen. McCain. I don't think the Gulf War provided the Vietnam veteran with any sort of accolades and, in fact, it was the other way around. All the press build-up to the Gulf War was comparing this volunteer military with the rags and tags that existed at the end of the Vietnam War. It was a negative for the people who served in Vietnam.

MR. MacNeil: Senator.

SEN. McCAIN: I might say that -- can I interrupt --

MR. MacNeil: Yes.

SEN. McCAIN: -- that Jim Webb was not present at numerous parades that I either attended or observed, at celebrations on the mall where the mention of the service of our Vietnam veterans evoked the most emotion and the most applause, and the most warmth and love on the part of the American people than I've ever seen displayed. Clearly, Jim, you were not there.

MR. WEBB: I wasn't where you are, but I am around a lot of Vietnam veterans and I feel pretty comfortable with what I -- and I read a lot of stuff, a lot of the analyses --

SEN. McCAIN: I'm sorry you weren't there.

MR. MacNeil: Jim Fallows.

MR. FALLOWS: I think the crucial word here is service. For many years after Vietnam, there were these polarized, stereotyped views of Vietnam veterans among non-veterans. Either they were dangerous, they were to be pitied, whatever. The last five or six years, and especially after the Gulf War, I agree with the Senator here, there has been this emphasis that Vietnam veterans served, they served the nation, they served duty, and that seems to be a much more widespread feeling than ten or fifteen years ago.

MR. MacNeil: With whom? You seem to feel it more strongly than the others. With what kind of voter could you mention a profile of America for whom you think this is still a big issue and who would look at somebody who didn't serve and didn't have a very good reason for not serving with some negative eye, what kind of America --

MR. WEBB: Just to get back to John McCain real quickly, I would be interested to look at some polls on whether this has changed the way people look at Vietnam veterans.

SEN. McCAIN: I'd be more than happy to show them to you.

MR. WEBB: Well, I'd like to see them because I would disagree with you on that. I think the best way to put this behind us is for all of us who spent so much energy on the Vietnam War to try to get the right political conditions inside Vietnam. We've got 67 million people over there who have been put under a Stalinist system, a million of the best young leaders in Vietnam have been marched off, some of them are still in reeducation camps, and we can't get anybody to focus on it because people are still embarrassed about the war, and in terms of who this particular issue will resonate with, I think, you know, we're sitting up here in the newsroom and on the Senate floor and whatever, go into the factory floor and talk to the people who are the supervisors there and see how they react.

MR. MacNeil: Michael Mandelbaum.

MR. MANDELBAUM: Robin, James Fallows made a very important point. He used the word "service." I think those of us who felt conflicted and anguished in the Vietnam era and did not serve have thought ever since about what our obligation to our country is and what kind of service we can render and how we can justify our actions. James Fallows has written a very important article on the subject. I, myself, became a professional student of foreign policy, and I've thought about that war constantly, and I have the impression that one effect that it had on Bill Clinton was to push him more deeply into public service as a way of demonstrating to himself and to his community that although he did not feel able conscientiously to volunteer for service in Vietnam, although he did make himself available for the draft, there were ways, constructive ways, that he could serve the country just as Sen. McCain and Sec. Webb have served it in that way as well.

MR. MacNeil: Sorry to cut you off, but we have used up our time this evening. Gentlemen, thank you all. Charlayne.

MS. HUNTER-GAULT: Still ahead, Buchanan on the stump and a doctor's prescription for the nation's ailing health care system. FOCUS - '92 ELECTION - MAKING HIS CASE

MS. HUNTER-GAULT: Next, we continue our series of extended excerpts from the Presidential candidates' stump speeches. Tonight we hear from Republican Patrick Buchanan, the conservative columnist and former Presidential speechwriter. Earlier this week, he spoke to the New Hampshire state legislature in Concord, the same body President Bush addressed yesterday.

PATRICK BUCHANAN, Republican Presidential Candidate: You know it was nine weeks ago that I came up here to New Hampshire and I have traveled your wonderful state all the way from Derrey to Dixville Notch and from Nashua to the north country. I have seen and I have come to understand what has happened here. You have lost in three years 50,000 jobs; 5,000 more disappeared in December. And I've talked to women who have lost their homes, to men who have lost everything and are leaving the state. I've seen the defeated faces in the unemployment offices in Manchester, in Laconia, and in Concord. I've been up to the north country and seen parts of this great state almost begin to empty out like towns and cities in the dust bowl of 60 years ago. And excuse me, but until I came to New Hampshire, those people in Washington behaved as if they did not care. What caused this depression in the state of New Hampshire? It is my contention that it is not the work of bad men at all, it is the work of wrong-headed ideas and bad policies. As you know, my opponent, the President of the United States, came up here in 1988, limping out of Iowa after being defeated by Bob Dole, and campaigned up here as a conservative. He won your votes and he won your hearts and he took out of here a victory that propelled him to the nomination and propelled him to the highest office in our land. But what did he do? He became in Washington, D.C., the biggest taxer in American history when he added 165 billion in new taxes. He has become the greatest spender in American history. His new budget spends well over 25 percent of America's Gross National Product when Ronald Reagan's last year we spent only 22. He is now running this year the biggest deficit in American history at $400 billion even. He delivered a State of the Union which I believe sounded good, but when you got into the details, it was anemic, and it was pathetic. The conservative who heads our own Department of Housing & Urban Development, Jack Kemp, said the State of the Union was "full of gimmicks." As for Mr. Kemp right now, we're sending a human rights team over to HUD to make sure that his political dissent is not punished. So let us not focus or dwell on the past. Let's look at the future. Where does Mr. Bush propose to take America? And I think the place to look is into the new federal budget. As I said, was impressed with the rhetoric of the State of the Union, but look at the new federal budget, hidden within it $52 billion in new domestic spending, $25 billion in new taxes, and when Mr. Bush finishes having to compromise with the Congress, both of those figures will be higher. We are going, my friends, down the same road we have been down the last three years. So the question it gets down to is, is that the right road for America? Now, Mr. Lincoln said they have a right to criticize who have a hear to help. So instead of criticizing Mr. Bush any further, let's talk about our own country. Even though we completed this great victory in the cold war 78 percent of our people think the United States of America is on the wrong track, Democrats, Republicans and independents. I think we've got two immediate great national objectives. The first is to get the American economy up and moving again and creating jobs for all our people and the second is to make America first again not only militarily but in manufacturing and industry and business and in rising standard of living. [applause] Thomas Jefferson, that great American, once said, "I hold it that a little rebellion now and again is a good thing, as necessary in the political world as storms in the physical." Now that's what the Buchanan campaign is all about, a little rebellion in the political world. And where would that rebellion lead America? I think the only way out of our economic condition brought on by that big government philosophy I described is we Americans have got to find the road back to economic freedom in the United States. Let me talk briefly now about the trade issue. I don't want and no American wants a trade war. But we Americans have got to stop being trade wimps. Look at what we have lost -- radios, TVs, those industries, VCRs, textiles, shoes. We're losing automobiles and steel. I think we have to get tough with our trading partners because they are as apprehensive of any such conflict as we are. Today, fellow Americans, folks of New Hampshire, I think the American people are ready to take their country back, to take it back from the big spenders and the high taxers in Washington of both parties, to take it back from the arrogant bureaucrats and the special interests who control so much of American policy and to take America back from those registered and unregistered agents of influence down in Washington who are looking out for everybody and everything, except the national interest of our country. America, my friends, needs a second American revolution today, a middle American revolution whose people rise up and take this country back and take her home again to the people who truly care about here. Thank you very much for hearing me out. [applause]

MR. MacNeil: That was Republican Patrick Buchanan addressing the New Hampshire state legislature. FOCUS - PRESCRIPTION FOR CHANGE

MS. HUNTER-GAULT: Finally, we continue our series of conversations on America's ailing health care system. Health reform has become a central issue of the 1992 campaign and in recent weeks, politicians, including President Bush, have issued calls for change. This week we are getting prescriptions from doctors. Tonight we speak with Dr. Michael Isikoff, a practicing radiologist from Titusville, Florida. Dr. Isikoff, thank you for joining us.

DR. ISIKOFF: It's a pleasure to be here.

MS. HUNTER-GAULT: What, in your view, is wrong with the American health care system? Why is it so sick?

DR. ISIKOFF: Well, I think there are a number of things that are a problem with our health care system. I think first and foremost the access issue is one of the major problems. We have a health care system where 37 million Americans cannot get health care, they do not have health insurance. And that's intolerable. There are a number of other things that we are not making rational decisions on how we use our money, we are basically not making any decisions about that. What we're doing is we're putting money into the system and not making a decision whether we should put the money in the beginning of the system.

MS. HUNTER-GAULT: You mean in prevention?

DR. ISIKOFF: Yeah, prevention, prenatal care, et cetera. We're using a lot of money at the end of someone's life, and that's not necessarily where we need to put it. We have to start making intelligent decisions about where we're going to put our limited resources.

MS. HUNTER-GAULT: What is to blame for this state of affairs, in your view?

DR. ISIKOFF: I don't know who's to blame for that. I really, I don't think we can put blame. I think what we need to do is, is not even address that issue and deal with the situation that we have, and try to correct the problem.

MS. HUNTER-GAULT: You've been dealing with a problem in your state of Florida that you feel is a major contributor to this illness that the system is suffering now. Tell me a little bit about that and where you see that in this whole equation.

DR. ISIKOFF: I have been involved in trying to get something done about a situation called physician self-referral or joint ventures, as it's sometimes called. Basically what that is is that a physician will buy a facility that he can then send the patient to. And it's usually a radiology facility, physical therapy facility or laboratory, durable medical goods company, and basically what's happening is the physician controls the patient. The family practitioner or internist basically has the patient and he will see the patient in his office and then send them for an X-ray or laboratory study to the facility that he also owns a share in, and in so doing, significantly increase his income. And I think that's morally and ethically wrong. I don't think a physician should make money merely by his ability to send a patient to a facility that he owns a share in. And not only do I feel that way, but the American Medical Association has recently come out and stated essentially the same thing, that it's against a physician's fiduciary responsibility to a patient to own a share in a facility that he can send that patient to.

MS. HUNTER-GAULT: Aside from the ethical question, and we can deal with that more in a minute, how does that contribute to bloating the, the system?

DR. ISIKOFF: Basically what we found in Florida, there was a study that was done about a year ago by the Health Care Cost Containment Board, and what was found there and has been seen in other studies as well is that when a doctor owns a share in a facility that he can send a patient to, the utilization goes up tremendously. Now, it depends on what type of facility as to how high the utilization goes, but for example, in my area, which is diagnostic imaging, for example MRI, which is Magnetic Resonance Imaging, which is a very sophisticated technique that is very popular now, we, the Health Care Cost Containment Board found that for example in Baltimore, which is a very sophisticated medical community, they're doing 12 MRI scans per thousand population. In Broward County, they're doing 38 per thousand. The only difference between those two areas, with the exception of a little bit of difference in the demographics of the area, was that all the MRI machines in Broward County were joint-ventured and virtually none of them in Baltimore were joint-ventured. So there was a 340 percent increase in utilization that really can only be attributed to joint ventures. And this has been confirmed in other studies.

MS. HUNTER-GAULT: And you're saying that because doctors own these facilities, they're ordering more tests and expensive kinds of tests than is necessary?

DR. ISIKOFF: Without question.

MS. HUNTER-GAULT: What kind of money are we talking about here?

DR. ISIKOFF: Well, again, that depends on the type of facility you're talking about, but certainly if you're talking about MRI, which is a very expensive technology, can run anywhere from a thousand to fifteen hundred dollars in my area, there are physicians in the State of Florida who just on limited partnership shares of facilities are making over $200,000 a year. That's merely for sending a patient to a facility that they own an interest in. That's not for interpreting or doing anything else in that facility.

MS. HUNTER-GAULT: Are we talking about something that's limited to the state of Florida, or is this a widespread practice?

DR. ISIKOFF: This is a widespread practice. It's more prevalent, significantly more prevalent in Florida. It was estimated by the study that I just spoke of, the Health Care Cost Containment Board study, that in 1989, 40 percent of the physicians in the state of Florida had ownership interest in facilities that they could send patients to. The national average, according to the AMA, is 10 percent. So it is across the country but much more of a problem in my state.

MS. HUNTER-GAULT: The Florida Medical Association and other doctors argue that this, in fact, is not a negative thing, that the fact that physicians own facilities that they can oversee ensures the quality of the service because they're looking at it, it provides more access --

DR. ISIKOFF: Absolutely.

MS. HUNTER-GAULT: -- people say in rural areas than in others.

DR. ISIKOFF: Right.

MS. HUNTER-GAULT: Are they just wrong? And that they --

DR. ISIKOFF: They're wrong. First of all, I'm a radiologist. It would be impossible for an internist or a surgeon who owns a share in a facility which is a radiology office to do any significant quality control. I can't walk into an operating room and tell a surgeon how to operate on a patient. The quality control in a radiology facility is going to be done by the radiologist. That is a smoke screen. That is not the issue. The other point that you brought up about increasing access in rural areas, that would be wonderful in theory, but, in fact, when the Florida researchers looked at it, they didn't find a single facility in a rural area in Florida. So although that is great in theory, that this is bringing technology into the rural areas, it doesn't occur in fact, in my state at least, and the other thing is that the bill that is presently in front of the legislature in Florida that Rep. Charlie Roberts drafted --

MS. HUNTER-GAULT: That would make this whole thing illegal.

DR. ISIKOFF: Right.

MS. HUNTER-GAULT: Excuse me, that would make it illegal for doctors to --

DR. ISIKOFF: Exactly.

MS. HUNTER-GAULT: -- be part of joint ventures --

DR. ISIKOFF: Exactly right.

MS. HUNTER-GAULT: -- or facilities that conduct --

DR. ISIKOFF: Basically what was written into that was an exemption for the rural facility. We didn't find any in Florida, but there is an exemption that if there is a rural facility that is a sole provider in a particular area, then that facility is exempted. We're not trying to take access away from rural areas. Certainly this technology needs to be widespread. The one other issue I would like to address is access for poor. In fact, the Health Care Cost Containment Board study in Florida found virtually no Medicaid being done by these joint ventures, that Medicaid patients were being sent to the hospital where they were not joint-ventured. They were not doing any Medicaid to speak of, less than 1 percent. So there certainly isn't increased access for Medicaid patients.

MS. HUNTER-GAULT: All right. Well, how would you fix this problem? What would you do to correct the situation?

DR. ISIKOFF: There's two ways to approach it. One is what the AMA has said and I'd like to say that the AMA has significantly changed their feeling on this issue.

MS. HUNTER-GAULT: The AMA has said that this should be, the AMA has called for voluntary withdrawals.

DR. ISIKOFF: Right.

MS. HUNTER-GAULT: Doctors to get out of these things on their own --

DR. ISIKOFF: Exactly.

MS. HUNTER-GAULT: -- might be forced --

DR. ISIKOFF: Exactly. They've said it's immoral, it's unethical, we shouldn't be doing it, but we want them to get out voluntarily. And the facts are that doctors who are making $200,000 per year on an investment are not getting out voluntarily. I would, I would like to see the AMA become stronger in that because the position is just, it's correct, but they're not going to get out voluntarily and the only way we're going to be able to do this to correct this problem is legislatively. And that's what the bill in the State of Florida attempts to do. We're not trying to tell the doctors that they can't own facilities. A doctor can own any facility he wants to own. The point is he cannot refer a patient to that facility. If he wants to own a radiology office, that's fine. He just cannot refer patients to it.

MS. HUNTER-GAULT: Why not just tighten up regulation, which is what some people have argued, saying that the prescription that you're proposing punishes the vast majority of doctors who really are ethical --

DR. ISIKOFF: Right.

MS. HUNTER-GAULT: -- and it just lumps them up in with those who are abusing the system and that tighter regulation would take care of the problem?

DR. ISIKOFF: First of all, tighter regulation very rarely works. You're talking about creating a tremendous bureaucracy and you cannot tell, I cannot tell as a radiologist whether a study's indicated or not. What we're talking about here is over-utilization, and that's almost impossible for a regulator sitting in Tallahassee to determine whether a MRI scan on a patient's knee was needed or not needed. It wouldn't work. It just plain wouldn't work and it circumvents the moral and ethical issue that is I think very important here, a doctor should not have a conflict of interest when he's dealing with a patient. It is his fiduciary responsibility to do what's in the patient's best interest, not in what is the best interest of him economically.

MS. HUNTER-GAULT: Do you think if the law that you're trying to get passed -- I assume you want this to be, to apply nationally in all states.

DR. ISIKOFF: Yes.

MS. HUNTER-GAULT: What would you say the savings would be to the entire system? Because you told our reporter, Stuart Share, about what you thought were billions of dollars being --

DR. ISIKOFF: Right. Let me tell you want we know in Florida. A study was done recently that looked at the effect of joint ventures on the over-utilization of services and how much that was costing the state of Florida in three areas: radiology, and specifically CT and MRI, laboratory, clinical laboratory, and physical therapy, and the number they came up with using conservative data was $500 million in those three areas a year in Florida.

MS. HUNTER-GAULT: In one state?

DR. ISIKOFF: In one state. I saw a recent study that came out of California and they were estimating several billion dollars in California of unnecessary testing that could, that was directly related to physician self-referral. So if I say many billions of dollars I think I'm being very, that's the ballpark, tens of billions maybe.

MS. HUNTER-GAULT: Dr. Isikoff, thank you very much for joining us.

DR. ISIKOFF: Thank you. It was a pleasure to be here. RECAP

MR. MacNeil: Again, the major stories of this Thursday, the Bush administration and House Democrats battled over rival election year tax bills aimed at jumpstarting the economy, retail sales posted their biggest gain in eight months in January, Ford Motor Company said it lost $2.3 billion in 1991, making it the automaker's worst year ever, Southern California braced for more rain after flooding killed at least seven people. Good night, Charlayne.

MS. HUNTER-GAULT: Good night, Robin. That's the NewsHour tonight. Tomorrow, Judy Woodruff reports from New Hampshire, Mark Shields and David Gergen analyze the campaign, and former Surgeon General C. Everett Koop gives us his prescription for fixing our health care system. I'm Charlayne Hunter-Gault. Good night.